Estradiol in women: norms by age, reasons for increased and decreased levels. How to increase or decrease estradiol in girls

Estradiol is a female estrogen hormone and the most potent hormone. Affects fertility and reproduction. Produced by ovarian follicles and partly by the adrenal cortex.

Estradiol stimulates the development of sexual characteristics , prepares the mammary glands for milk production and causes an enlargement of the uterus . Affects bone density and the balance of biochemical elements.

The most “female” hormone

According to its chemical composition, estradiol is classified as a steroid. Its chemical formula is C18H24O2. Like other estrogens, E2 hormone is synthesized from cholesterol or acetate. Interestingly, testosterone, the male sex hormone, is one of the intermediate products of this chemical reaction.

Where is E2 produced?

The main producer of estradiol is the follicular apparatus of the ovaries in women. Also, a small amount of the hormone is synthesized in:

testicles in men;
adrenal cortex in both sexes;
placenta (during pregnancy);
peripheral tissues.

Note! During the day, the body of a healthy woman produces 300-700 mcg of estradiol.

By binding to transport proteins in the blood, the sex hormone is delivered to target organs. These include:

female reproductive apparatus (uterus with appendages, vagina, vulva);
mammary gland;
hypothalamus;
pituitary;
liver;
adipose tissue;
leather, etc.

Penetrating through cytoplasmic membranes, E2 binds to specific receptors and affects the cell nucleus. This leads to the synthesis of certain strands of RNA and proteins.

Treatment

If the hormone level is elevated, the doctor prescribes treatment based on the patient’s age. Therapy also depends on how much the indicator deviates from the norm. If the increase is small, then the woman needs to change her lifestyle to a more active one. It is also important to solve problems with the gastrointestinal tract. Sometimes following a certain diet is enough.

Some herbs help reduce estradiol in the body. Excess amounts of the hormone in the intestines can be removed by consuming fiber of plant origin (for example, wheat bran, cocoa, flax seeds).

Self-medication is unacceptable ! All nuances of therapy should be discussed with your doctor.

What is estradiol responsible for?

Estradiol has a complex effect on the body. Hormone:

Responsible for the formation of primary sexual characteristics in a girl during intrauterine development.
Affects the growth of individual bones and the skeleton as a whole.
Inhibits the destruction of bone tissue.
Stimulates the development of the stroma and ducts of the mammary glands.
Forms the silhouette characteristic of a woman, gives roundness to the chest and hips.
Sets the voice to a high pitch.
Promotes regular shedding of the endometrium and the appearance of menstruation.
Provides preparation of the body for childbirth, reduces the risk of spontaneous abortion.
Suppresses lactation.
Controls libido.
Has antiatherogenic properties. Prevents the deposition of cholesterol plaques on artery walls. Reduces the risk of developing cardiovascular diseases.
It has a procoagulant effect - increases blood clotting.
Stimulates the functioning of the thyroid gland.
Increases the concentration of iron and copper in the blood.

Note! In men, estrogens have an indirect effect on spermatogenesis.

Deviation of E2 from the norm - both more and less - always has clinical manifestations. Moreover, the problems concern not only the reproductive sphere, but also the health of women in general.

Functions

During the menstrual cycle, estradiol is responsible for the following aspects:

Forms the follicle and prepares it for ovulation. Therefore, if the cycle is disrupted or there are problems with fertilization, it is measured on different days of the month.
Stimulates follicle rupture - ovulation.
Prepares the uterine epithelium for the attachment of the embryo and its retention in it during pregnancy.
Participates in adjusting the exchange of other hormones (progesterone, prostaglandins, pituitary hormones).

During pregnancy:

Allows the fetus to attach normally to the wall of the uterus and stay there.
Stimulates blood circulation and nutrition through the placenta to the fetus.
Before childbirth, it prepares the pelvic bones for the passage of the baby.
Increases the body's sensitivity to hormones necessary for childbirth (for example, oxytocin).
Prepares the breasts for lactation, together with progesterone, maintains milk production until childbirth.

In prepubertal children, the normal hormone level is less than 30 pgmol. Changes begin during puberty and mostly affect girls. Visible changes under the influence of estradiol occur between the ages of 8 and 14 years.

Estradiol decreases slightly with physical activity, so excessive exercise in girls can reduce the hormone in the blood and delay sexual development.

During puberty, the hormone provides:

Development of genital organs and mammary glands. A common reason for visiting an endocrinologist in childhood is early thelarche. This is the formation (swelling) of the breast before 8 years of age.
Skeletal development and female-type hair growth. And also influencing the distribution of adipose tissue, it ensures proportionality of the waist and hips for normal childbearing in the future.
It accelerates the formation of the body and skeleton, which is why girls, in an earlier period, rapidly “stretch out” compared to boys.

Additionally, estradiol performs such functions as:

A number of other hormones are stimulated by estradiol - oxytocin, somatotropin, aldosterone, corticotropin.
Improves metabolism in bone tissue and reduces their weakening. Which explains why a disease such as osteoporosis develops in old age after estradiol begins to be produced in smaller quantities.
Stimulates fat deposition. A diet high in carbohydrates and low in fat reduces estradiol in a feedback loop, which can lead to cessation of menstruation.
Reduces appetite and cholesterol levels.
Retains water and calcium in the body. Its increase leads to edema.
Prevents the development of coronary heart disease in women by improving metabolism on the walls of blood vessels.
It has a depressing effect on erythropoiesis (a type of hematopoiesis), reducing its intensity. Therefore, after puberty, women have lower values of red blood cells and hemoglobin than men.
Has an immunostimulating effect.
Plays a role in the oncological protective function against colon cancer.
Hormone estradiol is involved in the protection of nervous tissue in Alzheimer's disease, brain injury and ischemic damage during stroke.
Participates in memory formation.
It is considered a hormone of sexuality and good mood in women.

Estrogen has a harmonizing, kind-hearted effect on mood rather than a militantly optimistic effect, like testosterone. Therefore, its effect varies depending on the amount in the blood.

The best state lasts from the end of menstruation until ovulation - mood swings are rare, sexual appetite is normal. During the ovulatory period, there may be some anxiety and at low numbers, before and during menstruation, irritability and excitability increase.

During the onset of menopause, against the background of a decrease in estradiol, dissatisfaction, mood swings and deterioration of well-being may increase - hot flashes, pressure fluctuations, weakness. When the body gets used to the new values of the hormone in the blood, the state of health and condition normalizes and becomes more uniform.

Estradiol level analysis

The concentration of E2 in the blood is determined by electrochemiluminescent immunoassay (ECLM, ECLIA). This is an automated study: it is performed on a hemoanalyzer and is highly accurate.

The biomaterial for ECLM is venous blood. The result in most laboratories is known the next day.

Indications for testing

An estradiol test is prescribed for:

determining ovarian function in women;
diagnosis of premature puberty in girls;
identifying the causes of amenorrhea;
assessment of the state of the reproductive system before the in vitro fertilization (IVF) procedure;
diagnosing gynecomastia in men.

Indications for the study in women:

Primary or secondary infertility.
Lack of menstruation or irregularity.
Painful menstruation.
Meno-/metrorrhagia (uterine bleeding).
Severe manifestations of premenstrual syndrome.
Diagnosed polycystic disease, ovarian neoplasms.
Planning pregnancy, including with the help of IVF.
Male pattern hair growth in women.
Signs of early/late puberty in girls.
Symptoms of menopause in women of childbearing age (night sweats, hot flashes, menstrual irregularities).
Osteoporosis.

In men, estrogen are determined by:

hypogonadism;
testicular tumors;
hyperplasia of the adrenal cortex;
increasing the size of the mammary glands.

When is the best time to take it?

The level of estradiol is a variable value. The concentration of the hormone constantly fluctuates and depends on the woman’s age, the day of the menstrual cycle and even the time of day. Therefore, for passing the analysis, there are the following recommendations:

Non-pregnant women of childbearing age are examined 5-7 days after the start of their next menstruation, unless the attending physician gives other instructions. To compare the indicators, a gynecologist-endocrinologist may advise you to take this test again on days 21-23 of the menstrual cycle.
During premenopause, the analysis is performed twice: on days 1 and 6 of the cycle.
Expectant mothers must indicate their gestational age during the examination.
Girls before menarche and postmenopausal women are tested any day.
For patients with amenorrhea, the doctor determines the day of the test individually, based on the results of an ultrasound of the pelvic organs.

Important! For some diseases, repeated studies of estradiol levels are required so that the doctor can assess the dynamics of the hormone.

Preparing for the examination

To determine the E2 level, standard preparation is required:

It is better to conduct the study in the morning, from 8.00 to 12.00.
Blood is donated strictly on an empty stomach. It is acceptable to drink a small amount of still water.
The day before the analysis, it is recommended to avoid stress, heavy physical activity, alcohol and fatty foods. You should also not take medications (except those that the patient takes constantly).
It is advisable to take biomaterial before any other diagnostic measures (X-ray, bimanual gynecological examination, etc.).
Before drawing blood, it is important to relax and breathe calmly.

How to normalize hormone concentrations

Correction of estradiol is carried out after a thorough diagnosis, therefore treatment should be carried out under the supervision of a gynecologist-endocrinologist. During menopause, it is better to take a course of contraceptives (the regimen is prescribed by a gynecologist). These medications include: Ovestin, Ethinyl-estradiol, Estradiol valerate and others. Preparations with estrogen are made in the form of suppositories, ointments and even patches.

If the patient has had her ovaries removed or has premenstrual syndrome, it is better to take oral medications. If the fetus is post-term, medications are prescribed to increase the hormone to stimulate labor and increase the concentration of estradiol. In case of delayed sexual development, a blood test for estradiol is prescribed, as well as a hormone in a dose of 1-2 mg for 3 weeks. The same purpose is attributed to people suffering from estrogen deficiency. Diagnosis of the hormone must be carried out on the 5th day of the cycle. If you do not pay attention to the level of the hormone in the body in time, various pathologies may arise. It is especially important to monitor estradiol in pregnant women.

Age norms

The concentration of sex hormones changes throughout life. Interestingly, until the age of 12-14 years, the level of E2 in girls and boys is approximately the same. It is only during puberty that the ovaries begin to secrete large amounts of estrogens. The reverse process occurs in the body of women 45-50 years old, when reproductive function gradually fades away. That is why it is important to correctly interpret the obtained estradiol values: the norm for women by age is presented in the table below.

Age, years	E2: age norm
Age, years	pg/ml	pmol/l
0-6	0-22	0-155
7-14	22-57	42-355
15-55	57-227	68-1269
>55	19-85	0-73

In addition, in women of reproductive age, E2 levels vary depending on the phase of the cycle.

MC Day	Phase	Estradiol: norm in women 15-45 years old
MC Day	Phase	pg/ml	pmol/l
1-14	Follicular	57-227	68-1269
15-16	Ovulation	127-427	131-1665
16-30	Luteal	77=227	91-861

In healthy men, the concentration of estradiol is more stable and remains almost unchanged throughout life. Reference values are presented in the table.

Age, years	E2: normal for men
Age, years	pg/ml	pmol/l
0-1	0-54	0-86
1-10	0-20	0-69
11-18	0-86	0-182
>18	7,63-42,6	40-161

What influences the result

There are several factors influencing the reliability of the results obtained. Thus, falsely elevated estradiol levels occur when:

taking combined oral contraceptives (birth control pills);
long-term treatment with glucocorticosteroids, penicillins, phenothiazines, cascara sagrada herb;
use of anabolic steroids.

Intense physical activity, a vegetarian diet, and insufficient dietary fat intake, on the contrary, can lead to a decrease in estrogen levels in the body.

What does reduced level mean?

A reading below normal limits may indicate the following health problems:

Hypopituitarism is a decrease in the concentration of pituitary hormones with further atrophy of the functions of the thyroid and gonads, adrenal glands.
Shereshevsky-Turner syndrome is a chromosome disease in which anomalies of physical development, growth inhibition, and sexual infantilism are observed.
Hypogonadism is ovarian dysfunction due to damage in infancy, due to congenital underdevelopment.
Early menopause is a sharp decrease in estrogen levels due to pathologies of the female genital organs or disruption of the endocrine system.

The reasons that provoke a decrease in the production of female hormones are different. For example, extreme endurance exercises. Strong physical activity disrupts the functioning of the organs of the reproductive system. Stress and emotional suffering disrupt the functioning of all systems.

Other predisposing factors include:

bad habits (smoking, alcohol abuse);
delayed sexual development;
threat of miscarriage;
taking certain medications;
inflammatory diseases of the reproductive system;
losing weight with strict dietary restrictions.

A reduced concentration of the female hormone is detected by the following signs:

absence of menstruation for more than six months;
difficulty conceiving;
dry skin, loss of elasticity;
dullness and fragility of hair;
reduction of breast and uterine parameters.

If characteristic signs are detected, it is recommended to consult a doctor. A referral for analysis can be issued by a physician. If there are certain health problems, a consultation with an endocrinologist or gynecologist is carried out. There is no point in delaying going to the clinic; any pathology is easier to treat if diagnosed early.

Hormonal levels during pregnancy

Along with progesterone, E2 plays a big role during pregnancy. The hormone not only creates optimal conditions for gestation, but also regulates blood clotting processes. This significantly reduces the risk of bleeding during childbirth. Therefore, the level of estradiol in pregnant women increases sharply, and its concentration, depending on the trimester, is normally 210-27000 pg/ml.

Gestation period (weeks)	Estradiol, pg/ml
1-2	210-400
3-4	380-680
5-6	1060-1480
7-8	1380-1750
9-10	1650-2290
11-12	2280-3120
13-14	2760-4300
15-16	5020-6580
17-18	4560-7740
19-20	7440-9620
21-22	8260-11460
23-24	10570-14650
25-26	10890-14090
27-28	11120-16220
29-30	12170-15960
31-32	13930-18550
33-34	13930-18550
35-36	15320-21160
37-38	15080-22850
39-40	13540-26960

After childbirth, the concentration of E2 quickly decreases and reaches the age norm within 4-5 days.

Estradiol is increased

An increase in the concentration of E2 in the blood is called hyperestrogenism. To find out the causes of this laboratory symptom, you need to conduct a comprehensive diagnosis of the body. An estradiol test is not used as an independent test to make a diagnosis.

Causes

E2 concentration increases under the following conditions:

premature puberty;
follicle persistence;
endometrioid ovarian cysts;
hormone-secreting tumors of the ovaries and adrenal cortex;
estrogen-secreting testicular tumors in men;
hyperthyroidism – increased activity of the thyroid gland;
metabolic syndrome;
cirrhosis of the liver;
chronic liver failure;
gynecomastia is hyperplasia (enlargement) of the mammary glands in men.

Symptoms

Elevated estradiol in women has the following clinical manifestations:

Menstrual irregularities.
Algodysmenorrhea (painful menstruation).
Pronounced PMS.
Induration and tenderness of the mammary glands.
Sudden weight gain.
Swelling.
Increased blood clotting.
Convulsive muscle twitching.
Disorders of the gastrointestinal tract.
Emotional lability, tearfulness.

In adult men, an excess of female hormones manifests itself:

decreased libido;
problems with potency;
infertility;
gynecomastia;
obesity with distribution of subcutaneous fat according to the female type;
increasing the timbre of the voice;
emotional disorders, depression.

How to normalize

Therapy for hyperestrogenism is selected by the doctor individually, depending on the cause that caused it. Among the basic principles:

Conservative treatment (normalization of work and rest schedule, reduction of physical activity, nutritional correction with restriction of phytoestrogens in the diet, giving up bad habits).
Control over medications taken, avoidance of COCs and other medications that increase estradiol levels.
Etiotropic treatment aimed at the cause of hyperestrogenism (therapy of thyrotoxicosis, metabolic syndrome, obesity, etc.).
Drug treatment: taking aromatase inhibitors (Arimidex, Exemestane), antiestrogens (Tamoxifen, Clomid).
Radical therapy is surgical removal of hormone-producing tumors.

Reasons for rejection

The reasons that estradiol is elevated in a woman often lie in the development of diseases of varying severity. Often these diseases affect the genitals, but other organs may also be involved in the pathological process.

The reasons for high estradiol in women may be associated with the development of:

adenomyosis (a form of endometriosis in which only the cavity of the reproductive organ is affected);
chiorionepitheliomas;
pituitary diseases;
thyroid diseases;
obesity.

Among other causes of elevated estradiol in women, the following should also be noted:

the formation of tumors in the genital area, pituitary gland or adrenal glands, leading to increased secretion of estrogen;
development of liver cirrhosis as a secondary disease in hepatitis;
situations when the egg does not leave the follicle.

An increase in estradiol in women can also occur during prolonged or uncontrolled use of estrogen-containing hormonal drugs, as well as when using other hormone therapy. Such treatment should only be carried out under the supervision of the attending physician. If this condition is not met, the consequences of self-medication can be very serious!

Increase in luteal phase

Elevated estradiol in the luteal phase is a dangerous phenomenon, since it can signal the development of diseases of the reproductive system. Tumor processes in the uterus, follicular ovarian cyst, endometriosis - all these pathologies can lead to hyperestrogenism in women.

Important! Along with the symptoms of this deviation (see below), a clinical picture arises that is characteristic of the disease that the woman has. For this reason, if you experience nagging pain in the lower abdomen, intermenstrual bleeding from the vagina, discomfort during sexual intercourse, you must immediately contact a gynecologist and undergo all the examinations prescribed by him.

Increased estradiol in women over 40

What does it mean if estradiol is elevated in women after 40 years of age? On the eve of menopause, the level of this substance, as a rule, decreases, which leads to gradual biological aging of the female body. But sometimes, on the contrary, it increases. What does it say?

Often this phenomenon indicates that a woman’s reproductive function has not died out, and she may well still become a mother. And although cases of late pregnancy (especially during perimenopause) do not occur so often, if the patient experiences a delay in menstruation due to high estradiol, this may well be evidence of pregnancy.

Estradiol is reduced

Low estradiol in women is also a fairly common symptom in medical practice. It is called hypoestrogenism.

Causes

A decrease in E2 concentration in women of reproductive age is caused by:

Shershevsky-Turner syndrome is a chromosomal abnormality manifested by disturbances in physical development and sexual infantilism.
Hypopituitarism is a decrease in the production of tropic hormones of the pituitary gland, characterized by hypofunction, and subsequently atrophy of the adrenal cortex, thyroid and gonads.
Pituitary dwarfism (dwarfism) is a delay in growth, physical and sexual development caused by insufficient production of the growth hormone of the pituitary gland.
Hyperprolactinemia is a condition accompanied by increased production of the pituitary hormone prolactin.
Virile syndrome is masculinization, excessive synthesis of male sex hormones.
Hypogonadism is a congenital underdevelopment of the ovaries with a persistent decrease in their functions.
PCOS, or polycystic ovarian syndrome, is a polyendocrine syndrome accompanied by the absence of ovulation and increased secretion of androgens in women.
Anorexia nervosa is a mental disorder characterized by significant weight loss caused by the patient in order to lose weight.
Chronic adnexitis and salpingoophoritis.
Threat of miscarriage (usually endocrine origin).

Symptoms

Since receptors for E2 are present in many cells of the body, the clinical manifestations of hypoestrogenism are varied:

instability of blood pressure;
dizziness, headaches;
feeling of heartbeat;
intolerance to high temperatures;
numbness or convulsive twitching of the limbs;
dryness, sagging skin;
hair loss;
brittle nails;
sweating;
hot flashes;
increased fatigue;
emotional instability;
decreased sex drive;
osteoporosis – decreased bone density, tendency to fractures;
high risk of developing cardiovascular pathology (atherosclerosis, angina, chronic arterial hypertension);
atrophic urethritis and cystitis, manifested by painful urination in small portions;
vaginal dryness, colpitis;
increased risk of developing obesity and type 2 diabetes.

How to normalize

To increase the level of estradiol in the blood, the following measures are recommended for patients:

Lifestyle correction: proper sleep, regular exercise, daily walks and the fight against adynamia.
A complete diet that contains foods high in phytoestrogens - legumes, soy, vegetable oils (sesame, flaxseed), meat and dairy products, fatty fish, carrots, tomatoes, apricots.
Active sex life. It has been proven that regular sex with one partner and intense orgasms help normalize hormonal levels.
Etiotropic therapy is a specific treatment of the disease that causes hypoestrogenism.
Taking dietary supplements that help increase estradiol (Premarin, Hemafemin).
Taking folk remedies based on phytoestrogen-containing plants - red brush, soy, sesame, flax seeds, hops, clover, hibiscus, etc.
Hormone replacement therapy with synthetic estrogens (Hormoplex, Proginova, Estrogel, Ovepol).
Long-term use of COCs (Novinet, Jess, Tri-Regol, Diane-35).
Vitamin therapy – taking vitamins C, E and group B.

Steps to a Healthy Menopause

Women aged 45-55 years face a programmed decrease in ovarian estradiol production. Due to the cessation of secretion of sex hormones, the harmonious functioning of organs that have receptors for E2 (central nervous system, genitourinary system, bones, skin, mammary glands) is disrupted and the unpleasant symptoms of hypoestrogenism described above appear.

To reduce the manifestations of menopause and painlessly move to a new stage of life, obstetrician-gynecologists recommend:

give up bad habits, especially smoking;
eat healthy food, limiting as much as possible fatty, fried, overly salty foods and fast food;
exclude coffee and caffeine-containing drinks from the diet;
spend at least 30 minutes daily doing physical exercise and walking;
to strengthen the pelvic floor muscles, perform Kegel exercises (alternately tensing and relaxing the levator ani muscle) three times a day for 15-20 repetitions;
after consulting a doctor, take vitamin D3 and calcium supplements to prevent osteoporosis;
according to indications - use hormone replacement therapy in the form of local agents (vaginal suppositories, creams, capsules) or orally.
in case of severe emotional and mental disorders, take natural or synthetic drugs that calm the nervous system.

Most problems associated with the onset of menopause can be easily eliminated if you pay attention to them in time. In this case, the main role is played not so much by hormonal drugs, but by lifestyle and diet correction.

How to increase estradiol in women?

You should consult a doctor and undergo laboratory diagnostics if a woman observes:

irregular menstrual cycle;
excessive hair loss and brittle nails;
acne;
excessive oily or dry skin;
excess body hair growth;
sudden mood swings;
neuroses, depressive disorders;
vaginal dryness;
pain during sexual intercourse;
change in body weight without objective reasons;
long-term infertility;
increased fatigue, decreased libido or drowsiness.

Correcting the state of lack of female sex hormones is a complex and lengthy process. Particular attention should be paid to the correct daily routine and your diet. Perhaps there is a stable imbalance of essential macro- and microelements in the diet, and the number of hours of rest/sleep is insufficient. I should add fish, nuts, berries and beans.

Emotional stress should be reduced whenever possible. Taking anti-anxiety medications is not a solution to the problem because it does not address the root cause of stress.

Important: selection of drug treatment is possible only if data from comprehensive laboratory tests on hormone levels are available. The dosage of the drugs, as well as the duration of the course of treatment, is selected by the attending physician. The decision to stop taking medications is made when the indicator changes positively and returns to the normal range.

Consequences of hormonal imbalance

Like any other endocrine disorders, fluctuations in E2 negatively affect the functioning of all organs and systems. The sooner a hormonal imbalance is diagnosed, the less severe the consequences for the body will be.

If the pathology is not treated for a long time, it can lead to dangerous consequences for health. Thus, with chronic hyperestrogenism, endometrial hyperplasia and uterine fibroids often develop. This significantly increases the risk of uterine bleeding and severe posthemorrhagic anemia. In addition, excess estradiol is one of the factors that provokes the development of breast cancer.

Low E2 levels in women of reproductive age also have quite serious consequences. In addition to the inability to bear and give birth to a healthy child, patients with hypoestrogenism face:

increased risk of developing acute cardiovascular diseases, including heart attack and stroke;
complex fractures due to osteoporosis;
diabetes mellitus, metabolic syndrome and other endocrine diseases.

The functioning of the body is largely controlled by hormonal levels. To get rid of the unpleasant symptoms of hypo- or hyperestrogenism, it is important to undergo a timely examination, consult with a competent specialist and begin treatment. Remember that E2 imbalance can almost always be normalized. The main thing is to start therapy on time.

When to get tested

Estradiol levels in women should always be within normal limits. Any deviations up or down indicate the development of pathological processes and diseases. The analysis is carried out when:

hormonal imbalance;
disrupted menstrual cycle;
inability to conceive a child for a long period of time;
dysfunction of the gonads;
uterine bleeding not associated with menstruation;
polycystic disease;
pronounced signs of premenstrual syndrome;
ovarian cancer;
adrenal oncology.

The hormone estradiol must be checked when preparing a woman for in vitro fertilization. It is the substance responsible for the onset of conception.

Symptoms

Estradiol is a hormone that, if deviated from the norm, negatively affects the functioning of the entire body, the general condition and appearance of a woman. Signs of low hormone concentration:

inability to conceive or carry a child, all pregnancies end in spontaneous miscarriage;
chronic fatigue syndrome;
premature baldness;
swelling;
instability of psycho-emotional state;
pain and discomfort in the mammary glands;
rapid loss of body weight for no apparent reason;
poor hair condition: dullness and fragility;
change in the condition of the skin: dryness and flaking.

An increase in the level of estradiol in the blood has the following manifestations:

profuse acne, numerous acne throughout the body;
weight gain due to proper nutrition and regular exercise;
constant feeling of drowsiness, fatigue that occurs even after minor physical activity;
severe pain and heavy discharge during menstruation;
chest pain;
numbness and coldness of the fingers of the upper and lower extremities;
digestive system disorders;
insomnia;
frequent painful sensations in the abdomen;
convulsions.

The presence of at least several of the listed symptoms requires testing for estradiol levels.