Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (910 page)

   Estrogens are involved in development and maintenance of the female phenotype, germ cell maturation, and pregnancy. They also are important for many other, non–gender-specific processes, including growth, nervous system maturation, bone metabolism/remodeling, and endothelial responsiveness. The two major biologically active estrogens in nonpregnant humans are estrone (E
₁
) and estradiol (E
₂
). A third bioactive estrogen, estriol (E
₃
), is the main pregnancy estrogen but plays no significant role in nonpregnant women or men.

   
Normal range:
see Table 16.31.

TABLE 16–31. Normal Ranges of Estrogens

Use

   Overall status of estrogens in females or males

   Must be interpreted according to phase of the menstrual cycle

   Interpretation

Increased In

   Estrogen-producing tumors (e.g., granulosa cell tumor, theca-cell tumor, luteoma), secondary to stimulation by hCG-producing tumors (e.g., teratoma, teratocarcinoma)

   Pregnancy

   Gynecomastia

Decreased In

   Ovarian failure

   Primary hypofunction of the ovary:

   Autoimmune oophoritis is the most common cause; usually associated with other autoimmune endocrinopathies (e.g., Hashimoto thyroiditis, Addison disease, type 1 DM); may cause premature menopause