2-hydroxyestrone and 16-hydroxyestrone are Phase I metabolites of Estrone (E1). Their ratio is of clinical significance in pre and peri-menopausal women. In post-menopausal women it does not have the same clinical significance. It is, however, hypothesized that the 2/16 ratio is important in menopausal women who are on hormone replacement therapy (HRT).
While traditional 2/16 ratio clinical utility may not be as robust as previously thought, a majority of findings indicate that metabolism of parent estrogens through 2-hydroxylation (independent of any relationship to 16α- OHE1) may be considered as a benign or even protective pathway. (Of note: one study found increased breast cancer risk with higher 2-OH levels, but only in a small subgroup of ER-/PR- cases.)
The clinical utility of the ratio of 2-hydroxyestrone (2-OHE1) to 16α-hydroxyestrone (16α-OHE1) – the 2/16 ratio or Estrogen Metabolite Ratio (EMR) – historically reported lower 2/16 ratio levels among breast cancer cases compared to controls (particularly in premenopausal women). Recent studies have been mixed: there appears to be no strong evidence in the literature that a higher urinary 2/16 ratio protects postmenopausal women from breast cancer, and only weak evidence of a protective effect in premenopausal women.
Men: Higher 2-OH (E1+E2)/16α –OH ratios in males have been associated with reduced risk of prostate cancer.
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16a-OH Estrone, 2-MeO E1/2-OH E1, 2-MeO Estradiol, 2-MeO Estrone, 2-OH (E1 + E2)/16-a- OH E1, 2-OH Estradiol, 2-OH Estrone, 20a- Dihydroprogesterone, 3a- Dihydroprogesterone, 4-MeO E1/4-OH E1, 4-MeO E2/4-OH E2, 4-MeO Estradiol, 4-MeO Estrone, 4-OH Estradiol, 4-OH Estrone, 5a,3a-Androstanediol, 5a-DHT, Allopregnanediol, Allopregnanolone, Androstenedione, Androsterone, Bisphenol A, Corticosterone, Cortisol/Cortisone, Creatinine (1st morning), Creatinine (2nd morning), Creatinine (Evening), Creatinine (Night), Creatinine (pooled), Deoxycorticosterone, DHEA, E3/(E1+E2), Epi-Testosterone, Estradiol, Estriol, Estrone, Etiocholanolone, Free Cortisol (1st Morning), Free Cortisol (2nd Morning), Free Cortisol (Evening), Free Cortisol (Night), Free Cortisone (1st Morning), Free Cortisone (2nd Morning), Free Cortisone (Evening), Free Cortisone (Night), Melatonin (1st Morning), Melatonin (2nd Morning), Melatonin (Evening), Melatonin (Night), Pgdiol/E2, Pregnanediol, T/Epi-T, Testosterone, Tetrahydrocortisol, Tetrahydrocortisone, Total Cortisol, Total Cortisone
