Estriol is the weakest of the three major naturally-occurring estrogens in women. It is a product of the metabolism of estrone and estradiol and is excreted in the urine in greater amounts than estradiol. Because of its weak estrogenic activity, estriol is sometimes preferred for intravaginal use as an alternative to systemic estrogen therapy for the treatment of urogenital atrophy in postmenopausal women. It is also used in anti-aging skin creams as a form of topical estrogen replacement to counteract the effects of age-related estrogen loss on skin.
Estriol is the major estrogen found in the maternal circulation during pregnancy; 90% of this circulating estriol is the product of metabolism of DHEA from the fetal adrenals, and so maternal estriol levels are used as an indicator of fetal health. In non-pregnant women, estriol levels are similar in both pre– and post-menopause, and are also similar to levels in men. The saliva test for estriol has been found to be predictive of increased risk of preterm labor in pregnant women. In non-pregnant women it is most commonly used for monitoring of levels in women using estriolcontaining supplements as part of hormone replacement therapy.
Hampson E, Phillips SD, Soares CN, Steiner M. Steroid concentrations in antepartum and postpartum saliva: normative values in women and correlations with serum. Biol Sex Differ. 2013;4:7.
Soghra K, Zohreh S, Kobra AK, Reza MM. Single measurement of salivary estriol as a predictor of preterm birth. Pak J Biol Sci. 2014;17:730-4.
Capobianco G, Donolo E, Borghero G, Dessole F, Cherchi PL, Dessole S. Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women. Arch Gynecol Obstet. 2012;285:397-403.
Doctors usually test Estriol during pregnancy, when it temporarily becomes the main estrogen. Abnormal levels of estriol may be a sign of problems with the baby’s health -- but you’d get a lot more tests to find out for sure. You might need several tests to track changes in your estrogen levels over time.
High estriol implies a potential for elevated 16alpha-hydroxyestrone (16-OH-E1), a very potent estrogen that is associated with increased risk of breast cancer. There appears to be an association of elevated estriol and elevated 16alpha-hydroxyestrone in patients with systemic lupus erythematosus, implying shifted metabolism in that condition.
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