Estrogens and Metabolites (Urine) - DUTCH

Total Estrogen

Optimal Result: 35 - 70 ng/mg.

Where is estrogen made?

Estrogen is made primarily in the ovaries of cycling women, while smaller amounts can be converted from testosterone through aromatization. In menopause, estrogen production shifts almost completely to aromatization. The enzyme responsible for aromatization is found in fat tissue, the brain, gonads, blood vessels, skin, and bone.

In Men: 

Men need far less estrogen than women, and it is aromatized primarily from testosterone. Women who are still cycling have much greater estradiol quantities than men, but it is important to note that men do make estrogen. In fact, the level of estrogen in men is actually higher than the level in a post-menopausal woman!  

What does estrogen do?

- Growth and development of female secondary sex characteristics

- Thickens the uterus for implantation, increases vaginal acidity to protect against infection, important for vaginal lubrication (particularly E3) 

- Necessary for bone health 

- In the brain helps maintain body temperature, protects against memory loss, increases serotonin and serotonin receptors

- Important for collagen production, skin thickness, and getting blood supply to the skin

- Helps protect against atherosclerosis

Normal Ranges for Total Estrogen in pg/mL:

Adult Female (depends on the menstrual phase)


   Follicular Phase (1-12 days)  90-590 pg/mL

   Luteal Phase                         130-460 pg/mL

   Postmenopausal                    50-170 pg/mL

   Adult Male                              60-190 pg/mL


Critical Range: anything outside the limits mentioned above.

The three primary estrogens:

Estrone (E1):

- Weaker compared to Estradiol

- Research says the estrogenic activity is about 4% of estradiol’s activity 

- Most abundant in menopause

- Made via aromatization in several tissues like fat and muscle

- Converts into estradiol (E2)

Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause. 

Estradiol and estrone can interconvert into each other. 

Estradiol (E2):

- Most potent

- Made primarily in the ovaries

The main and most potent estrogen is known as Estradiol (E2). It is made primarily in the ovaries or testes and in the fat, liver, and neural tissue. 

Expected values for E2:

- 1.8 - 4.5 Premenopausal (days 19-22), not on birth control

- 1.0 - 2.0 Collecting right after menstruation

- 4.0 - 12.0 Collecting close to ovulation

- 0.2 - 0.7 Postmenopausal (and not supplementing) or on birth control

Estriol (E3):

- The ‘end product’ of estradiol/estrone metabolism

- 16-OH-E1 can convert into estriol

- Not made in the ovaries

- Very weak estrogen

- Elevated in pregnancy due to placental production 

The third estrogen is known as Estriol (E3) and is produced in significant amounts during pregnancy. In men and women, Estriol is irreversibly produced by estradiol (estriol cannot make estradiol) or from estrone through 16-OH-Estrone, which makes it the largest circulating estrogen because both Estrone and Estradiol can make it. Despite this, estriol is not nearly as potent as estradiol (Estradiol is 80x more potent!).

What does it mean if your Total Estrogen result is too low?

Why does estrogen decrease?

- Age (peri-menopause and menopause)

- Irregular cycles/skipped cycles/anovulation

- Hysterectomy with ovaries removed

- Anorexia

- Low cholesterol (backbone to hormones)

- Extreme exercise or training

- Extreme stress resulting in skipped menses

- Under appropriate body weight percentage for height/age (Mixed research: suggested <15% body fat = amenorrhea)

- Hypogonadism (ovaries fail)

- Hypopituitarism (pituitary not communicating)

- Decreased blood flow to the ovaries (Ex. Surgery or smokers)

- Breastfeeding

- Hypothyroidism


- Fertility medications

- Opioid pain medications (in last 6 months)

- Hormonal birth control – pill, patch, ring, implant, injection

Common symptoms of low estrogen:

- In women - fatigue, depression, hot flashes, night sweats, vaginal dryness, pain with intercourse, low libido, joint pain, brain fog, migraines/headaches, fertility issues, dry skin

- In men - not generally considered symptomatic, but in very extreme cases, men may have similar symptoms as in the list above for women

Common ways to raise estrogen:

In women - address the cause, phytoestrogens such as Red Clover, Dong Quai, Kudzu, soy, diosgenin, genistein, fennel, and Black Cohosh (although studies are mixed on whether it acts as a phytoestrogen or not), Maca, and bioidentical estrogen replacement.

What does it mean if your Total Estrogen result is too high?

Why do Estrogen levels increase?

- Overweight/obesity

- Peri-menopause = surges of estrogen

- Diabetes


- Estrogen supplementation

- Steroid medications

- Poor liver clearance so estrogens build-up

- Dysbiosis/Estrobolome problems

- Over aromatization from testosterone

- Environmental estrogens (difficult to test, however)

- Alcohol (2 or more glasses/day shown to increase estrogen)

- Ovarian cysts

- Having elevated testosterone levels – testosterone gets converted to estrogen through the aromatase enzyme. Therefore, having Polycystic Ovarian Syndrome (PCOS), over supplementing with testosterone or DHEA, or generally having a high production of this hormone, can lead to more estrogen being produced as a byproduct.

In men – over aromatization from testosterone to estrogen due to inflammation and blood sugar/insulin issues, environmental/xenoestrogen exposure (this does not show up on DUTCH testing, but they can cause symptoms), moderate alcohol use, and obesity

Common symptoms of elevated estrogen:

- In women – mood swings, weight gain, breast tenderness, fibrocystic breasts, heavy menses, fibroid/polyp development.

- In men – breast development, weight gain, and mood swings.

Common ways to lower estrogen:

Please consult with your health care provider about advice/treatment/diagnosis. The following statements are general informational statements.

- In women - address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber (especially ground flax seeds), increased detoxification support, and weight loss

- In men – address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber, decrease blood sugar and insulin, increased detoxification support, weight loss, and things that block aromatase (Chrysin, Damiana, Zinc and pharmaceutical aromatase inhibitors)

Other general interventions to keep in mind that can be beneficial for everyone if you don’t know the status of your hormones includes:

- Avoiding xenoestrogen exposure. Here is a great link to the top endocrine disruptors to avoid your environment [L]:

- Eat more cruciferous vegetables from the Brassica family- broccoli, kale, Brussels sprouts, cauliflower, cabbage, kale, etc.  

- Support your liver on-going – from the basic lemon water to increasing consumption of dandelion or dandelion tea, doing a liver cleanse twice a year, and reducing consumption of sugar and alcohol.

- Make sure your bowels are going – lots of fluids and high fiber in your diet will help regulate your bowel movements and make sure your hormones are properly detoxified rather than sitting in your body and recirculating back in the system.

10 000+ happy clients
100% satisfaction
★ ★ ★ ★ ★ customer support

Understand blood, stool, and urine medical results from all your laboratories.

Get Started With Our Personal Plan

Advanced Plan

  • ✓ Yearly subscription
  • ✓ Five free uploads
  • ✓ Cancel anytime
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support
  • ✓ Yearly subscription
  • ✓ Five free uploads
  • ✓ Cancel anytime
$79 per year
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support

Unlimited Plan

  • ✓ No subscription
  • ✓ Ten free uploads
  • ✓ Unlimited access
  • ✓ Instant interpretations
  • ✓ Use the free self-upload form
  • ✓ 3000+ biomarkers explained
  • ✓ Nutrition Recommendations
  • ✓ Dedicated support
  • ✓ No subscription
  • ✓ Ten free uploads
  • ✓ Unlimited access
$250 full version

Are You a Health Professional?

Get started with our professional plan

Welcome to Healthmatters Pro.

Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more

Pro Plan

for health professionals

  • ✓ Track multiple clients results
  • ✓ No setup fees
  • ✓ No hidden costs
  • ✓ Cancel anytime
  • ✓ Instant interpretations
  • ✓ Use the free template forms
  • ✓ 3000+ biomarkers explained
  • ✓ Additional team member $25
  • ✓ Personal training and support

$45 per month

Use promo code to save 10% off any plan.

We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.


Understand Your Lab Result Now

  • Instant interpretation
  • 3000+ biomarkers explained
  • Science-based recommendations
  • Online support
  • Secure and private portal

Get 10% off with promocode: