What is the role of hormones in reproduction?

Every living organism continue life on earth through the process of reproduction. It is a biological phenomenon to give birth to young ones of its own kind by which new offerings are produced from their parent. The new born gains all genetic traits or characteristics from his parent. Reproduction is an essential life process to give birth to offsprings of ones own kind. Male and female gametes unite to form a zygote during the process of sexual reproduction. This zygote matures, develops different organs and body structures, that has all genetic information of his parents which eventually grows into a foetus. Female reproductive system is formed of uterus, fallopian tubes and two ovaries and external genital organs located within the pelvis. It is only due to the normal physiological hormonal balance that release ovum from one of the fallopian tubes from either of the two ovaries every month within the uterine cavity. Ovaries produce eggs that travel through the fallopian tubes into the uterus. When the egg gets fertilized by sperm a zygote is formed in the uterus which acts like a pouch to hold the fertilized egg for upto 9 months till a full grown foetus develops. If the egg is not fertilized it disintegrates along with the uterine lining and sheds during  menstrual flow.

In addition to eggs, the prime and another most important function of ovaries is to secrete hormones—oestrogen and progesterone. There are two ovaries located in opposite ends of pelvic wall on either side of uterus. The sex hormones secreted by ovaries – three major oestrogens – estradiol, estrone, estriol along with progesterone are vital for  normal reproduction and fertility in women. These hormones work to develop female sexual characters during puberty and contribute to a healthy fertility. Estradiol is a hormone that has a vital role, essential for development of breasts, fat distribution around hips, legs, breasts and growth of reproductive organs in female. The release of oestrogen and progesterone is regulated and governed by hypothalamus—a center located on the undersurface of the brain. A signal from the pituitary gland within the brain, stimulates the process of ovulation by releasing follicle stimulating hormone and luteinising hormone.  This is the initial step for regulation of menstrual cycle. The egg or the ovarian follicle released from any one of the ovary migrates to the fallopian tube. It grows, matures due to presence of oestrogen hormone when it reaches the uterus.  Progesterone released forms uterine lining for formation of  a cushion like thickness for preparation of pregnancy. If the egg does not get fertilized then this thickness disappears to shed as menstrual flow. Fertilization of egg into a zygote causes pregnancy in women  during which high oestrogen levels stop further egg formation in the ovary. Increased oestrogen levels during pregnancy also cause uterine contractions. Maximum hormones are released during pregnancy and as women enters menopause,  oestrogen levels fall rapidly. Oestrogen regulates female fertility. Oestrogen is also essential for strengthening bones.  Hence, an optimum proportional balance of hormones is of prime significance during every phase – from puberty, during pregnancy and menopause in life of woman. An imbalance in these sex hormones cause different medical conditions.

What is estradiol?

Hormones are body’s chemical messengers that travel through the blood stream to reach tissues and organs to help them in their normal physiological function. They play an important part in growth, development and reproduction. Oestrogen is a female hormone produced by ovaries, adrenal glands and fat tissues. Estradiol is the most important type of oestrogen that unanimously works with other hormones during reproductive years of female to enhance fertility. High levels of estradiol causes acne, loss of sexual drive, osteoporosis, depression, uterine and breast cancer. Low levels of estradiol causes weight gain and cardiovascular diseases.

What are the symptoms from estradiol imbalance?

Oestrogen levels need to be balanced from the time a girl enters puberty and enters menopause. However, these levels often fluctuate during the reproductive years of female.

Certain factors affect the levels of estradiol are –

The levels vary or fluctuate during pregnancy, end of pregnancy and breast feeding.

Levels of estradiol vary during puberty, menopause and as age advances or in old age.

Overweight and obesity cause hormonal imbalance.

Anorexia nervosa or extreme loss of weight cause fluctuations in hormonal levels.

Use of certain medicines like steroids, ampicillin, oestrogen containing drugs, tetracycline cause hormonal imbalance.

Metabolic conditions like hypertension, diabetes mellitus, underactive thyroid, polycystic ovarian disease and tumours of ovaries or adrenal glands cause fluctuations in estradiol levels.

These above medical conditions give rise to abnormal sensations or symptoms like—

Irregular menstrual cycle or complete cessation of menses termed as amenorrhoea.

Heavy bleeding during menstrual cycle.

Premenstrual syndrome or menopausal symptoms.

Hot flushes and night sweat or increased perspiration.

Benign growths in uterus and breasts.

Mood swings, depression and sleeping problems.

Fatigue, dry skin, feeling of anxiety and depression.

Due to the above symptoms caused from estradiol imbalance during child bearing age of a female, it is essential to know its levels for a healthy menstrual cycle each month and to regulate or control normal fertility in women. The levels of estradiol are high during puberty to menopause in female, it becomes an important diagnostic test to measure its levels during a clinical condition or when a pathological diseased state is found in woman.

What is an E2 test?

Estradiol hormone is a form of oestrogen secreted by the ovary that plays a major role in female reproductive system for physiological functions of uterus, fallopian tubes during puberty to development of secondary sexual characters. It is also called 17 beta-estradiol.  A high or a low level of estradiol in blood is observed during certain medical conditions. An estradiol test or an E2 test measures the amount of estradiol levels in blood. A normal estradiol level for a menstruating women range from 15 to 350 pg/ml; for post menopausal women it goes lower than 10pg/ml.

E2 or estradiol levels are seen to fluctuate during menstrual irregularities, ovarian and breast tumours. E2 test is done to know the levels of estradiol when a female is being treated for infertility or when she is advised assisted reproductive technique if she is infertile. Hormones are monitored when women is treated for assisted reproductive technology, so E2 test is advised by the physician to understand levels of estradiol in blood. It is a marker test for adolescent girls to diagnose an early puberty. Lower levels of estradiol indicate delayed puberty when secondary sexual characters do not develop at normal rate. E2 test helps to note problems with adrenal glands and determine functions of pituitary gland. It determines whether ovary is  functioning normally or is diseased from a pathological condition. As oestrogen regulates bone, cholesterol metabolism, insulin, glucose metabolism and body weight, an E2 test  help to understand, identify a pathological condition caused due to hormonal imbalance. A doctor may advise an E2 test if patients show signs of anaemia, abnormal kidney functions, high blood pressure, irregular or absence of menstrual cycle, increased urinary tract infections, depression, anxiety with mood swings and premenstrual syndrome that causes bloating sensation or feeling, pain in pelvic area, weight loss or fatigue.

How is E2 test done?

A patient whose estradiol levels fluctuate from metabolic diseases or different pathological conditions, is on birth control pills, oestrogen therapy, glucocorticoids, antibiotics and who are undergoing treatment for fertility are advised an E2 test by their gynecologist or an obstetrician. A technician or a phlebotomist  conduct an E2 test. It is a blood test, where blood is drawn from a vein or inside of patient’s elbow or back of her hand. The technician uses an antiseptic to cleanse the area from where the blood has to be drawn out. A tourniquet is tied around the upper arm of patient’s hand. The pressure from a tourniquet causes a rush of blood in the vein. The technician then inserts a needle to draw the blood into a tube from the selected blood swelled vein. A bandage is applied at the punctured site. The blood sample is sent to the laboratory for testing and analysis. Once the results are confirmed post the test is performed, a medical professional determines the treatment.

Abnormal results mean early onset of puberty in girls, amenorrhoea, ovarian hypofunction or low body weight. A thorough diagnosis through an E2 test for identifying the pathology by a skilled health care professional can treat the cause of elevated or low E2 levels in blood.

Estradiol is a primary sex hormone released by follicles in the ovaries. It is a natural hormone who needs to be balanced and is also given as a medicine during hormone replacement therapy. As E2 test measures the amount of estradiol levels in blood, it is a marker, a diagnostic aid during several diseases in woman.

Infertility is a major issue, a medical concern in present era. Infertility clinic, hospitals with advanced technology have grown in different parts of the world. India is now a pioneer in modern, latest fertility treatment. IVF is one treatment solution for women who are infertile. E2 test monitors levels of estradiol in blood. When E2 levels are tracked in blood, when a woman is pregnant or when she is infertile, a definate treatment approach can be decided by the physician. Patients now do not get disheartened with several solutions that help towards fertility by diagnostic tests such as E2.

Similarly hormones can be balanced by a check on estrogen levels through an E2 test either by medication or hormonal therapy in different medical conditions like polycystic ovarian disease, tumour of ovary, hypothyroidism, during menstrual irregularities and menopause. Cost of E2 test varies depending upon the laboratory and location in different parts of the country.

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