Estrogen Metabolism Test

About this test – Estrogen Metabolism Test

When is this test relevant?

• Hormonal imbalances or symptoms related to estrogen

• PMS or irregular menstrual cycles

• Perimenopause or menopause-related symptoms

• Fatigue, mood changes, or brain fog

• Interest in understanding estrogen metabolism rather than just hormone levels

• When looking for a more in-depth hormone assessment

• When previous hormone tests have not provided clear answers

How it works

1. Collect a dried urine sample at home

2. Send your sample to the laboratory using the prepaid return envelope

3. Your sample is analysed using advanced laboratory methods at a NATA-accredited laboratory, following ISO 15189 standards

4. Receive your digital results within 7 days

You can also use our AI-based chat to help interpret your results.

Key information

• Sample type: Dried urine

• Markers: Estrogens (E1, E2, E3), estrogen metabolites (2-OH, 4-OH, 16α-OH pathways), methylation markers, progesterone metabolites, DHEA, testosterone, cortisol

• Additional markers: Selected environmental compounds (e.g. BPA, PFAS) and heavy metals

• Focus: Estrogen metabolism and related hormonal patterns

• Turnaround time: 7 days from when the lab receives your sample

• Results: Delivered digitally

• Laboratory: NATA-accredited laboratory (ISO 15189)

• Shipping: Return shipping included

Before you test

For best results, avoid certain foods and preservatives for 48 hours prior to sample collection, as these may influence some of the measured compounds.

It is also recommended to pause supplements for 48 hours before collection, unless otherwise advised by your healthcare provider. Do not discontinue prescribed medications without consulting your physician.

Accredited Laboratory

Your sample is analysed at a NATA-accredited laboratory, operating in accordance with ISO 15189 standards for medical testing. This ensures that all analyses are performed using validated methods and strict quality control procedures.

Biomarkers included – Estrogen Metabolism Test

• Estradiol (E2): Primary Estrogens — Estradiol is the most biologically active form of estrogen in the body. It plays a central role in reproductive health, regulating the menstrual cycle, ovulation, and fertility. Estradiol also affects bone density, cardiovascular health, brain function, and metabolism. Levels vary throughout the menstrual cycle and across different life stages such as puberty, pregnancy, and menopause. Measuring e
• Estriol (E3): Primary Estrogens — Estriol is a naturally occurring estrogen and the weakest of the three primary estrogens. It is produced in small amounts in non-pregnant individuals but becomes the dominant estrogen during pregnancy, as it is generated through interactions between the placenta and the fetus. Estriol reflects aspects of estrogen metabolism and hormone turnover. Measuring estriol can help provide a broader picture
• Estrogen Quotient, E3 / (E1 + E2): Primary Estrogens — Estrogen Quotient, E3 / (E1 + E2) reflects how estriol (E3) compares with the stronger estrogens estradiol (E2) and estrone (E1). Estriol is generally considered a weaker estrogen, while estradiol and estrone have stronger estrogenic activity. A lower Estrogen Quotient means the estrogen pattern is more weighted toward E1 and E2 rather than E3. This can be relevant when assessing estrogen metaboli
• Estrone (E1): Primary Estrogens — Estrone is one of the three main forms of estrogen produced in the body. It is synthesized primarily from androgens in fat tissue and becomes the dominant estrogen after menopause. Estrone can be converted into estradiol or further metabolized into various estrogen metabolites. Measuring estrone helps provide insight into overall estrogen production and balance, particularly in relation to age, bo
• Testosterone: Other Primary Hormones — Testosterone is the primary male sex hormone, although it is also produced in smaller amounts in women. It plays a crucial role in male reproductive development, muscle mass, bone density, and sex drive. In women, testosterone contributes to libido, muscle mass, and bone health. Imbalances can lead to various issues, including decreased libido, erectile dysfunction (in men), fatigue, loss of muscl
• Pregnanediol/Estradiol: Other Primary Hormones — Pregnanediol is a metabolite of progesterone, while estradiol is a primary estrogen. Measuring both can provide insights into the balance of sex hormones, which play crucial roles in reproductive health, menstrual cycles, and pregnancy. Elevated or decreased levels can indicate various hormonal imbalances or conditions affecting fertility or reproductive function.
• DHEA-S: Other Primary Hormones — DHEA-S is a hormone produced mainly by the adrenal glands and serves as a precursor to sex hormones, including androgens and estrogens. Compared with DHEA, DHEA-S is more stable in the bloodstream and is therefore commonly measured to evaluate adrenal androgen production. Levels typically peak in early adulthood and gradually decline with age. Elevated DHEA-S may be seen in conditions associated w
• Pregnanediol: Other Primary Hormones — Pregnanediol is a metabolite of progesterone, a key hormone in the female reproductive system. Measuring pregnanediol levels can help assess progesterone production by the ovaries and adrenal glands, providing insights into ovulation, pregnancy, and certain hormonal imbalances.
• Total Cortisol: Other Primary Hormones — Total cortisol is a measure of all cortisol circulating in the blood, including both free (active) cortisol and cortisol bound to proteins. It is a crucial steroid hormone produced by the adrenal glands that plays a vital role in regulating metabolism, immune response, and the body's reaction to stress.
• DHEA: Other Primary Hormones — DHEA (dehydroepiandrosterone) is a hormone produced by the adrenal glands and acts as a precursor to sex hormones. Measuring DHEA in saliva reflects the body’s active hormone levels, providing insight into immediate DHEA production. This measurement is useful for assessing adrenal health, aging, and the risk of chronic conditions.
• 2-Hydroxyestrone: Estrogen Metabolism Phase 1 Hydroxylation — 2-Hydroxyestrone is produced when estrone undergoes hydroxylation at the 2-position during estrogen metabolism. It is part of the 2-hydroxylation pathway, one of the main metabolic routes for estrogen processing. This metabolite can be further converted into 2-methoxyestrone through methylation reactions. Measuring 2-hydroxyestrone provides insight into estrogen metabolism patterns and how estrone
• 16-Hydroxyestrone: Estrogen Metabolism Phase 1 Hydroxylation — 16-Hydroxyestrone (16-OHE1) is a metabolite of estrone, which is a type of estrogen hormone. It is formed in the liver and other tissues and plays a role in the metabolism and elimination of estrogens. Elevated levels can be associated with certain health conditions.
• 2-Hydroxyestradiol: Estrogen Metabolism Phase 1 Hydroxylation — 2-Hydroxyisobutyric Acid is a metabolite associated with exposure to methyl tert-butyl ether (MTBE), a fuel additive used in gasoline that may contribute to environmental pollution and air contamination.
• 2-Hydroxyestrogens / 16-Hydroxyestrone Ratio: Estrogen Metabolism Phase 1 Hydroxylation — This biomarker is a ratio comparing two forms of estrogen: 2-hydroxyestrone and 16-alpha-hydroxyestrone. It's considered important as an indicator of estrogen metabolism and can provide insights into potential risks for hormone-related cancers.
• 4-Hydroxyestrone: Estrogen Metabolism Phase 1 Hydroxylation — 4-Hydroxyestrone is generated when estrone undergoes hydroxylation at the 4-position during estrogen metabolism. Like other hydroxylated metabolites, it represents an intermediate step before further methylation or elimination. Monitoring 4-hydroxyestrone provides information about how estrone is metabolized and which pathways are active in estrogen breakdown.
• 4-Hydroxyestradiol: Estrogen Metabolism Phase 1 Hydroxylation — 4-Hydroxyestradiol is a metabolite formed when estradiol is metabolized through the 4-hydroxylation pathway. This pathway represents another route by which the body processes estrogens before further modification and elimination. The metabolite can be converted into methylated forms such as 4-methoxyestradiol. Measuring 4-hydroxyestradiol helps evaluate how estradiol is being processed through dif
• 2-Methoxyestrone / 2-Hydroxyestrone Ratio: Estrogen Metabolism Phase 2 Methylation — The 2-Methoxyestrone/2-Hydroxyestrone (2-ME/2-HE) ratio is a measure of how estrogen is metabolized in the body. It reflects the balance between two key estrogen metabolites, where a higher ratio can indicate a preferred pathway of estrogen breakdown that may be associated with certain health conditions.
• 2-Methoxyestradiol: Estrogen Metabolism Phase 2 Methylation — 2-Methoxyestradiol is a methylated metabolite formed when 2-hydroxyestradiol undergoes a methylation reaction, typically involving the enzyme catechol-O-methyltransferase (COMT). This process represents a secondary step in estrogen metabolism that helps convert hydroxylated metabolites into more stable forms for elimination. Measuring 2-methoxyestradiol provides information about the efficiency of
• 2-Methoxyestrone: Estrogen Metabolism Phase 2 Methylation — 2-Methoxyestrone is produced when 2-hydroxyestrone is methylated as part of phase II estrogen metabolism. Methylation reactions help the body further process estrogen metabolites so they can be more easily excreted. Monitoring 2-methoxyestrone can help assess how effectively the body is carrying out this secondary detoxification step within estrogen metabolism.
• 4-Methoxyestrone: Estrogen Metabolism Phase 2 Methylation — 4-Methoxyestrone is a methylated estrogen metabolite formed when 4-hydroxyestrone undergoes a methylation reaction during phase II estrogen metabolism. This step is typically catalyzed by the enzyme catechol-O-methyltransferase (COMT), which helps convert reactive hydroxylated estrogen metabolites into more stable forms that can be eliminated from the body. Measuring 4-methoxyestrone provides insi
• 4-Methoxyestrone / 4-Hydroxyestrone Ratio: Estrogen Metabolism Phase 2 Methylation — The 4-Methoxyestrone / 4-Hydroxyestrone Ratio is a biomarker that reflects the balance of estrogen metabolism in the body. Specifically, it compares the levels of two metabolites of estrone, an estrogen hormone, and can be an indicator of how efficiently the body is clearing these compounds. This ratio is often studied in relation to hormone-sensitive cancers and other health conditions.
• 4-Methoxyestradiol / 4-Hydroxyestradiol Ratio: Estrogen Metabolism Phase 2 Methylation — The 4-Methoxyestradiol / 4-Hydroxyestradiol Ratio is a measure of how the body metabolizes estrogen. It reflects the balance between two estrogen metabolites, with a higher ratio potentially indicating greater estrogen breakdown. This ratio can be important in understanding individual responses to hormone therapy and may be explored in relation to certain hormone-dependent conditions.
• 4-Methoxyestradiol: Estrogen Metabolism Phase 2 Methylation — 4-Methoxyestradiol is a methylated metabolite formed when 4-hydroxyestradiol undergoes methylation. This reaction is part of the body’s process of converting reactive hydroxylated estrogen metabolites into more stable compounds that can be cleared from the body. Measuring 4-methoxyestradiol helps provide insight into how the 4-hydroxylation pathway metabolites are being further processed and elimi
• Chromium: Endocrine Disruptors and Metals — Chromium (Cr), in trace amounts, is an essential nutrient that supports glucose metabolism and insulin function. While beneficial in its nutritional form, certain types — such as hexavalent chromium (Cr⁶⁺) — are highly toxic and carcinogenic. Excessive exposure can harm the skin, respiratory system, and kidneys, leading to serious health complications.
• Mercury: Endocrine Disruptors and Metals — Mercury is a naturally occurring heavy metal found in certain products such as thermometers and dental fillings. While low exposure is generally harmless, excessive levels can be toxic, affecting the nervous, digestive, and immune systems. High mercury exposure may cause symptoms like tremors, sleep disturbances, and cognitive impairment, and it poses significant environmental risks, particularly
• Lead: Endocrine Disruptors and Metals — Lead is a toxic heavy metal with no beneficial role in the human body. Exposure to lead can cause serious health problems, especially affecting the nervous system. Even low levels of lead can impact multiple body systems, with children being particularly vulnerable to developmental delays and cognitive impairments.
• Polyfluoroalkyl Substances (PFAS): Endocrine Disruptors and Metals — Polyfluoroalkyl Substances (PFAS) are a group of man-made chemicals found in numerous consumer and industrial products. Because they do not break down easily, they can accumulate in the body and the environment, and are associated with various adverse health effects, making their detection important for monitoring exposure.
• Bisphenol A (BPA): Endocrine Disruptors and Metals — Bisphenol A is an industrial chemical commonly used in the production of certain plastics and resins, including polycarbonate plastics and epoxy coatings found in food containers and packaging materials. BPA is considered an endocrine-active compound because it can interact with estrogen receptors and influence hormone signaling pathways. Measuring BPA levels in urine can help assess environmental
• Perfluorooctane Sulphonic Acid (PFOS): Endocrine Disruptors and Metals — Perfluorooctanesulfonic acid (PFOS) is a long chain PFAS compound historically used in stain resistant coatings, firefighting foams, industrial products and water resistant materials. PFOS is notable because it can remain in the body for a long time and may accumulate with repeated exposure. Higher levels may be relevant because PFOS has been studied in relation to immune response, thyroid hormone
• Aluminium: Endocrine Disruptors and Metals — Aluminum (Al) is a harmful heavy metal that can pose health risks to the human body. Exposure to excessive levels of aluminum, often through diet or environmental sources, has been linked to neurotoxicity and may be associated with conditions such as Alzheimer's disease. Monitoring and reducing aluminum exposure is important for supporting overall health and well-being.
• Cadmium: Endocrine Disruptors and Metals — Cadmium (Cd) is a toxic heavy metal with no beneficial role in the human body. Prolonged exposure to cadmium can cause serious health problems, including kidney damage, weakened bones, and a higher risk of cancer. Because cadmium accumulates in the body over time, even low-level exposure poses a concern for long-term health.
• Arsenic: Endocrine Disruptors and Metals — Arsenic is a naturally occurring element that can be highly toxic to humans. Found in soil, water, and certain industrial materials, it disrupts normal cellular processes and is classified as a carcinogen. Even at low levels, arsenic exposure can pose significant risks to health, affecting multiple organs and systems.
• Perfluorooctanoic Acid (PFOA): Endocrine Disruptors and Metals — Perfluorooctanoic acid (PFOA) is a PFAS compound historically used in non stick coatings, water resistant materials and industrial processes. It is important because PFOA can persist in the environment and remain in the body for a long time. Higher levels may suggest cumulative exposure and are generally considered unfavourable because PFOA has been discussed in relation to kidney, endocrine, repr
• Nickel: Endocrine Disruptors and Metals — Nickel (Ni) is a naturally occurring metal and widely used industrial element. In trace amounts, it is generally harmless, but excessive exposure can cause health issues such as skin irritation, allergic dermatitis, and respiratory problems. Nickel is also classified as a potential carcinogen, with higher risks observed in occupational environments where exposure levels are elevated.
• Creatinine: Urine Normalisation Marker — Creatinine is a waste product formed in muscles from the normal breakdown of creatine. It is released into the bloodstream and filtered by the kidneys, then excreted in urine. Because creatinine levels are influenced by how efficiently the kidneys filter blood, it is commonly used to assess kidney function. Elevated creatinine may indicate reduced kidney filtration or kidney disease, while low lev

How to prepare – Estrogen Metabolism Test

Collect sample between days 19-22 of a 28-day cycle if regular. Avoid excessive fluid intake before collection.

Frequently asked questions – Estrogen Metabolism Test

Is dried urine more accurate than a blood test?

Dried urine is considered the gold standard for metabolites because it captures a 24-hour average of hormone production. While blood shows a snapshot of circulating hormones at one moment, dried urine allows us to see how those hormones are actually broken down and cleared by your liver.

What does the 2:16 ratio mean?

This ratio compares protective estrogen (2-OH) to proliferative estrogen (16-alpha-OH). Achieving an optimal ratio is generally associated with better breast and bone health, as it indicates your body is prioritizing the safer metabolic pathway.

How do PFAS and BPA impact my hormones?

Endocrine disruptors like PFAS and BPA can mimic estrogen or block metabolic enzymes like COMT. This prevents your body from clearing estrogen efficiently, often leading to stubborn symptoms of estrogen dominance even when hormone levels appear normal.

Customer reviews – Estrogen Metabolism Test

4.6/5 (5)

• 5/5 — The digital report was actually better than expected!
• 4/5 — Easy to do at home.
• 4/5 — Really helpful for checking my hormone markers, though I wish it was a bit cheaper.
• 5/5 — Fast results and I finally understand why my estrogen dominance symptoms weren't going away despite a clean diet.
• 5/5 — Everything arrived on time and the kit instructions were clear.