Fertility/Menopause Gauge Hormone Panel

Estradiol (estradiol-17 beta, E2) is part of an estrogen that is a group of steroids that regulate the menstrual cycle and function as the main female sex hormones. Estrogens are responsible for the development of female sex organs and secondary sex characteristics and are tied to the menstrual cycle and pregnancy. They are considered the main sex hormones in women and are present in small quantities in men. Estradiol (E2) is the predominant form of estrogen and is produced primarily in the ovaries with additional amounts produced by the adrenal glands in women and in the testes and adrenal glands in men. Estradiol levels are used in evaluating ovarian function. Estradiol levels are increased in cases of early (precocious) puberty in girls and gynecomastia in men. Its main use has been in the differential diagnosis of amenorrhea – for example, to determine whether the cause is menopause, pregnancy, or a medical problem. In assisted reproductive technology (ART), serial measurements are used to monitor follicle development in the ovary in the days prior to in vitro fertilization. Estradiol is also sometimes used to monitor menopausal hormone replacement therapy.

Prolactin is a hormone produced by the anterior portion of the pituitary gland, a grape-sized organ found at the base of the brain. Prolactin secretion is regulated and inhibited by the brain chemical dopamine. Normally present in low amounts in men and non-pregnant women, prolactin's primary role is to promote lactation (breast milk production). Prolactin levels are usually high throughout pregnancy and just after childbirth. During pregnancy, the hormones prolactin, estrogen, and progesterone stimulate breast milk development. Following childbirth, prolactin helps initiate and maintain the breast milk supply. If a woman does not breastfeed, her prolactin level soon drops back to pre-pregnancy levels. If she does nurse, suckling by the infant plays an important role in the release of prolactin. There is a feedback mechanism between how often the baby nurses and the amount of prolactin secreted by the pituitary as well as the amount of milk produced. Another common cause of elevated prolactin levels is a prolactinoma, a prolactin-producing tumor of the pituitary gland. Prolactinomas are the most common type of pituitary tumor and are usually benign. They develop more frequently in women but are also found in men. Problems resulting from them can arise both from the unintended effects of excess prolactin, such as milk production in the non-pregnant woman (and rarely, man) and from the size and location of the tumor. If the anterior pituitary gland and/or the tumor enlarge significantly, it can put pressure on the optic nerve, causing headaches and visual disturbances, and it can interfere with the other hormones that the pituitary gland produces. In women, prolactinomas can cause infertility and irregularities in menstruation; in men, these tumors can cause a gradual loss in sexual function and libido. If left untreated, prolactinomas may eventually damage the tissues around them.