Fractionated Estrogens performed by LCMSMS

May 8, 2024

Effective April 29, 2024, Warde medical laboratory has switched to a mass spectrometry method for detecting estrogen fractions (ESTM).

Circulating estrogen in non-pregnant individuals includes E1 (estrone) and E2 (estradiol) components. Liquid chromatography/tandem mass spectrometry allows highly sensitive quantification of both E1 and E2, with sensitivity roughly one order of magnitude greater than what is achieved through immunoassay measurement. Precise E1 and E2 measurements are used in the diagnosis and workup of precocious and delayed puberty or feminization, suspected disorders of sex steroid metabolism (including deficiencies of aromatase or 17-alpha hydroxylase), and possible hormone-producing neoplasms. E1 and E2 measurements can also be used as an adjunct to assessment of postmenopausal bone status and in monitoring hormone and anti-hormone therapy. In women of childbearing age, there is cyclical fluctuation of E1 and E2; values can contribute to documenting ovulation status for reproductive health purposes.

Since the E1+E2 total provided by this assay serves as a more precise measurement of total estrogen, the prior Warde assay measuring total estrogen by radioimmunoassay has been discontinued.

Normal ranges are provided for males and females of any age, with breakdowns for pediatric Tanner stages and ovulatory stages in premenopausal females.

E1, E2, and calculated total estrogen are all reported in this assay.

The test is offered for all patients except in the state of New York, as review by NY CLEP is still in progress.