Normal Estradiol Levels by Age: What’s Typical and What’s Not

Remember learning about estrogen in middle school health class? If not, you’re hardly alone. Now that you're not 13 anymore—and neither are your estrogen levels—consider this your refresher course on all things estrogen. 

What Is Estradiol (Estrogen)?

Before we dive directly into estradiol, it’s important to clarify a few things about estrogen. There are three main types of estrogen: estrone (E1), estradiol (E2), and estriol (E3). 

During your reproductive years, estradiol is basically the star of the show—the most abundant and powerful of the bunch. It is produced by your ovaries (and to a smaller degree your fat cells and adrenal glands) and is responsible for regulating your menstrual cycle. It helps facilitate the maturation and release of an egg each month, and if fertilization occurs, estradiol enables the egg to implant and grow in the lining of the uterus.

But wait, there's more! Estradiol is also busy keeping tabs on your heart, bones, brain, metabolism, sexual health, mood, and stress levels. "Estradiol is central to nearly every aspect of female health—not just reproduction,” says Christy Beyer, MD, FACOG, NCMP, Medical Director at Midi Health. “Its decline with age, especially during and after menopause, has widespread effects.”

Your body's estradiol levels aren't static; they shift constantly throughout your monthly cycle and as you age. And when you hit midlife, estradiol starts its rocky descent. Eventually, around menopause, you're producing so little estradiol that ovulation stops altogether. 

At that point, estrone (E1) takes over as the primary form of estrogen. Estrone helps with many of the same things estradiol does: sexual function, heart health, bone health, emotional well-being, but it's considered the less powerful sibling. 

As for estriol? That one mainly shows up during pregnancy to support the growth of the uterus and placenta. But it can also be harnessed as a topical cream in the years leading up to and following menopause to treat some symptoms.

Let’s recap:

• Estradiol (E2): The strongest and most abundant form of estrogen that’s produced primarily by the ovaries during your reproductive years. Because there are estrogen receptors all over the body, it has a hand in head-to-toe wellness. 
• Estrone (E1): Takes over as the primary form of estrogen after menopause and helps with many of the same things estradiol does: sexual function, heart health, bone health, emotional well-being, but generally less powerful.
• Estriol (E3): This form shows up the most during pregnancy to support the uterus and placenta. It’s often used in topical creams because it’s weaker and safer.

Changing Estradiol Levels

As estradiol levels drop with age, you may begin to notice some of the hallmark signs of perimenopause and menopause:

• Hot flashes and night sweats
• Fatigue
• Trouble sleeping
• Vaginal dryness
• Decreased sex drive
• Mood shifts
• Cognitive issues, like trouble concentrating

There’s also some evidence that low estradiol levels may put you at greater risk for insulin resistance, weight gain, high cholesterol, heart disease, reduced bone density, and high blood pressure. 

In some cases, estradiol levels can go the opposite way, and become too high. Causes of high estradiol range from polycystic ovarian syndrome (PCOS), being overweight or having obesity, or taking certain medications.

Normal Estradiol Levels

It’s normal for estradiol levels to fluctuate as the years go by—and even from week to week during your menstrual cycle. So what, exactly, does “normal” look like?

Before you have your first period and officially hit puberty, estradiol levels are typically very low—around 0 to 10 picograms per milliliter (pg/mL) or less. But after that, estradiol jumps to between 10 and 300 pg/mL (yes, that’s a wide range!). This surge is a major driver of breast and bone growth. It also shifts the way body fat is distributed and helps regulate menstruation and your reproductive system in general.  

Within your monthly cycle, estradiol roller-coasters up and down (and you’ll often notice it in how you feel). At the beginning of your cycle, estradiol tends to be on the lower end of the range. It then steadily climbs, peaking during ovulation, in preparation for a potential pregnancy. If fertilization doesn’t occur, estradiol levels largely decline over the next few weeks until your period arrives. If fertilization does happen, estradiol will steadily climb—from 1,000 to 5,000 pg/mL in the first trimester; 5,000 to 15,000 pg/mL in the second; and 10,000 to 40,000 pg/mL in the third.

As you enter perimenopause, estradiol levels go on an even wilder ride. They become less predictable, and they can rise and fall more steeply and frequently than they did during your prime reproductive years. Those all-over-the-place fluctuations are what may lead to symptoms such as hot flashes, night sweats, and irregular periods. And because estradiol levels are so erratic, most labs don’t have established, normal ranges for women in this phase of life. 

Then comes menopause. As you probably know, a woman is considered meno-fficial when she hasn’t had a period for 12 consecutive months. And estradiol plays a big role in that. The wacky hormonal ups and downs of perimenopause drop around age 50, until estradiol levels are so low that you stop ovulating (and menstruating) altogether. A normal range of estradiol in menopause is usually less than 10 pg/mL. This hormonal flatlining may trigger changes to your bone, skin, metabolic, cardiovascular, endothelial, and emotional health, says Dr. Beyer. 

Chart of Estradiol Ranges by Age

To make this even easier to remember, here’s a breakdown of typical estradiol levels by age. They’re based on when research shows the average woman tends to enter each phase, from puberty through menopause. 

• Pre-puberty (before age 8): 0 to 10 pg/mL
• Puberty (ages 8 to 13): 10 to 300 pg/mL
• Reproductive age (14 to 39): 10 to 300 pg/mL
• Perimenopause (40 to 49): Varies, so there is no widely accepted range
• Menopause (50 and up): Less than 10 pg/mL

An important note: These are general values—meaning that normal estradiol ranges may vary from the ones you see here, depending on the test performed and the lab you go to. There is no standardized range like there is with, say, blood pressure or cholesterol levels. (For example, some labs consider a normal estradiol range during your reproductive years to be 30 to 400 pg/mL, versus the 10 to 300 pg/mL here.) Your medical history could also affect what’s normal for you. If you have your levels tested, be sure to discuss the results with your clinician.

So if you’re looking for “normal estradiol levels by age,” know that “normal” is highly variable during perimenopause. That’s often why healthcare professionals, including Midi clinicians, won’t routinely test estrogen levels in order to provide care. Instead, they’ll focus on your symptoms because the numbers can look so vastly different depending on when you test. 

And given the wide range of normal and both cyclic and individual variability, a singular value is a rather unreliable indicator of ovarian function or menopause status. Two women with the same age and same E2 level, for example, may have very different symptoms. Another factor to weight: Serum levels reflect only on the amount of circulating hormone, but does not capture how an individual may metabolize estrogens or their estrogen receptor distribution and sensitivity. All this to say, E2 levels have to be interpreted in the context of reproductive age, cycle, medications, and symptoms so you can get the relief you deserve.

Signs Your Estradiol Levels May Be Off

Your body is pretty brilliant at letting you know when things aren’t right. So if you notice any of the following symptoms, it may be telling you that your estradiol levels aren’t where they should be. Aside from age, medical conditions such as polycystic ovarian syndrome (PCOS) or obesity, as well as cancer treatments like chemotherapy and radiation, can disturb your estradiol levels. So can certain medications. (More on that coming up.)

Signs and Symptoms of High Estradiol 

High estradiol symptoms include:

• irregular periods 
• light or heavy bleeding during periods
• dense breasts
• tender breasts
• decreased sex drive
• worsening PMS or premenstrual dysphoric disorder (PMDD)
• weight gain, particularly around your middle

Signs and Symptoms of Low Estradiol

Low estradiol symptoms include:

• irregular periods or stopped periods
• breast tenderness
• decreased sex drive
• hot flashes and night sweats
• reduced bone density, or osteoporosis 
• low back pain
• mood changes, like depression or irritability
• headaches and migraine
• skin and hair changes, including dryness 
• vaginal dryness causing painful sex (dyspareunia)
• fatigue 
• trouble sleeping
• weight gain

Why and When to Test Your Estradiol Levels

This is definitely a case where talking to a healthcare professional, like a Midi clinician, about questions or concerns about your symptoms is vital. 

“For example, with perimenopause and menopause, women often complain of moodiness, poor sleep, hot flashes, night sweats, irritability, joint pain, brain fog, midsection weight gain, and irregular periods,” says Dr. Beyer. And as noted, those symptoms are usually enough to pursue treatment, be it birth control, hormone replacement therapy (HRT) to supplement estrogen levels, or a range of non-hormonal treatment options for menopause. 

An E2 value at the time of blood draw–even if it is within “normal” ranges—wouldn’t mean you’d have to keep on suffering until your levels said otherwise. By treating the symptoms, clinicians can focus on optimizing your health and wellbeing today. That said, for some women, testing estradiol levels alongside other blood tests (like TSH) may be useful to address concerns surrounding fertility, PCOS, and metabolic health, and rule out conditions that can mimic perimenopause and menopause.  

What to Expect with Estradiol Serum Testing

Getting your estradiol levels checked involves a simple blood draw—called an estradiol serum test. And just as the name suggests, it measures how much estradiol is circulating in your blood at the time of the blood draw. 

Remember: Levels of this hormone vary widely between your premenopausal and postmenopausal years. Your clinician will take that into account, along with your medical history and symptoms, when reviewing the results.

Factors That Influence Estradiol Levels

Many things can affect your estrogen levels, but these are some of the most common, according to Dr. Beyer:

• age
• body mass index (BMI)
• contraception use
• timing in your cycle
• hormone therapy, like HRT
• pregnancy and breastfeeding
• lifestyle factors such as diet, exercise, stress levels, and alcohol consumption
• medical conditions including PCOS, thyroid issues, infertility, and certain cancers

Conditions and Disorders

What are the common conditions and disorders associated with estrogen?

Estrogen plays a role in most conditions that fall under the umbrella of women’s health. Some of the most common include:

• Anorexia nervosa: Conditions like anorexia nervosa are associated with low estrogen levels. Too little estrogen can cause irregular and missed periods (amenorrhea). People with very little body fat (models, athletes) or who engage in disordered eating may also have low estrogen.
• Breast cancer: Long-term exposure to high levels of estrogen—naturally occurring or from some forms of birth control or hormone replacement therapy (HRT)—may increase your risk of breast cancer. HRT comes with both health benefits and risks, which may be higher in some people. Your healthcare professional can help determine whether the benefits of HRT outweigh the risks.
• Endometriosis: Estrogen doesn’t cause endometriosis, but it may worsen endometriosis pain.
• Female sexual dysfunction: Falling estrogen levels can cause physical and emotional changes that make sex less enjoyable. However, estrogen isn’t considered for hormone replacement until you’re menopausal.
• Fibrocystic breasts: Fluctuating estrogen levels during your menstrual cycle may make your breast tissue feel lumpy, tender, or uncomfortable.
• Infertility: Low and high estrogen can disrupt your menstrual cycle. Underlying causes that can lead to low and high estrogen may be associated with infertility.
• Obesity: Estrogen levels are often higher among people with more body fat.
• Osteoporosis: Low estrogen levels can weaken your bones so that they fracture and break more easily.
• Polycystic ovary syndrome (PCOS): PCOS is a condition that occurs when the ovaries produce too many androgens (hormones associated with being male). Sometimes, with PCOS, estrogen levels are too high in relation to progesterone levels.
• Primary ovarian insufficiency: With this condition (also known as premature menopause), the ovaries prematurely stop producing eggs (before age 40). As a result, your ovaries don’t secrete the estrogen your body needs.
• PMS and PMDD: The cyclical hormone changes associated with menstruation can lead to unpleasant physical symptoms and mood changes. Dips in estrogen following ovulation are a potential cause of PMS and PMDD.
• Turner syndrome: This is a genetic condition in which the ovaries are often underdeveloped, resulting in low estrogen. As a result, if you have this condition, you may not develop breasts or get your period.
• Uterine cancer (endometrial cancer): High estrogen levels may cause the lining of your uterus to build up. Eventually, cancer cells may start to grow.
• Uterine fibroids and polyps: Too much estrogen may be associated with noncancerous tumors called fibroids or polyps that grow in your uterus.
• Vaginal atrophy (atrophic vaginitis): Too little estrogen may cause the lining of your vagina to thin and become dry. Vaginal atrophy is most common during menopause and postmenopause.

Research is ongoing about estrogen’s role in conditions affecting other body systems. For instance, estrogen has been linked to some endocrine disorders and gastrointestinal diseases.

When to See a Professional About Estradiol Levels

As a general rule, you should talk with a healthcare professional, like a Midi clinician, about any health changes or concerns that pop up—hormonal or otherwise. Any new or worsening symptoms warrant scheduling an appointment. This could include frequent irregular periods, heavy bleeding, or menopausal symptoms such as hot flashes and brain fog. Fertility issues also warrant a visit to your healthcare professional. And so do concerns related to medications, such as HRT or hormonal contraception. Bottom line: Don’t brush off any changes you’re noticing. If you’re not feeling like yourself, find a healthcare professional who will work with you to get things back on track. 

Key Takeaways

• When it comes to normal estradiol levels by age, there’s a wide range of what’s considered normal throughout a woman’s life, from puberty to menopause
• During perimenopause and menopause, estradiol (estrogen) can dip and spike so erratically that testing levels isn’t always the best way to determine if you’re in perimenopause
• Healthcare professionals, including Midi clinicians, won’t routinely test estrogen levels in order to provide care for perimenopause and menopause; symptoms are usually a more reliable indicator

Frequently Asked Questions (FAQs)

What is a normal estradiol level by age?

There isn’t a single benchmark the way there is with, say, normal blood pressure levels. Depending on the lab, the ranges may vary slightly from these. That’s why it’s particularly important to discuss your results (if you get tested) with a healthcare professional—to find out what’s normal for you. Here are some common age-by-age estradiol ranges, though:

Pre-puberty (before age 8): 0 to 10 pg/mL

Puberty (ages 8 to 13): 10 to 300 pg/mL

Reproductive age (14 to 39): 10 to 300 pg/mL

Perimenopause (40 to 49): varies, so there is no widely accepted range

Menopause (50 and up): less than 10 pg/mL

What is a bad estradiol level?

Hormone levels that are much higher or lower than normal ranges could signal an issue. That said, experts note that the results of an estradiol blood test are only one factor that your doctor will look at when considering whether your levels are “normal” and what your treatment options should be. Beyond just a “bad” estradiol level, your symptoms will be a much more important factor in your overall care.

How do I read my estradiol results?

If you’re like most people without an MD after their name, then terms like “pg/mL” are understandably not going to mean much to you—but they will to your actual clinician. Leave it to your healthcare professional to walk you through your results and what they could mean for you in the context of your symptoms.    

What is a menopausal level of estradiol?

A typical range is less than 10 pg/mL, which can be as much as 30 times lower than in your reproductive years. When estradiol drops this dramatically (and consistently), you’ll stop ovulating and having periods.

What are the levels of estradiol for fertility?

A normal range of estradiol during your reproductive years is between 10 and 300 pg/mL. Levels that are too low or too high could indicate issues with fertility. Your doctor may test your levels if you’re having trouble conceiving.