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Endocrinology

Estradiol, ultrasensitive, LC/MS (Male)

Other names: ESTRADIOL,ULTRASENSITIVE, LC/MS

Optimal Result: 0 - 29 pg/mL.

What Is Estradiol, Ultrasensitive, LC/MS (Male)?

Estradiol, Ultrasensitive, LC/MS is a highly accurate test that measures very low levels of estradiol (E2)—the most potent form of estrogen—in the male body. This version uses liquid chromatography-tandem mass spectrometry (LC/MS or LC-MS/MS), a gold-standard method for hormone testing, especially when precise measurement at low concentrations is required.

In men, estradiol is mainly produced through the conversion of testosterone via the enzyme aromatase. While estrogen is often thought of as a female hormone, estradiol plays several important roles in male health, including maintaining bone density, supporting mood and cognitive function, regulating libido, and contributing to cardiovascular health.

Why Use the “Ultrasensitive” LC/MS Method?

Standard estradiol tests may not accurately detect the low estradiol levels typically found in men. The ultrasensitive LC/MS test offers much greater accuracy and is particularly useful for:

  • Monitoring men on testosterone replacement therapy (TRT)

  • Evaluating symptoms of hormonal imbalance, such as low libido, gynecomastia, or mood changes

  • Assessing fertility concerns or estrogen-producing tumors

Reference Range (Adult Males):
≤ 29 pg/mL

What Do Abnormal Results Mean?

  • Elevated estradiol may result from increased conversion of testosterone to estrogen, which is more common in men with higher body fat, liver dysfunction, or those taking certain medications. Symptoms can include fatigue, weight gain, gynecomastia (breast tissue development), and reduced libido.

  • Low estradiol levels in men can contribute to reduced bone density, cognitive issues, and may affect sexual function—even if testosterone levels are normal.

In summary, Estradiol, Ultrasensitive, LC/MS is a valuable tool for understanding subtle hormonal imbalances in men and is particularly useful when precise hormone tracking is needed for diagnosis or treatment monitoring.

What does it mean if your Estradiol, ultrasensitive, LC/MS (Male) result is too high?

Elevated estradiol levels in men—especially when measured using the ultrasensitive LC/MS method and found to be above 29 pg/mL—can indicate a hormonal imbalance, often involving excess conversion of testosterone into estrogen (a process called aromatization).

Here’s what elevated estradiol might suggest in men:

1. Increased Aromatase Activity

  • Aromatase is the enzyme that converts testosterone to estradiol.

  • Higher aromatase activity is often linked to excess body fat, especially abdominal fat.

  • This can lead to a disrupted testosterone-to-estrogen ratio, even if total testosterone is within the normal range.

2. Symptoms of Estrogen Dominance

When estradiol is elevated, and not balanced by sufficient testosterone, men may experience:

  • Low libido or erectile dysfunction

  • Fatigue or low energy

  • Gynecomastia (breast tissue development)

  • Increased abdominal fat or difficulty losing weight

  • Mood swings, irritability, or depression

3. Medication or Supplement Effects

Certain drugs and supplements can raise estradiol levels, including:

  • Testosterone therapy (especially without an aromatase inhibitor)

  • Anabolic steroids

  • Spironolactone, some antidepressants, and anti-fungal medications

  • Phytoestrogens from supplements or a high soy intake

4. Liver or Kidney Dysfunction

  • The liver is responsible for breaking down and clearing estrogen.

  • Impaired liver or kidney function can lead to a build-up of estradiol in the blood.

5. Rare Causes

  • Estrogen-producing tumors (very uncommon)

  • Genetic conditions affecting hormone metabolism

Why It Matters:

Persistently high estradiol in men can interfere with sexual function, mood, metabolism, and bone health. It may also reduce the effectiveness of testosterone (whether natural or from therapy) by altering the hormone balance.

If your estradiol level is elevated, it's important to also assess:

  • Total and free testosterone

  • SHBG (sex hormone-binding globulin)

  • LH and FSH

  • Possibly estrone, prolactin, and liver function markers

This helps uncover the root cause and guide treatment, which may include lifestyle changes, adjusting medications, or using an aromatase inhibitor under medical supervision.

Frequently asked questions

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