Code: 30289N Estradiol, Ultrasensitive, LC/MS/MS (30289X)
https://www.labcorp.com/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os_hACzO_QCM_IwMLXyM3AyNjMycDU2dXQwN3M6B8JG55AwMCuv088nNT9QtyI8oBPK_DWA!!/dl2/d1/L0lDU0NTQ1FvS1VRIS9JSFJBQUlnb0FNeUtibTZtL1lCSkp3NDU0a3N1eWx3ISEvN19VRTRTMUk5MzBPR1MyMElTM080TjJONjY4MC92aWV3VGVzdA!!/?testId=408440&criterion=Estradiol%2C+Sensitive
"The use of a sensitive, LC/MS assay for serum E2 measurement in males is preferred over direct immunoassays because of its greater sensitivity and lesser interference by other steroids.28 In males, estradiol is present at low concentrations in blood, but it is extraordinarily high in semen.4 Estradiol plays an important role in epididymal function and sperm maturation and is essential for normal spermatogenesis and sperm motility.4
Gynecomastia refers to a syndrome of abnormal feminization with swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone.29 Gynecomastia is common during puberty in boys and can be seen in older males due to increased estrogen level-related obesity (increase aromatase activity), decreased hepatic clearance, estrogen ingestion, and estrogen producing tumors. Asymptomatic gynecomastia is common in older men, but individuals who present with gynecomastia of recent onset associated with pain and tenderness may require clinical workup.29 Gynecomastia and other signs of male feminization may be caused by an absolute increase in E2 and/or E1. The testes may directly secrete too much estradiol due to a Leydif-cell or Sertoli-cell tumor. They may also secrete estradiol indirectly through the stimulatory effects of a human chorionic gonadotropin-secreting tumor of gonadal or extragonadal germ-cell origin.29
Alternatively, men with normal estrogen levels can develop gynecomastia, if testosterone levels are low due to primary/secondary testicular failure, resulting in an abnormally elevated estrogen-to-androgen ratio. Feminization may also occur in men treated with antiandrogen therapy or drugs with antiandrogenic effects (eg, spironolactone, digitalis). Conversely, individuals with elevated androgen levels will often exhibit gynecomastia caused by aromatase catalyzed estrogen production.
Estrogens (and androgens) play an important role in the normal physiology of the skeleton in both sexes.4 Males with diminished estrogen levels due to congenital aromatase deficiency or insensitivity to estrogens due to estrogen receptor deficiency have a characteristic phenotype with regard to bone development.4,25,30 These males exhibit significant increased overall height due to lack of estrogen-induced epiphyseal closure.25 The importance of estradiol in bone health is further supported by the fact that estradiol levels correlate better with bone mineral density than do testosterone levels in aging men.25 The Endocrine Society has recently reported that low estradiol levels are associated with increased fracture risk and accelerated bone loss in older men.3"