Urine
Estrogen Metabolites
Investigation of the five estrogen metabolites and their relative strengths
€ 285,00
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Hormones · Urine
4-hydroxy-estrone (4OH-estrone)
Breakdown product of estrone via a smaller breakdown route; mainly measured in scientific research.
At a glance
- Measured in urine
- In 1 test panel
- Check the preparation
Explanation
4-hydroxy-estrone (4OH-estrone): what is measured?
4-hydroxy-estrone is formed when an OH group is attached at the 4 position of estrone; this is a smaller breakdown route than the 2 route. It is further converted by the enzyme COMT into 4-methoxy-estrone. Because it is present in the urine in only small amounts, the measurement is especially sensitive to differences between measurement methods.
What can it detect?
- No recognized condition: the result is a snapshot of estrogen breakdown and is not validated for a diagnosis
- The effect of the menstrual cycle, menopause, hormone use, body weight, diet and medicines on the amount of estrogen and its breakdown
Result
What does the result mean?
4-hydroxy-estrone (4OH-estrone) too high
A raised value usually means there was more estrogen to break down, for example around ovulation or in the second half of the cycle, during pregnancy, with overweight (fat tissue makes estrone) or with the use of hormones such as menopausal hormone therapy. Diet, such as a lot of cabbage-family vegetables, alcohol and medicines can also change the ratio between the breakdown routes. A high value or a particular ratio is not a diagnosis and does not mean the breakdown is 'healthy' or 'unhealthy'.
4-hydroxy-estrone (4OH-estrone) too low
A low value usually means there was little estrogen, such as after menopause, in men, during menstruation or early in the cycle, with use of the contraceptive pill (which suppresses the body's own production), or with a lot of exercise or eating little. Diluted urine also gives lower values. A low value of one breakdown product does not mean a breakdown route is 'not working properly'.
After an abnormal result
An abnormal result is no reason for further tests or treatment, because there are no cutoff values and its meaning is not established. With symptoms such as irregular or absent periods or menopausal symptoms, the GP assesses the symptoms themselves and has hormones measured in blood if needed.
Reliability
How reliable is the test?
The test is not validated for clinical decisions: there are no cutoff values at which a doctor would do anything differently. The measurements are mainly used in scientific research. Different measurement methods give clearly different results for the same urine, especially at low amounts such as after menopause and in men; as a result, results from different laboratories cannot be compared. With symptoms, hormone levels in blood, such as estradiol and FSH, say more about the hormone balance.
What can affect the result?
- The values vary strongly with the phase of the menstrual cycle; without a fixed collection time, results cannot be compared.
- Hormone use (contraceptive pill, menopausal hormone therapy, estrogen cream) and pregnancy change the values strongly.
- Diet (including cabbage-family vegetables), alcohol, body weight, smoking and some medicines affect the breakdown routes.
- Measurement methods and reference values differ greatly between laboratories, and a single urine sample depends on how much you have drunk.
Preparation
- Do not eat for 8 hours before collecting the sample. Do not drink much the evening before, no more than 300 to 500 ml.
- Collect the first morning urine, the middle part of the stream.
- Do not collect urine during your period.
- Write your cycle day on the request form, because the values change with your cycle.
Who it is for
Who is the test useful for?
Useful for
There is no group in whom the result has been shown to say something about health or disease. Not useful for assessing hormonal symptoms, menstrual symptoms, menopausal symptoms or health risks, or for choosing supplements, a diet or hormones based on it, because there are no cutoff values and the values vary strongly. With symptoms related to the cycle or menopause, the GP assesses the symptoms and has hormones measured in blood if needed.
How common is it?
No condition is diagnosed with this test, so there is no figure for how often an abnormal result means something.
Get tested
4-hydroxy-estrone (4OH-estrone): test panels
4-hydroxy-estrone (4OH-estrone) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results