Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (908 page)

   Gynecomastia

   Hepatic cirrhosis

   Hyperthyroidism

Decreased In

   Primary and secondary hypogonadism

   PCOs

   Eating disorders, anorexia nervosa.

   Limitations

   Oral contraceptives inhibit physiologic increase.

   Estradiol values from pregnant females may be affected by high levels of estriol such as those present in the second and third trimesters of pregnancy.

   Current estradiol assays are sensitive for women of child-bearing age and induction of ovulation monitoring. In contrast, levels in postmenopausal women, men, and prepubertal children <20 pg/mL are not adequate.

   HPLC-MS methods are sensitive and specific compared to immunoassays, and lack of standardization and analytical variations makes test results need to be interpreted with caution.

ESTROGEN/PROGESTERONE RECEPTOR ASSAY

   Definition

   Estrogen and progesterone receptors play a role in hormone-directed transcriptional activation.