In a Position Statement unveiled today, The Endocrine Society advocates that all methods for measuring estrogens, which play a crucial role in human biology, be made traceable to a common standard.
In addition to the well-known role of estrogens in sexual development, these hormones, particularly estradiol, have a significant impact on the health of the skin, blood vessels, bones, muscle, kidney, liver, digestive system, brain, lung and pancreas. Studies have linked changes in estradiol levels to coronary artery disease, stroke and breast cancer.
"Estradiol levels need to be accurately, precisely and consistently measured to provide the proper care for patients from the cradle to the grave," said the statement's lead author, William Rosner, MD, of Columbia University. "Health care providers rely on estradiol testing to diagnose and help treat a variety of conditions, including infertility, osteoporosis and breast cancer. Current testing methods need to evolve to meet patients' needs."
The statement identifies a number of issues with the current testing methods used for a typical patient's care. Most of the tests used in the clinical setting cannot detect the low estradiol concentrations found in men, children, menopausal women and breast cancer patients taking drugs that decrease estradiol levels. In addition, other compounds in the body can interfere with the testing, leading to results that can be 10 times the true estradiol level. Quality assessments have found large variations in measurements performed by different laboratories or with different pieces of equipment. Accurate results are needed so that diagnoses are not missed, and patients and health care providers can make informed decisions about treatment options.
In addition, current testing methods limit the ability to generalize results from any given study to the population at large. Furthermore, in the current environment, data from different studies often cannot be compared because measurements and standards were not uniform.
Although a "gold standard" estradiol testing method using mass spectrometry exists, its cost and complexity have discouraged many clinical and research laboratories from implementing this approach.