Progesterone–estrogen balance marker
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About β-Pregnanediol / Estradiol (E2)
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About β-Pregnanediol / Estradiol (E2)
Overview and History
β‑Pregnanediol is a primary urinary metabolite formed after progesterone is metabolized by the liver and conjugated for excretion. Estradiol (E2) is the most bioactive form of estrogen in many tissues. The ratio of β‑pregnanediol to estradiol therefore reflects downstream progesterone activity relative to circulating estrogen signals.
Clinically, urinary pregnanediol measures have been used for decades as noninvasive markers of luteal progesterone production and ovulatory status. When paired with direct estrogen measures, the ratio provides insight into production, metabolism, and clearance pathways that affect reproductive timing, end-organ signaling, and downstream metabolic effects.
Interpreting Highs and Lows
A higher β‑pregnanediol/E2 ratio may reflect relatively greater progesterone metabolism or lower estradiol exposure — for example, robust luteal progesterone excretion or shifts in estrogen clearance. Conversely, a low ratio may reflect relatively lower progesterone metabolite output versus estradiol, which can be seen when ovulation is absent, luteal progesterone is reduced, or estrogen activity is comparatively higher. Interpretation depends on sample timing (cycle phase), other sex hormone and metabolite results, and measurements of adrenal and metabolic markers in the full panel.
Featured Test
Included in the Hormone Zoomer to quantify the balance between progestogenic and estrogenic signaling via a urinary metabolite-to-hormone comparison. This marker helps assess ovulatory and luteal activity, relative estrogen exposure, and metabolic clearance patterns that inform individualized evaluation and monitoring within an integrated endocrine picture.
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Mary Beth Augustine
DCN, RDN, FAND- Lead Clinical Educator
Suzanne Barker
MS, RDN, LD, CTTS, CGP- Clinical Educator
Suzette Garcia
MSc- MHNE- Clinical Educator
Brooke Mader Ganev
MS, CNS, LDN, FDN- Clinical Educator
Adair Anderson
MS, RDN, LDN- Clinical Educator
Lillie Luu Nguyen
DCN, CNS, LDN- Clinical Educator
Jason Barker
ND- Clinical Educator
Emaline Brown
ND- Clinical Educator
Dana Filatova
DCN, CNS, LDN- Clinical Educator
Jessy Dhanjal
ND- Clinical Educator
Nour Amri
MS, LDN, CNS, CKNS- Clinical Educator
