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Estrogen Metabolism Assessment

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Estrogen Metabolism Assessment


Assessing the 2/16 Ratio in Estrogen Metabolism

The Estrogen Metabolism Assessment™ is a convenient, at-home urinary collection profile. This targeted hormone assessment measures select hydroxyestrogens:

- 16α-hydroxyestrone (16α-OH E1)

- 2-hydroxyestrone and 2-hydroxyestradiol (2-OHE1 + 2-OHE2)

The ratio of 2/16 hydroxyestrogens is calculated based on these results.

Why use the Estrogen Metabolism Assessment Profile?

Estrogen metabolism and the ratio of 2-hydroxyestrogens to 16α-hydroxyestrone has been used to identify patients at risk for cancer and other hormone-related diseases in both men and women.1-5 Relative increases in levels of the 2-hydroxylation pathway metabolites are associated with decreased risk.1,6


How can the results be clinically useful?

Knowing the 2/16 ratio is clinically important since estrogen metabolism may be modified by a variety of dietary and lifestyle changes, including, but not limited to:

- exercise

- smoking cessation

- cruciferous vegetables

- essential fatty acids

- flaxseed 7-11

What other profiles can offer insight into Estrogen Metabolism?

The Estrogen Metabolism Assessment profile is a sub-panel of two other available urinary hormone profiles:

- Complete Hormones is our most comprehensive urinary profile. It assesses parent hormones, downstream metabolites, methylation and enzymatic activity, and other key metabolic pathways. An evaluation of stress-hormone metabolism is also provided as an assessment of anabolic and catabolic balance.

- Essential Estrogens is a targeted, focused evaluation of estrogen metabolism, including parent estrogens, key estrogen metabolites, and ratios.

Both are available as a first morning void sample or 24-hour collection for those on hormone therapy. Genetic single nucleotide polymorphisms (SNPs) are available as add-ons to these profiles for a combined genotypic and phenotypic assessment.       


- Sampson JN, Falk RT, Schairer C, et al. Association of estrogen metabolism with breast cancer risk in different cohorts of postmenopausal women. Cancer Res. 2017;77(4):918-925.

- Muti P, Westerlind K, Wu T, et al. Urinary estrogen metabolites and prostate cancer: a case-control study in the United States. Cancer Causes Control. 2002;13(10):947-955.

- Leelawattana R, Ziambaras K, Roodman-Weiss J, et al. The oxidative metabolism of estradiol conditions postmenopausal bone density and bone loss. J Bone Mineral Res. 2000;15(12):2513-2520.

- Napoli N, Faccio R, Shrestha V, Bucchieri S, Rini GB, Armamento-Villareal R. Estrogen metabolism modulates bone density in men. Calcif Tissue Int. 2007;80(4):227-232.

- Sepkovic DW, Bradlow HL. Estrogen hydroxylation--the good and the bad. Ann N Y Acad Sci. 2009;1155:57-67.

- Samavat H, Kurzer MS. Estrogen metabolism and breast cancer. Cancer Lett. 2015;356(2 Pt A):231-243.

- Matthews CE, Fortner RT, Xu X, Hankinson SE, Eliassen AH, Ziegler RG. Association between physical activity and urinary estrogens and estrogen metabolites in premenopausal women. J Clin Endocrinol Metab. 2012;97(10):3724-3733.

- Gu F, Caporaso NE, Schairer C, et al. Urinary concentrations of estrogens and estrogen metabolites and smoking in caucasian women. Cancer Epidemiol Biomarkers Prev. 2013;22(1):58-68.

- Kall MA, Vang O, Clausen J. Effects of dietary broccoli on human in vivo drug metabolizing enzymes: evaluation of caffeine, oestrone and chlorzoxazone metabolism. Carcinogenesis. 1996.

- Fowke JH, Longcope C, Hebert JR. Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2000;9(8):773-779.

- Lord RS, Bongiovanni B, Bralley JA. Estrogen metabolism and the diet-cancer connection: rationale for assessing the ratio of urinary hydroxylated estrogen metabolites. Altern Med Rev. 2002;7(2):112-129.

Test Type: Urine Test


Upon purchase of this exam, you are able to schedule a free 15-minute phone consultation with Dr. Bob to discuss your results.

Refund Policy: Due to the nature and integrity of our suppliers, all sales of testing services are final and non-refundable. Thank you.

New Consultation & Lab Test Policy (EFFECTIVE AUG 2021): At this time, we are only servicing online consultations and lab tests with individuals located in the U.S. Thank you for your understanding.

Refund and Return Policy: Due to the integrity and time restraints related to our products, as well as our COVID-19 protocols, ALL sales are final. No refunds or exchanges will be given. No warranties, either implied or expressed, are offered on our products. Any order cancelled within 24 hours will be given a full refund, less $7.50 to cover all operating expenses incurred on said order.

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