Measuring estrogens and progestagens in humans: an overview of methods

Estrogens and progestagens (ovarian steroids) not only play an important a role in sexual behavior and reproduction, but they are involved in the development, regulation, and function of all body systems, including aging, sleep, pain, pharmacodynamics, immune response, and cognition. They are essential to the maintenance of cardiovascular, renal, mental, and bone health. Often, their effects are positive and their absence, negative. However, in certain contexts they can promote the development of cancers and neurologic conditions. Finally, ovarian steroids can even affect the response to pharmacologic treatments for many diseases. Given their central role in human biology, it is essential to be able to accurately determine the circulating levels of these hormones. To facilitate such endeavors, this review provides a comprehensive overview of the role of ovarian steroids in normal and abnormal physiology, primarily in women. It discusses the sensitivity, specificity, and precision of the most commonly used assays for estrogens and progestagens: bioassay, immunoassay, and mass spectrophotometry. Examples of how each of these assays has been used with samples taken from serum, urine, and saliva are provided. Strengths and limitations of each method are discussed.