Test tube of blood for Estradiol test

Sensitive Assay Estradiol Test Vs Regular Estradiol Test – Which Do You Need And Why

Why You Need To Get A Sensitive Assay Estradiol Test

The standard hormone profiles by default include the cheaper FDA-approved Roche ECLIA (Electrochemiluminescence Immunoassay) methodology.

That test is wildly inaccurate in men, unfortunately.

Most men get by default when they get blood work done, and consequently receive an inaccurate result.

As a result, men will get skewed results that often lead them to using aromatase inhibitors when they don't need them, or using a dosage that is too high or too low for their needs.

As you can imagine, this can have detrimental effects on a man's quality of life and health, not to mention make it nearly impossible for him to nail down his Estrogen to a healthy spot.

To illustrate just how significant of an issue this can be, I compared the results of a Sensitive Assay Estradiol Test to a regular Estradiol Test conducted on the same blood sample.

The goal was to see how much the results of the two methods varied, and to assess whether the default Estradiol blood test is even viable for men.

Results Of My Blood Tests

The first thing I looked at was my result from the default Estradiol test that most labs use.

Roche ECLIA Methodology Estradiol Test Results

Estradiol Results - Roche ECLIA Methodology

My estradiol levels using the traditional default Roche ECLIA methodology was 36.8 pg/mL, which is on the high end of normal.

Not too high, but 30 pg/mL is my usual target.

You can see the normal range is from 7.6 to 42.6 pg/mL.

Some guys would see this and logically think to themselves, “Okay, so things look pretty good, maybe I could use a bit of an AI to bring me down closer to 30.”

I had the same blood tested using Liquid chromatography tandem mass spectrometry (LC/MS/MS) which is not an FDA approved test.

As you would expect, the LC/MS/MS test is more expensive as well.

This test was developed to measure Estradiol with greatly increased sensitivity in postmenopausal women, men, children and adolescents [R].

The Sensitive Assay Estradiol test should be the default for men in my opinion, as it has vastly different results.

Most men won't go out of their way to add this to their cart separately, or opt for a more expensive panel to get this included when they get their blood work done.

I assure you, it's worth the additional price to see what's actually going on.

Sensitive Assay Estradiol Test Results

This was the result of the sensitive assay test conducted on the same sample:

Estradiol Results - Sensitive Assay Estradiol Test

As you can see in the image above, my Estradiol levels are actually only at 9.9 pg/mL.

If you know how to interpret estrogen levels, you would know that a 9.9 pg/mL result, despite it being in the normal range, is on the extreme low end of normal and could very likely lead to negative outcomes.

Use of Sensitive Assay Estradiol test for serum e2 snippet

The Potential Harm Of A False Reading On An Estradiol Test

The difference between the sensitive assay estradiol test and the regular estradiol test is massive.

The difference in my test result was almost 30 pg/mL, which is practically the entire reference range.

If you think you're at 36.8 pg/mL and think to yourself, “Oh, I could probably use a bit of Aromasin to bring me down to 30 pg/mL,” but you're only actually at 9.9 pg/mL and then you use Aromasin and tank it even further, you can just imagine what's going to happen.

Here are some of the potential side effects of low estrogen:

  • Dull weak orgasms
  • Dry skin and lips
  • Dehydration
  • Erectile dysfunction
  • Low libido
  • Irritability
  • Mood swings
  • Loss of appetite
  • Fatigue
  • Lethargy
  • Dry, achy joints
  • Bone degeneration
  • Decreased muscle growth
  • Decreased fat loss

You could inadvertently cause all of these issues, and exacerbate them even further by using an inappropriate aromatase inhibitor dosage that isn't congruent with your body's actual needs.

You could think you need an even higher dosage of your AI because you're having libido or ED issues, pop some Aromasin and then screw yourself up even more.

This is extremely common, and often times doctors will prescribe predetermined dosages of AI's without even looking at your E2 levels at all, let alone looking at the accurate version of the test, which still baffles me to this day how much harm ignorant doctors cause to their patients on TRT with idiotic AI protocols.


It's very important that you get the Sensitive Assay Estradiol test added to your blood work if it is not already included in your panel.

It's the difference between you potentially screwing yourself up and not screwing yourself up.

It's especially critical if you're on TRT or PED's that you know exactly how much aromatization is actually occurring in your body.

If you are crashing your E2 into the ground for no reason, you're unnecessarily impairing your health and quality of life.

In the example above, I need more Estrogen in my body and should not use an AI at all, or should lower the dose accordingly if I were on one.

You will operate at a much higher quality of life with E2 levels closer to 30 pg/mL rather than 9 pg/mL, as well as build more muscle.

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11 thoughts on “Sensitive Assay Estradiol Test Vs Regular Estradiol Test – Which Do You Need And Why”

  1. Thank you a lot for all the information you give, I’m living in a country where the only test for estradiol available are the Immuno-Elisa or radioimmunoassay, and there’s no international lab that ship here, I don’t really know what to do to figure out what my estrogen levels are , thanks.

  2. I just wanted to thank you for this article and tell you a story about how it helped me on my TRT.

    I have been on TRT for over 10 years and recently added finasteride for hair loss prevention. Before finasteride my total T was around 600-700 and i felt pretty good. My TRT dose at this time was 80 mg test cyp per week spread out into 2 doses. (my genius doctor never tested estrogen and i didn’t know any better at the time)

    After adding finasteride my Total T went up to around 1050, my SHBG also increased to above 80. My SHBG was around 40 before finasteride, and my free T went down to the bottom of the range despite having high total T.

    My doctor basically freaked out at the higher total T levels and cut my TRT dose in HALF down to 40mg a week of test CYP, which brought my Total T down to around 600. I felt like absolute ass BTW, but i guess all she cared about was the number.

    After a while of this i complained how terrible i felt and i felt emotional/irritable all the time (also libido issues). She finally tested my estrodial (NOT the sensitive test) and it came back at 70, so she assumed my issues i was having were high caused by the high-ish estrogen. she prescribed anastrazole at 1mg EOD. I did NOT take it, because around the same time i read this article and started watching your videos.

    I paid to get the sensitive estradiol test done myself and it came back at… 12. I am so glad i did not take the AI because it just would have made things worse. Instead i increased my testosterone dose to 100mg a week and i’m feeling amazing now. My sensitive estradiol is 25 and my Free T is right in the middle of the range. My Total T is above 1000 since im on Finasteride and have high SHBG but i feel great now.

    Anyway long story short thanks for all you do, saved me a lot of hardship.

    1. That’s great to hear and I’m glad I could help man. That is a perfect example of why it is so crucial to do your own research.

  3. I ran Clomid for two weeks of PCT from a seven-week RAD140, then started straight into a Test E cycle.
    I am going to my doctor to get some blood work, but I’m nearly certain i crashed my e2.
    Should i stop my test E cycle or are there other things i can use to bring my e2 back into normal range?

  4. Hi!
    I did my bloodwork mid cycle. I am on 500mg test e /w and 250mg eq /w. Every blood component is in range. LDL,HDL is in range. I did e2 because I felt like I have high levels and ohh boy it is 760,0 pmol/l (its 207 pg/ml done it with a converter http://www.endmemo.com/medical/unitconvert/Estradiol.php) reference top is 100 pmol/l . I am already on 0,5mg anastrozole eod. I bumped it up to 1mg/ed see how it goes. Will do another bloodwork for e2 in days. I asked if it is a high sensitivity test, the lady said in the phone she doesn’t know. I found no info in my country about sensitive test. lol My bloodpressure lowered when started to take ai. Have a good sexdrive. Do not really feel the sides either low or high e2. What do you think?

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