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Home › Genova Diagnostics › Essential Estrogens™
Genova Diagnostics · Official Swedish Distributor
Estrogen Metabolism · Urine-Based (FMV)

Essential Estrogens™
How your estrogen breaks down.

Measures not just estrogen levels — but how estrogen is metabolised. Identifies protective and harmful metabolites affecting risk for hormone-driven conditions.

Order Essential Estrogens™ — 6 800 kr

The test kit is shipped to your home. Includes 2 months access to meet mario.

Hormone-Driven Conditions Breast Cancer Risk PMS Endometriosis Menopause Methylation
UrineSpecimen (FMV)
8Estrogen metabolites
HomeCollection — kit shipped
14–21Days turnaround
Global Constraint Rule

Why estrogen metabolism must be measured

Serum estrogen levels tell you what is circulating. Essential Estrogens tells you what happens to estrogen afterwards — how it is broken down, which metabolites are formed, and whether they protect against or increase the risk of hormone-driven conditions.

2-OH metabolites are protective. 4-OH metabolites can form DNA adducts with carcinogenic potential. 16-OH metabolites are potently estrogenic. The ratio between these determines the risk profile — and the COMT enzyme, whose function is affected by genetic variants, governs critical steps of the breakdown pathway.

GCR — Estrogen metabolism in the constraint hierarchy

COMT rs4680 (Val/Met, Met/Met) impairs detoxification of catecholestrogens (4-OH) and potentially increases risk of hormone-driven cancers. Essential Estrogens confirms whether the genetic risk is actually expressed functionally — invisible in conventional serum estrogen tests.

GCR Protocol · Three diagnostic layers

Essential Estrogens is always interpreted in context with WGS and CMA

1
WGS genomic analysis identifies CYP1B1, CYP1A1 and COMT variants that govern estrogen hydroxylation and catecholestrogen detoxification. Essential Estrogens confirms whether the genetic risk variants are actually expressed functionally.
2
Essential Estrogens FMV maps the eight estrogen metabolites — E1, E2, E3 and their 2-, 4- and 16-hydroxylated breakdown products — and determines whether estrogen metabolism is protective or risk-increasing.
3
CMA intracellular nutrient analysis confirms whether the cofactors required for phase 2 detoxification — magnesium, B6, folate — are present inside the cells. COMT is magnesium-dependent — magnesium deficiency directly impairs catecholestrogen detoxification.
What It Measures

Five clinical measurement domains

Domain 01 · Estrogens

Estrogen Profile

Estrone (E1), estradiol (E2) and estriol (E3) are measured in urine via fasted morning void sample. Provides the complete estrogen profile in functional context rather than as a snapshot value in serum.

Domain 02 · Protective Metabolites

2-OH Metabolites

2-hydroxy-estrone and 2-hydroxy-estradiol are protective estrogen metabolites with weak estrogenic activity. High 2-OH production via the CYP1A1/1A2 pathway is associated with lower risk of estrogen-driven cancer.

Domain 03 · Risk Metabolites

4-OH Metabolites

4-hydroxy-estrone and 4-hydroxy-estradiol are potentially harmful metabolites that can form DNA-reactive quinone complexes. The COMT enzyme detoxifies 4-OH metabolites via methylation — impaired COMT function increases 4-OH accumulation.

Domain 04 · Estrogenic Activity

16-OH Metabolites

16-alpha-hydroxy-estrone is a potently estrogenic metabolite. Elevated 16-OH production is associated with increased proliferative signalling in estrogen-receptor-positive tissue — breast, endometrium, cervix.

Domain 05 · Methylation

Methylation Activity

2-methoxyestrone and 4-methoxyestrone are measured as indicators of COMT enzyme function. These methylated metabolites are inactive and safe. The methylated/unmethylated ratio confirms COMT activity's actual clinical expression.

Sample Report

What your results look like

The Essential Estrogens report shows the eight estrogen metabolites with clinical ratio calculations — the 2-OH/16-OH ratio, methylation index and catabolic/anabolic estrogen balance.

Essential Estrogens sample report — estrogen metabolism map and steroidogenic pathways

Five clinical domains

  • 01 Estrogens — estrone (E1), estradiol (E2), estriol (E3)
  • 02 2-OH Metabolites — protective estrogen metabolism
  • 03 4-OH Metabolites — potentially harmful metabolites
  • 04 16-OH Metabolites — estrogenic activity and cancer risk marker
  • 05 Methylation Activity — COMT enzyme function and phase 2 detoxification
View full sample report (PDF) →
GCR Protocol

How we work with Essential Estrogens findings

The estrogen metabolism profile is the starting point for a hormonal protection protocol that addresses risk metabolites with precisely targeted interventions.

01
Clinical Consultation & GCR Prioritisation
45-minute review of hormonal symptom picture, family history and risk factors. The GCR framework determines whether Essential Estrogens is the primary investigation or whether parallel analyses are indicated. Familial breast cancer risk or estrogen-driven symptoms always warrants an estrogen metabolism profile.
GCR AssessmentClinical History
02
Sample Collection & Laboratory Analysis
The kit is shipped to your home. Urine is collected as fasted morning void (FMV) — first morning urine in a fasting state. The sample is shipped directly to Genova's laboratory with a prepaid return envelope. Turnaround 14–21 days.
Home CollectionFMV UrineCLIA-Certified
03
Multi-Layer Analysis & Interpretation
The estrogen metabolism profile is interpreted by Dr Mario Anthis in context with WGS and CMA data. Elevated 4-OH is cross-referenced against COMT rs4680 genotype (WGS). Methylation index is linked to intracellular magnesium and B6 status (CMA).
Multi-Layer AnalysisGCR HierarchyPrioritisation
04
Targeted Estrogen Intervention
Based on the metabolite profile, a hormonal protection protocol is designed: DIM (diindylmethane) for elevated 4-OH to stimulate the 2-OH pathway, magnesium and methylfolate for impaired COMT function, I3C/cruciferous support for CYP1A1 induction, reduction of 16-OH via specific phytonutrients. Follow-up after 6 months.
Targeted Treatment6 MonthsFollow-Up
Why MediBalans

What sets us apart

01

Estrogen metabolism is never interpreted in isolation

At MediBalans, Essential Estrogens is cross-referenced with WGS genomic data (CYP1B1, COMT) and CMA intracellular nutrient status (magnesium, B6, folate). It is the combination that reveals whether the genetic risk is functionally expressed and whether cofactor deficiency is driving the risk profile.

02

Official Genova Distributor

MediBalans is Genova's official Swedish distributor with a direct laboratory relationship and full access to all Genova panels.

03

We sell no supplements

MediBalans sells no supplements. All recommendations — DIM, magnesium, methylfolate — are based exclusively on what the metabolite measurements and genomic data show.

FAQ

Questions about Essential Estrogens

Essential Estrogens measures the eight primary estrogen metabolites in urine — estrone (E1), estradiol (E2), estriol (E3) and their hydroxylated breakdown products via the 2-OH, 4-OH and 16-OH pathways. FMV (Fasted Morning Void) is the preferred collection method for hormone metabolites as it reflects the body's detoxification activity overnight without dietary interference.

2-OH metabolites are protective — weak estrogenic activity, efficiently methylated by COMT to inactive forms. 4-OH metabolites are potentially harmful — they can form reactive quinone adducts with DNA if COMT detoxification is impaired. 16-OH metabolites are potently estrogenic and associated with proliferative signalling in estrogen-receptor-positive tissue. Clinical guidelines indicate that the 2-OH/16-OH ratio should exceed 2.0 for optimal risk profile.

The methylation index measures the actual activity of the COMT enzyme — how efficiently catecholestrogens are methylated to inactive methoxy forms. An impaired methylation index indicates that 4-OH metabolites are not being detoxified quickly enough, increasing the risk of DNA adduct formation. COMT is magnesium-dependent — magnesium deficiency, which is common and invisible in standard tests, directly impairs COMT activity.

Essential Estrogens is indicated for familial breast cancer risk, estrogen-driven fibrocystic breast disease, endometriosis, PMS, menopausal symptoms and for known COMT or CYP1B1 variants on WGS. It is particularly valuable when serum estrogen is normal but estrogen-driven symptomatology persists — a discordance often explained by an unfavourable metabolite profile rather than absolute estrogen levels.

Related Tests

Often combined with Essential Estrogens

Complete Hormone Panel · Genova

Women's Health Plus+ — Complete Hormone Panel

Women's Health Plus+ includes estrogen metabolism, sex hormones, cortisol, DHEA and melatonin in a comprehensive panel. Recommended for complete hormonal picture.
Genomic · Genova

MethylDetox — 38 Methylation Genes

MethylDetox reveals CYP1B1 and COMT variants that govern estrogen hydroxylation and detoxification. Provides the genetic framework for Essential Estrogens interpretation.
Intracellular · Cell Science Systems

CMA — Cellular Micronutrient Analysis

CMA confirms whether magnesium, B6 and folate — the COMT cofactors — are low inside the cells. The combination gives cause and remedy.

Essential Estrogens™ — the only test of its kind in Sweden

A fact-based comparison.

MediBalans / Essential Estrogens™ GetTested Werlabs / Oestrogen Standard blood test
Measures oestrogen metabolism✓ (8 metabolites)———
2-OH metabolites (protective)✓———
4-OH metabolites (potentially harmful)✓———
16-OH metabolites✓———
COMT methylation activity✓———
2/16 ratio (cancer risk marker)✓———
Oestrogen levels (E1, E2, E3)✓—✓✓ (E2)
LaboratoryGenova, CLIA-cert., USA—KarolinskaRegional lab
Physician interpretation✓ Always included—PartialVia referral
PriceSEK 6,800Not available~SEK 500SEK 0–200

No other provider in Sweden measures oestrogen metabolism. It is the only information that determines whether your oestrogen is broken down via protective or harmful pathways — and is critical for risk assessment with hormone therapy.

Next Step

Map your
estrogen metabolism.

Essential Estrogens is interpreted by Dr Mario Anthis in context with your WGS and CMA findings. Book a consultation to determine which combination of tests is indicated for your specific presentation.

Order Essential Estrogens™ — 6 800 kr Book Consultation

The test kit is shipped to your home. Includes 2 months access to meet mario.

meet mario