Practical aspects of laboratory monitoring of estrogens in men

Since the discovery of estrogens in the 30s of the XX century, scientific and practical interest in them has been concentrated exclusively from the standpoint of female endocrinology, and the physiology and pathophysiology of estrogens in men, due to the historically established interpretation of the role of these steroids exclusively as female sex hormones, have remained practically unexplored for a long time. However, according to the classical theory of steroidogenesis, estrogens are the end product of this biochemical process, and testosterone, in addition to its well-known independent functions in the male body, also acts as their biochemical precursor. Therefore, normal endocrinology of sex steroids in men is in principle impossible without the participation of estrogens, and over the past decades, convincing scientific data have been accumulated indicating important physiological functions of estrogens in the male body. The review article, based on the literature of recent years, briefly examines the key aspects of clinical endocrinology of estrogens in men and describes in more detail the modern possibilities of methods for laboratory monitoring of estrogens in blood serum in men and some diagnostic tools that allow a more complete and objective interpretation of the results of laboratory methods for determining estrogens, in particular, testosterone/estradiol ratio. It is shown that the calculation of this ratio is a more reliable method for assessing estrogen metabolism disorders in routine clinical practice than the separate determination of serum levels of sex steroids, and can be considered as an important marker of various diseases in men.