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id="sidebar-title">Contents</span></div><div id="sidebar-contents"><div class="toc-h1"><a id="heading-0" href="index.html#top" class="toc-link">Top of page</a><div><div class="toc-h2"><a id="heading-1" href="index.html#preface" class="toc-link">Preface</a></div><div class="toc-h2"><a id="heading-2" href="index.html#estrogen-levels" class="toc-link">Estrogen Levels</a><div><div class="toc-h3"><a id="heading-3" href="index.html#esoterixlabcorp-2020" class="toc-link">Esoterix/LabCorp (2020)</a></div><div class="toc-h3"><a id="heading-4" href="index.html#frederiksen-et-al-2020" class="toc-link">Frederiksen et al. (2020)</a></div><div class="toc-h3"><a id="heading-5" href="index.html#kushnir-et-al-2008" class="toc-link">Kushnir et al. (2008)</a></div><div class="toc-h3"><a id="heading-6" href="index.html#janfaza-et-al-2006" class="toc-link">Janfaza et al. (2006)</a></div><div class="toc-h3"><a id="heading-7" href="index.html#madsen-et-al-2020" class="toc-link">Madsen et al. (2020)</a></div><div class="toc-h3"><a id="heading-8" href="index.html#other-studies" class="toc-link">Other Studies</a></div></div></div><div class="toc-h2"><a id="heading-9" href="index.html#progesterone-levels" class="toc-link">Progesterone Levels</a><div><div class="toc-h3"><a id="heading-10" href="index.html#esoterixlabcorp-2020-1" class="toc-link">Esoterix/LabCorp (2020)</a></div><div class="toc-h3"><a id="heading-11" href="index.html#fisher-salameh--furlanetto--quest-diagnostics-2007" class="toc-link">Fisher, Salameh, & Furlanetto / Quest Diagnostics (2007)</a></div><div class="toc-h3"><a id="heading-12" href="index.html#wu-2006" class="toc-link">Wu (2006)</a></div><div class="toc-h3"><a id="heading-13" href="index.html#kühnel-2000" class="toc-link">Kühnel (2000)</a></div><div class="toc-h3"><a id="heading-14" href="index.html#other-studies-1" class="toc-link">Other Studies</a></div></div></div><div class="toc-h2"><a id="heading-15" href="index.html#androgen-levels" class="toc-link">Androgen Levels</a><div><div class="toc-h3"><a id="heading-16" href="index.html#esoterixlabcorp-2020-2" class="toc-link">Esoterix/LabCorp (2020)</a></div><div class="toc-h3"><a id="heading-17" href="index.html#arup-laboratories-undated" class="toc-link">ARUP Laboratories (Undated)</a></div><div class="toc-h3"><a id="heading-18" href="index.html#other-studies-2" class="toc-link">Other Studies</a></div></div></div><div class="toc-h2"><a id="heading-19" href="index.html#prolactin-levels" class="toc-link">Prolactin Levels</a></div><div class="toc-h2"><a id="heading-20" href="index.html#references" class="toc-link">References</a></div></div></div></div></div></div><div id="main-area"><div id="article"><h1 id="hormone-levels-during-normal-puberty-in-cisgender-girls"> <a href="index.html#hormone-levels-during-normal-puberty-in-cisgender-girls" aria-labelledby="hormone-levels-during-normal-puberty-in-cisgender-girls" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Hormone Levels During Normal Puberty in Cisgender Girls</h1><p>By <a href="../../about/index.html#aly">Aly</a> | First published April 29, 2020 | Last modified April 7, 2023</p><h2 id="preface"> <a href="index.html#preface" aria-labelledby="preface" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Preface</h2><p>This is a collection of published data on hormone levels throughout normal <a href="https://en.wikipedia.org/wiki/Puberty">puberty</a> in cisgender girls. Levels of estrogens (estradiol and estrone), progesterone, and androgens are included. Data are limited to those determined with <a href="https://en.wikipedia.org/wiki/Mass_spectrometry">mass spectrometry</a>-based <a href="https://en.wikipedia.org/wiki/Analytical_technique">analytic techniques</a> wherever available.</p><h2 id="estrogen-levels"> <a href="index.html#estrogen-levels" aria-labelledby="estrogen-levels" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Estrogen Levels</h2><h3 id="esoterixlabcorp-2020"> <a href="index.html#esoterixlabcorp-2020" aria-labelledby="esoterixlabcorp-2020" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Esoterix/LabCorp (2020)</h3><p>Esoterix/LabCorp. (2020). <em>Endocrinology Expected Values and S.I. Unit Conversion Tables.</em> LabCorp/Endocrine Sciences. [<a href="https://web.archive.org/web/20200330030510/https://www.esoterix.com/sites/default/files/L5167-0320-17.pdf">PDF</a>]:</p><p><strong>Table:</strong> Estradiol and estrone levels in cisgender girls and women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th> </th><th> </th><th>Estradiol</th><th> </th><th>Estrone</th><th> </th></tr><tr><th>Life stage</th><th>Age (years)</th><th>Mean (pg/mL)</th><th>Range (pg/mL)</th><th>Mean (pg/mL)</th><th>Range (pg/mL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><9.2</td><td>8.0</td><td>5.0–20</td><td>13</td><td>4.0–29</td></tr><tr><td>Tanner stage 2</td><td>9.2–13.7</td><td>16</td><td>10–24</td><td>21</td><td>10–33</td></tr><tr><td>Tanner stage 3</td><td>10.0–14.4</td><td>25</td><td>7.0–60</td><td>30</td><td>15–43</td></tr><tr><td>Tanner stage 4</td><td>10.7–15.6</td><td>47</td><td>21–85</td><td>36</td><td>16–77</td></tr><tr><td>Tanner stage 5</td><td>11.8–18.6</td><td>110</td><td>34–170</td><td>61</td><td>29–105</td></tr><tr><td>Adult follicular</td><td>>18.0</td><td>?</td><td>30–100</td><td>?</td><td>30–100</td></tr><tr><td>Adult luteal</td><td>>18.0</td><td>?</td><td>70–300</td><td>?</td><td>90–160</td></tr></tbody></table></div><p><strong>Figure:</strong> Mean (± ref. range) estradiol and estrone levels in normal female puberty (HPLC–MS/MS):</p><p><img src="../../assets/images/6gfjyyqdowv41.png" alt="" /></p><h3 id="frederiksen-et-al-2020"> <a href="index.html#frederiksen-et-al-2020" aria-labelledby="frederiksen-et-al-2020" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Frederiksen et al. (2020)</h3><p>Frederiksen, H., Johannsen, T. H., Andersen, S. E., Albrethsen, J., Landersoe, S. K., Petersen, J. H., Andersen, A. N., Vestergaard, E. T., Schorring, M. E., Linneberg, A., Main, K. M., Andersson, A. M., & Juul, A. (2020). Sex-specific estrogen levels and reference intervals from infancy to late adulthood determined by LC-MS/MS. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>105</em>(3), 754–768. [DOI:<a href="https://doi.org/10.1210/clinem/dgz196">10.1210/clinem/dgz196</a>]:</p><p>(The graphs below were created from analysis of this study by <a href="../../about/index.html#sam">Sam</a>.)</p><p><strong>Figure:</strong> Mean (± SD) estradiol and estrone levels in normal female puberty (LC–MS/MS):</p><p><img src="../../assets/images/dfn3x19i8vw41.png" alt="" /></p><p><strong>Figure:</strong> Median (± SD) estradiol and estrone levels in normal female puberty (LC–MS/MS):</p><p><img src="../../assets/images/jifdfi0a8vw41.png" alt="" /></p><p>The lower estradiol and estrone levels in TS5 relative to TS4 are likely due to sampling error.</p><h3 id="kushnir-et-al-2008"> <a href="index.html#kushnir-et-al-2008" aria-labelledby="kushnir-et-al-2008" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Kushnir et al. (2008)</h3><p>Kushnir, M. M., Rockwood, A. L., Bergquist, J., Varshavsky, M., Roberts, W. L., Yue, B., Bunker, A. M., & Meikle, A. W. (2008). High-sensitivity tandem mass spectrometry assay for serum estrone and estradiol. <em>American Journal of Clinical Pathology</em>, <em>129</em>(4), 530–539. [DOI:<a href="https://doi.org/10.1309/LC03BHQ5XJPJYEKG">10.1309/LC03BHQ5XJPJYEKG</a>]:</p><p><strong>Table:</strong> Estradiol and estrone levels in cisgender girls and women (LC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th> </th><th>Estradiol</th><th>Estrone</th></tr><tr><th>Life stage or age (years)</th><th>Ref. range (pg/mL)</th><th>Ref. range (pg/mL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><55</td><td><26</td></tr><tr><td>Tanner stage 2</td><td>2–133</td><td>1–39</td></tr><tr><td>Tanner stage 3</td><td>12–277</td><td>8–117</td></tr><tr><td>Tanner stage 4/5</td><td>2–259</td><td>4–109</td></tr><tr><td>Before menarche</td><td>1–84</td><td><41</td></tr><tr><td>After menarche</td><td>3–264</td><td>4–113</td></tr><tr><td>7–9 years</td><td><35</td><td><25</td></tr><tr><td>10–12 years</td><td><87</td><td><42</td></tr><tr><td>13–15 years</td><td>9–248</td><td>8–105</td></tr><tr><td>16–17 years</td><td>2–266</td><td>4–133</td></tr><tr><td>Postmenopausal (41–63 years)</td><td>2–21</td><td>3–32</td></tr></tbody></table></div><p><em>Figure:</em> Median estradiol and estrone levels around puberty in cisgender girls (LC–MS/MS):</p><p><img src="../../assets/images/ienpbnhbjz251.png" alt="" /></p><p>It should be noted however that this study has been criticized on methodological grounds (<a href="https://doi.org/10.1309/AJCPNANPRF50LCHN">Ankarberg-Lindgren & Norjavaara, 2009a</a>; <a href="https://doi.org/10.1309/AJCPA65OUUFASOAN">Ankarberg-Lindgren & Norjavaara, 2009b</a>).</p><h3 id="janfaza-et-al-2006"> <a href="index.html#janfaza-et-al-2006" aria-labelledby="janfaza-et-al-2006" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Janfaza et al. (2006)</h3><p>Janfaza, M., Sherman, T. I., Larmore, K. A., Brown-Dawson, J., & Klein, K. O. (2006). Estradiol levels and secretory dynamics in normal girls and boys as determined by an ultrasensitive bioassay: a 10 year experience. <em>Journal of Pediatric Endocrinology and Metabolism</em>, <em>19</em>(7), 901–910. [DOI:<a href="https://doi.org/10.1515/JPEM.2006.19.7.901">10.1515/JPEM.2006.19.7.901</a>]:</p><p><strong>Table:</strong> Estradiol levels in 375 cisgender girls (RCBA—ultrasensitive recombinant cell bioassay):</p><div class="table-wrapper"><table><thead><tr><th>Pubertal stage</th><th>n</th><th>Mean age (years)</th><th>Mean estradiol (pg/mL)</th><th>Estradiol range (pg/mL)</th></tr></thead><tbody><tr><td>1</td><td>147</td><td>8.7 ± 1.7</td><td>1.6 ± 2.6</td><td><0.02–18</td></tr><tr><td>2</td><td>68</td><td>11.1 ± 1.1</td><td>6.9 ± 1.1</td><td><0.02–40</td></tr><tr><td>3</td><td>55</td><td>11.9 ± 1.1</td><td>23 ± 33</td><td><0.02–147</td></tr><tr><td>4</td><td>68</td><td>13.4 ± 1.4</td><td>27 ± 38</td><td>0.10–270</td></tr><tr><td>5</td><td>37</td><td>15.0 ± 1.6</td><td>48 ± 65</td><td>0.49–306</td></tr></tbody></table></div><h3 id="madsen-et-al-2020"> <a href="index.html#madsen-et-al-2020" aria-labelledby="madsen-et-al-2020" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Madsen et al. (2020)</h3><p>Madsen, A., Bruserud, I. S., Bertelsen, B. E., Roelants, M., Oehme, N. H. B., Viste, K., Bjerknes, R., Almås, B., Rosendahl, K., Mellgren, G., Sagen, J. V., & Juliusson, P. B. (2020). Hormone references for ultrasound breast staging and endocrine profiling to detect female onset of puberty. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>105</em>(12), e4886–e4895. [DOI:<a href="https://doi.org/10.1210/clinem/dgaa679">10.1210/clinem/dgaa679</a>]:</p><p><strong>Table:</strong> Estradiol and estrone levels in cisgender girls (LC–MS/MS):</p><htmlprotect><div class="table-wrapper"><table><thead><tr><th></th><th></th><th colspan="2">Estradiol (pg/mL)</th><th colspan="2">Estrone (pg/mL)</th></tr><tr><th>Tanner stage</th><th>n</th><th>Median</th><th>Range (2.5–97.5%)</th><th>Median</th><th>Range (2.5–97.5%)</th></tr></thead><tbody><tr><td>B1</td><td>260</td><td>1.3</td><td>0.24–10</td><td>3.8</td><td>1.2–10</td></tr><tr><td>B2</td><td>69</td><td>6.5</td><td>1.6–56</td><td>9.2</td><td>3.5–32</td></tr><tr><td>B3</td><td>63–66</td><td>25</td><td>1.2–77</td><td>21</td><td>3.2–52</td></tr><tr><td>B4</td><td>73–78</td><td>48</td><td>7.1–219</td><td>32</td><td>11–108</td></tr><tr><td>B5</td><td>76–81</td><td>41</td><td>13–268</td><td>36</td><td>15–129</td></tr></tbody></table></div></htmlprotect><h3 id="other-studies"> <a href="index.html#other-studies" aria-labelledby="other-studies" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Other Studies</h3><ul><li>Courant, F., Aksglaede, L., Antignac, J. P., Monteau, F., Sorensen, K., Andersson, A. M., Skakkebaek, N. E., Juul, A., & Bizec, B. L. (2010). Assessment of circulating sex steroid levels in prepubertal and pubertal boys and girls by a novel ultrasensitive gas chromatography-tandem mass spectrometry method. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>95</em>(1), 82–92. [DOI:<a href="https://doi.org/10.1210/jc.2009-1140">10.1210/jc.2009-1140</a>]</li><li>Biro, F. M., Pinney, S. M., Huang, B., Baker, E. R., Walt Chandler, D., & Dorn, L. D. (2014). Hormone changes in peripubertal girls. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>99</em>(10), 3829–3835. [DOI:<a href="https://doi.org/10.1210/jc.2013-4528">10.1210/jc.2013-4528</a>]</li><li>Ankarberg-Lindgren, C., Dahlgren, J., & Andersson, M. X. (2018). High-sensitivity quantification of serum androstenedione, testosterone, dihydrotestosterone, estrone and estradiol by gas chromatography–tandem mass spectrometry with sex-and puberty-specific reference intervals. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>183</em>, 116–124. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2018.06.005">10.1016/j.jsbmb.2018.06.005</a>]<ul><li>Note: Has estrone sulfate levels in the different Tanner breast stages.</li></ul></li><li>Bae, Y. J., Zeidler, R., Baber, R., Vogel, M., Wirkner, K., Loeffler, M., Ceglarek, U., Kiess, W., Körner, A., Thiery, J., & Kratzsch, J. (2019). Reference intervals of nine steroid hormones over the life-span analyzed by LC-MS/MS: Effect of age, gender, puberty, and oral contraceptives. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>193</em>, 105409. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2019.105409">10.1016/j.jsbmb.2019.105409</a>]</li></ul><h2 id="progesterone-levels"> <a href="index.html#progesterone-levels" aria-labelledby="progesterone-levels" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Progesterone Levels</h2><h3 id="esoterixlabcorp-2020-1"> <a href="index.html#esoterixlabcorp-2020-1" aria-labelledby="esoterixlabcorp-2020-1" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Esoterix/LabCorp (2020)</h3><p>Esoterix/LabCorp. (2020). <em>Endocrinology Expected Values and S.I. Unit Conversion Tables.</em> LabCorp/Endocrine Sciences. [<a href="https://web.archive.org/web/20200330030510/https://www.esoterix.com/sites/default/files/L5167-0320-17.pdf">PDF</a>] [<a href="https://web.archive.org/web/20180814132700/https://ltd.aruplab.com/Tests/Pub/2008509">Alt</a>] [<a href="https://doi.org/10.1007/978-3-319-18371-8_16">Alt</a>]:</p><p><strong>Table:</strong> Progesterone levels in cisgender girls and women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage / age (years)</th><th>Range (ng/mL)</th></tr></thead><tbody><tr><td><10 years</td><td>≤0.26</td></tr><tr><td>11 years</td><td>≤2.6</td></tr><tr><td>12 years</td><td>≤8.6</td></tr><tr><td>13 years</td><td>≤6.9</td></tr><tr><td>14 years</td><td>≤12.0</td></tr><tr><td>15 years</td><td>≤10.8</td></tr><tr><td>16 years</td><td>≤12.9</td></tr><tr><td>Adult early follicular (days 1–6)</td><td>≤0.17</td></tr><tr><td>Adult late follicular (days 7–12)</td><td>≤1.4</td></tr><tr><td>Adult mid-cycle (days 13–15)</td><td>≤15.6</td></tr><tr><td>Adult luteal (days 16–28)*</td><td>≤25.6</td></tr><tr><td>Postmenopausal</td><td>≤0.10</td></tr><tr><td>Pregnancy first trimester</td><td>6.3–45.5</td></tr><tr><td>Pregnancy second trimester</td><td>15.4–52.1</td></tr><tr><td>Pregnancy third trimester</td><td>25.0–99.9</td></tr></tbody></table></div><p>Note: Luteal progesterone peaked from 3.5 to 37.5 ng/dL ranging on cycle days 17 to 23.</p><p>Progesterone levels in males: ≤0.15 ng/mL (age 1–16 years) and ≤0.11 ng/mL (adult).</p><h3 id="fisher-salameh--furlanetto--quest-diagnostics-2007"> <a href="index.html#fisher-salameh--furlanetto--quest-diagnostics-2007" aria-labelledby="fisher-salameh--furlanetto--quest-diagnostics-2007" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Fisher, Salameh, & Furlanetto / Quest Diagnostics (2007)</h3><p>Fisher, D. A., Salameh, W., & Furlanetto, R. W. (2007). <em>[The Quest Diagnostics Manual:] Endocrinology: Test Selection and Interpretation, 4th Edition.</em> San Juan Capistrano, California: Quest Diagnostics. [<a href="https://scholar.google.com/scholar?cluster=12597861634809375578">Google Scholar</a>] [<a href="https://books.google.com/books?id=Y7KDoAEACAAJ">Google Books</a>] [<a href="https://worldcat.org/title/879165267">WorldCat</a>] [<a href="http://docplayer.net/86293048-The-quest-diagnostics-manual-endocrinology-test-selection-and-interpretation-fourth-edition.html">PDF</a>] [<a href="https://studylib.net/doc/8074566/test-selection-and-interpretation-the-quest-diagnostics-m">Alt PDF</a>] [<a href="https://books.google.com/books?id=BBLRUI4aHhkC&pg=PA1982">Alt</a>]:</p><p><strong>Table:</strong> Progesterone levels in cisgender girls and women (LC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage / age</th><th>Range (ng/mL)</th></tr></thead><tbody><tr><td>5–9 years</td><td>≤0.6</td></tr><tr><td>10–13 years</td><td>≤10.2</td></tr><tr><td>14–17 years</td><td>≤11.9</td></tr><tr><td>Adult early follicular</td><td>≤0.6</td></tr><tr><td>Adult late follicular</td><td>≤14.5</td></tr><tr><td>Adult mid-cycle</td><td>≤16.1</td></tr><tr><td>Adult luteal</td><td>≤31.4</td></tr><tr><td>Postmenopausal</td><td>≤0.2</td></tr></tbody></table></div><p>Progesterone levels in males: ≤1.2 ng/mL (age 5–17 years) and ≤0.3 ng/mL (adult).</p><h3 id="wu-2006"> <a href="index.html#wu-2006" aria-labelledby="wu-2006" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Wu (2006)</h3><p>Wu, A. H. B. (2006). <em>Tietz Clinical Guide to Laboratory Tests, 4th Edition.</em> St Louis: Saunders/Elsevier. [<a href="https://scholar.google.com/scholar?cluster=3233780672685530716">Google Scholar</a>] [<a href="https://books.google.com/books?id=aQqjBQAAQBAJ&pg=PA894">Google Books</a>] [<a href="https://openlibrary.org/works/OL9174685W/Tietz_Clinical_Guide_to_Laboratory_Tests">OpenLibrary</a>] [<a href="https://worldcat.org/title/64067574">WorldCat</a>] [<a href="https://web.archive.org/web/20200516122625if_/http://dl.cafepezeshki.ir/book/Tietz-Clinical-Guide-to-Laboratory-Tests-4th-Edition(CafePezeshki.IR).pdf#page=947">PDF</a>] [<a href="https://books.google.com/books?id=9gvBlktAT6YC&pg=PA795">Alt</a>]:</p><p><strong>Table:</strong> Progesterone levels in cisgender girls and women (RIA):</p><div class="table-wrapper"><table><thead><tr><th>Life stage</th><th>Range (ng/dL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td>≤0.33</td></tr><tr><td>Tanner stage 2</td><td>≤0.55</td></tr><tr><td>Tanner stage 3</td><td>≤4.5</td></tr><tr><td>Tanner stage 4</td><td>≤13.0</td></tr><tr><td>Tanner stage 5</td><td>≤9.5</td></tr><tr><td>Adult follicular</td><td>0.15–0.70</td></tr><tr><td>Adult luteal</td><td>2.0–25.0</td></tr><tr><td>Adult postmenopausal</td><td>≤0.40</td></tr><tr><td>Pregnancy first trimester</td><td>10.3–44.0</td></tr><tr><td>Pregnancy second trimester</td><td>19.5–82.5</td></tr><tr><td>Pregnancy third trimester</td><td>65.0–229.0</td></tr></tbody></table></div><p>Progesterone levels in males: <0.10–1.1 ng/mL (age 1–10 years + puberty) and 0.13–0.97 ng/mL (adult).</p><p>Note: RIA gives less accurate and often overestimated values relative to MS-based techniques.</p><h3 id="kühnel-2000"> <a href="index.html#kühnel-2000" aria-labelledby="kühnel-2000" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Kühnel (2000)</h3><p>Kühnel, W. (2000). <em>IMMULITE® and IMMULITE® 2000 Reference Range Compendium, First English Edition.</em> Los Angeles, California: Diagnostic Products Corporation. [<a href="https://scholar.google.com/scholar?cluster=5133761102073390474">Google Scholar</a>] [<a href="http://www.dpcweb.com/documents/news&views/winter01/referencerange.htm">URL</a>] [<a href="https://www.dpcweb.com/documents/medical/reference_ranges/ZB197-A.pdf#page=41">PDF 1</a>] [<a href="https://www.scribd.com/doc/62827662/Reference-Range">PDF 2</a>]:</p><p><strong>Table:</strong> Progesterone levels in cisgender girls and women (IA):</p><div class="table-wrapper"><table><thead><tr><th>Life stage / age (years)</th><th>n</th><th>Median (ng/mL)</th><th>Range (variable) (ng/mL)</th></tr></thead><tbody><tr><td>7–8 years</td><td>24</td><td>0.50</td><td>0.25–0.99</td></tr><tr><td>9–10 years</td><td>40</td><td>0.55</td><td>0.13–1.00</td></tr><tr><td>11 years</td><td>22</td><td>0.66</td><td>0.37–0.92</td></tr><tr><td>12 years</td><td>17</td><td>0.78</td><td>0.49–1.68</td></tr><tr><td>13 years</td><td>25</td><td>0.72</td><td>0.40–1.46</td></tr><tr><td>14 years</td><td>30</td><td>1.20</td><td>0.56–12.3</td></tr><tr><td>15 years</td><td>48</td><td>1.40</td><td>0.70–13.4</td></tr><tr><td>16 years</td><td>40</td><td>5.0</td><td>0.65–14.5</td></tr><tr><td>17 years</td><td>30</td><td>1.40</td><td>0.77–11.3</td></tr><tr><td>18–19 years</td><td>12</td><td>2.4</td><td>1.27–13.0</td></tr><tr><td>Tanner stage 1</td><td>28</td><td>0.46</td><td>0.23–0.77</td></tr><tr><td>Tanner stage 2–3</td><td>70</td><td>0.70</td><td>0.36–2.2</td></tr><tr><td>Tanner stage 4</td><td>30</td><td>1.25</td><td>0.57–9.5</td></tr><tr><td>Tanner stage 5</td><td>66</td><td>2.4</td><td>0.75–14.6</td></tr><tr><td>Adult follicular</td><td>382</td><td>0.47</td><td>ND–1.13</td></tr><tr><td>Adult mid-follicular (days 5–11)</td><td>186</td><td>0.43</td><td>ND–0.98</td></tr><tr><td>Adult mid-cycle</td><td>27</td><td>1.06</td><td>0.48–1.72</td></tr><tr><td>Adult luteal</td><td>323</td><td>8.9</td><td>0.95–21</td></tr><tr><td>Adult mid-luteal (days 7–8)</td><td>54</td><td>13.1</td><td>6.0–24</td></tr><tr><td>Pregnancy first trimester</td><td>28</td><td>22.2</td><td>9.3–33.2</td></tr><tr><td>Pregnancy second trimester</td><td>10</td><td>35.4</td><td>29.5–50.0</td></tr><tr><td>Pregnancy third trimester</td><td>8</td><td>102</td><td>83.1–160</td></tr></tbody></table></div><p>Abbreviations/etc.: n = tests, not subjects; range = 90%, 95%, or absolute range; ND = not detectable.</p><p>Note: IA gives less accurate and often overestimated values relative to MS-based techniques.</p><h3 id="other-studies-1"> <a href="index.html#other-studies-1" aria-labelledby="other-studies-1" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Other Studies</h3><ul><li>Ceglarek, U., Werner, M., Kortz, L., Körner, A., Kiess, W., Thiery, J., & Kratzsch, J. (2010). Preclinical challenges in steroid analysis of human samples. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>121</em>(3–5), 505–512. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2010.03.039">10.1016/j.jsbmb.2010.03.039</a>]</li></ul><h2 id="androgen-levels"> <a href="index.html#androgen-levels" aria-labelledby="androgen-levels" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Androgen Levels</h2><h3 id="esoterixlabcorp-2020-2"> <a href="index.html#esoterixlabcorp-2020-2" aria-labelledby="esoterixlabcorp-2020-2" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Esoterix/LabCorp (2020)</h3><p>Esoterix/LabCorp. (2020). <em>Endocrinology Expected Values and S.I. Unit Conversion Tables.</em> LabCorp/Endocrine Sciences. [<a href="https://web.archive.org/web/20200330030510/https://www.esoterix.com/sites/default/files/L5167-0320-17.pdf">PDF</a>]:</p><p><strong>Table:</strong> Total testosterone levels in cisgender girls and women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage</th><th>Age (years)</th><th>Mean (ng/dL)</th><th>Range (ng/dL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><9.2</td><td>4.9</td><td><2.5–10</td></tr><tr><td>Tanner stage 2</td><td>9.2–13.7</td><td>18</td><td>7–28</td></tr><tr><td>Tanner stage 3</td><td>10.0–14.4</td><td>25</td><td>15–35</td></tr><tr><td>Tanner stage 4</td><td>10.7–15.6</td><td>22</td><td>13–32</td></tr><tr><td>Tanner stage 5</td><td>11.8–18.6</td><td>28</td><td>20–38</td></tr><tr><td>Adult premenopausal</td><td>>18.0</td><td>?</td><td>10–55</td></tr><tr><td>Adult postmenopausal</td><td>⪆50 years</td><td>?</td><td>7–40</td></tr></tbody></table></div><p><strong>Table:</strong> Dihydrotesterone (DHT) levels in cisgender girls and women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage</th><th>Age (years)</th><th>Mean (ng/dL)</th><th>Range (ng/dL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><9.2</td><td>?</td><td><3</td></tr><tr><td>Tanner stage 2</td><td>9.2–13.7</td><td>8</td><td>5–12</td></tr><tr><td>Tanner stage 3</td><td>10.0–14.4</td><td>12</td><td>7–19</td></tr><tr><td>Tanner stage 4</td><td>10.7–15.6</td><td>7</td><td>4–13</td></tr><tr><td>Tanner stage 5</td><td>11.8–18.6</td><td>9</td><td>3–18</td></tr><tr><td>Adult</td><td>>18.0</td><td>?</td><td>4–22</td></tr></tbody></table></div><p><strong>Table:</strong> Androstenedione levels in cisgender girls and women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage</th><th>Age (years)</th><th>Mean (ng/dL)</th><th>Range (ng/dL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><9.2</td><td><10</td><td><10–17</td></tr><tr><td>Tanner stage 2</td><td>9.2–13.7</td><td>33</td><td>10–72</td></tr><tr><td>Tanner stage 3</td><td>10.0–14.4</td><td>97</td><td>50–170</td></tr><tr><td>Tanner stage 4</td><td>10.7–15.6</td><td>105</td><td>47–208</td></tr><tr><td>Tanner stage 5</td><td>11.8–18.6</td><td>137</td><td>50–224</td></tr><tr><td>Adult premenopausal</td><td>18–40 years</td><td>?</td><td>28–230</td></tr><tr><td>Adult postmenopausal</td><td>⪆50 years</td><td>?</td><td><10–93</td></tr></tbody></table></div><p><strong>Table:</strong> Dehydroepiandrosterone sulfate (DHEA-S) levels in cisgender girls/women (HPLC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage</th><th>Age (years)</th><th>Mean (ng/dL)</th><th>Range (ng/dL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td><9.2</td><td>40</td><td>19–144</td></tr><tr><td>Tanner stage 2</td><td>9.2–13.7</td><td>72</td><td>34–129</td></tr><tr><td>Tanner stage 3</td><td>10.0–14.4</td><td>88</td><td>32–226</td></tr><tr><td>Tanner stage 4</td><td>10.7–15.6</td><td>120</td><td>58–260</td></tr><tr><td>Tanner stage 5</td><td>11.8–18.6</td><td>148</td><td>44–248</td></tr><tr><td>Adult premenopausal</td><td>18–50 years</td><td>?</td><td>17–372</td></tr><tr><td>Adult postmenopausal</td><td>⪆50 years</td><td>?</td><td><215</td></tr></tbody></table></div><h3 id="arup-laboratories-undated"> <a href="index.html#arup-laboratories-undated" aria-labelledby="arup-laboratories-undated" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> ARUP Laboratories (Undated)</h3><p>ARUP Laboratories. (Undated). <em>Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy).</em> ARUP Laboratories. [<a href="https://ltd.aruplab.com/Tests/Pub/0081056">URL</a>] [<a href="https://ltd.aruplab.com/Tests/Pub/0081059">Alt</a>]:</p><p><strong>Table:</strong> Total and free testosterone levels in cisgender girls and women (LC–MS/MS):</p><div class="table-wrapper"><table><thead><tr><th>Life stage / age</th><th>Total: Range (ng/dL)</th><th>Free: Range (pg/mL)</th></tr></thead><tbody><tr><td>Tanner stage 1</td><td>2–17 ng/dL</td><td><2.2</td></tr><tr><td>Tanner stage 2</td><td>5–40 ng/dL</td><td>0.4–4.5</td></tr><tr><td>Tanner stage 3</td><td>10–63 ng/dL</td><td>1.3–7.5</td></tr><tr><td>Tanner stage 4</td><td>11–62 ng/dL</td><td>1.1–15.5</td></tr><tr><td>Tanner stage 5</td><td>11–62 ng/dL</td><td>0.8–9.2</td></tr><tr><td>1–6 years</td><td><30 ng/dL</td><td><0.6</td></tr><tr><td>7–9 years</td><td>1–11 ng/dL</td><td>0.6–1.8</td></tr><tr><td>10–11 years</td><td>3–32 ng/dL</td><td>0.1–3.5</td></tr><tr><td>12–13 years</td><td>6–50 ng/dL</td><td>0.9–6.8</td></tr><tr><td>14–15 years</td><td>6–52 ng/dL</td><td>1.2–7.5</td></tr><tr><td>16–17 years</td><td>9–58 ng/dL</td><td>1.2–9.9</td></tr><tr><td>18–30 years</td><td>9–55 ng/dL</td><td>0.8–7.4</td></tr><tr><td>31–40 years</td><td>9–55 ng/dL</td><td>1.3–9.2</td></tr><tr><td>41–51 years</td><td>9–55 ng/dL</td><td>1.1–5.8</td></tr><tr><td>Postmenopausal</td><td>5–32 ng/dL</td><td>0.6–3.8</td></tr></tbody></table></div><h3 id="other-studies-2"> <a href="index.html#other-studies-2" aria-labelledby="other-studies-2" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Other Studies</h3><ul><li>Kushnir, M. M., Rockwood, A. L., Roberts, W. L., Pattison, E. G., Bunker, A. M., Fitzgerald, R. L., & Meikle, A. W. (2006). Performance characteristics of a novel tandem mass spectrometry assay for serum testosterone. <em>Clinical Chemistry</em>, <em>52</em>(1), 120–128. [DOI:<a href="https://doi.org/10.1373/clinchem.2005.052167">10.1373/clinchem.2005.052167</a>]</li><li>Kushnir, M. M., Blamires, T., Rockwood, A. L., Roberts, W. L., Yue, B., Erdogan, E., Bunker, A. M., & Meikle, A. W. (2010). LC-MS/MS assay for androstenedione, dehydroepiandrosterone and testosterone with pediatric and adult reference intervals. <em>Clinical Chemistry</em>, <em>56</em>(7), 1138–1147. [DOI:<a href="https://doi.org/10.1373/clinchem.2010.143222">10.1373/clinchem.2010.143222</a>]</li></ul><h2 id="prolactin-levels"> <a href="index.html#prolactin-levels" aria-labelledby="prolactin-levels" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Prolactin Levels</h2><ul><li>Kühnel, W. (2000). <em>IMMULITE® and IMMULITE® 2000 Reference Range Compendium, First English Edition.</em> Los Angeles, California: Diagnostic Products Corporation. [<a href="https://scholar.google.com/scholar?cluster=5133761102073390474">Google Scholar</a>] [<a href="http://www.dpcweb.com/documents/news&views/winter01/referencerange.htm">URL</a>] [<a href="https://www.dpcweb.com/documents/medical/reference_ranges/ZB197-A.pdf#page=44">PDF 1</a>] [<a href="https://www.scribd.com/doc/62827662/Reference-Range">PDF 2</a>]</li></ul><h2 id="references"> <a href="index.html#references" aria-labelledby="references" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> References</h2><ul><li>Ankarberg-Lindgren, C., & Norjavaara, E. (2009). Are Estradiol Results Determined by the Tandem Mass Spectrometry Assay Clinically Useful for Children? <em>American Journal of Clinical Pathology</em>, <em>131</em>(5), 746–750. [DOI:<a href="https://doi.org/10.1309/ajcpnanprf50lchn">10.1309/ajcpnanprf50lchn</a>]</li><li>Ankarberg-Lindgren, C., & Norjavaara, E. (2009). Estradiol in Pediatric Endocrinology. <em>American Journal of Clinical Pathology</em>, <em>132</em>(6), 978–980. [DOI:<a href="https://doi.org/10.1309/ajcpa65ouufasoan">10.1309/ajcpa65ouufasoan</a>]</li><li>Ankarberg-Lindgren, C., Dahlgren, J., & Andersson, M. X. (2018). High-sensitivity quantification of serum androstenedione, testosterone, dihydrotestosterone, estrone and estradiol by gas chromatography–tandem mass spectrometry with sex-and puberty-specific reference intervals. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>183</em>, 116–124. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2018.06.005">10.1016/j.jsbmb.2018.06.005</a>]</li><li>ARUP Laboratories. (Undated). <em>Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Females, Children, or Individuals on Testosterone-Suppressing Hormone Therapy).</em> ARUP Laboratories. [<a href="https://ltd.aruplab.com/Tests/Pub/0081056">URL</a>] [<a href="https://ltd.aruplab.com/Tests/Pub/0081059">Alt</a>]:</li><li>Bae, Y. J., Zeidler, R., Baber, R., Vogel, M., Wirkner, K., Loeffler, M., Ceglarek, U., Kiess, W., Körner, A., Thiery, J., & Kratzsch, J. (2019). Reference intervals of nine steroid hormones over the life-span analyzed by LC-MS/MS: Effect of age, gender, puberty, and oral contraceptives. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>193</em>, 105409. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2019.105409">10.1016/j.jsbmb.2019.105409</a>]</li><li>Biro, F. M., Pinney, S. M., Huang, B., Baker, E. R., Walt Chandler, D., & Dorn, L. D. (2014). Hormone changes in peripubertal girls. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>99</em>(10), 3829–3835. [DOI:<a href="https://doi.org/10.1210/jc.2013-4528">10.1210/jc.2013-4528</a>]</li><li>Ceglarek, U., Werner, M., Kortz, L., Körner, A., Kiess, W., Thiery, J., & Kratzsch, J. (2010). Preclinical challenges in steroid analysis of human samples. <em>The Journal of Steroid Biochemistry and Molecular Biology</em>, <em>121</em>(3–5), 505–512. [DOI:<a href="https://doi.org/10.1016/j.jsbmb.2010.03.039">10.1016/j.jsbmb.2010.03.039</a>]</li><li>Courant, F., Aksglaede, L., Antignac, J. P., Monteau, F., Sorensen, K., Andersson, A. M., Skakkebaek, N. E., Juul, A., & Bizec, B. L. (2010). Assessment of circulating sex steroid levels in prepubertal and pubertal boys and girls by a novel ultrasensitive gas chromatography-tandem mass spectrometry method. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>95</em>(1), 82–92. [DOI:<a href="https://doi.org/10.1210/jc.2009-1140">10.1210/jc.2009-1140</a>]</li><li>Esoterix/LabCorp. (2020). <em>Endocrinology Expected Values and S.I. Unit Conversion Tables.</em> LabCorp/Endocrine Sciences. [<a href="https://web.archive.org/web/20200330030510/https://www.esoterix.com/sites/default/files/L5167-0320-17.pdf">PDF</a>]</li><li>Fisher, D. A., Salameh, W., & Furlanetto, R. W. (2007). <em>[The Quest Diagnostics Manual:] Endocrinology: Test Selection and Interpretation, 4th Edition.</em> San Juan Capistrano, California: Quest Diagnostics. [<a href="https://scholar.google.com/scholar?cluster=12597861634809375578">Google Scholar</a>] [<a href="https://books.google.com/books?id=Y7KDoAEACAAJ">Google Books</a>] [<a href="https://worldcat.org/title/879165267">WorldCat</a>] [<a href="http://docplayer.net/86293048-The-quest-diagnostics-manual-endocrinology-test-selection-and-interpretation-fourth-edition.html">PDF</a>] [<a href="https://studylib.net/doc/8074566/test-selection-and-interpretation-the-quest-diagnostics-m">Alt PDF</a>]</li><li>Frederiksen, H., Johannsen, T. H., Andersen, S. E., Albrethsen, J., Landersoe, S. K., Petersen, J. H., Andersen, A. N., Vestergaard, E. T., Schorring, M. E., Linneberg, A., Main, K. M., Andersson, A. M., & Juul, A. (2020). Sex-specific estrogen levels and reference intervals from infancy to late adulthood determined by LC-MS/MS. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>105</em>(3), 754–768. [DOI:<a href="https://doi.org/10.1210/clinem/dgz196">10.1210/clinem/dgz196</a>]</li><li>Janfaza, M., Sherman, T. I., Larmore, K. A., Brown-Dawson, J., & Klein, K. O. (2006). Estradiol levels and secretory dynamics in normal girls and boys as determined by an ultrasensitive bioassay: a 10 year experience. <em>Journal of Pediatric Endocrinology and Metabolism</em>, <em>19</em>(7), 901–910. [DOI:<a href="https://doi.org/10.1515/JPEM.2006.19.7.901">10.1515/JPEM.2006.19.7.901</a>]</li><li>Kushnir, M. M., Rockwood, A. L., Roberts, W. L., Pattison, E. G., Bunker, A. M., Fitzgerald, R. L., & Meikle, A. W. (2006). Performance characteristics of a novel tandem mass spectrometry assay for serum testosterone. <em>Clinical Chemistry</em>, <em>52</em>(1), 120–128. [DOI:<a href="https://doi.org/10.1373/clinchem.2005.052167">10.1373/clinchem.2005.052167</a>]</li><li>Kühnel, W. (2000). <em>IMMULITE® and IMMULITE® 2000 Reference Range Compendium, First English Edition.</em> Los Angeles, California: Diagnostic Products Corporation. [<a href="https://scholar.google.com/scholar?cluster=5133761102073390474">Google Scholar</a>] [<a href="http://www.dpcweb.com/documents/news&views/winter01/referencerange.htm">URL</a>] [<a href="https://www.dpcweb.com/documents/medical/reference_ranges/ZB197-A.pdf">PDF 1</a>] [<a href="https://www.scribd.com/doc/62827662/Reference-Range">PDF 2</a>]</li><li>Kushnir, M. M., Rockwood, A. L., Bergquist, J., Varshavsky, M., Roberts, W. L., Yue, B., Bunker, A. M., & Meikle, A. W. (2008). High-sensitivity tandem mass spectrometry assay for serum estrone and estradiol. <em>American Journal of Clinical Pathology</em>, <em>129</em>(4), 530–539. [DOI:<a href="https://doi.org/10.1309/LC03BHQ5XJPJYEKG">10.1309/LC03BHQ5XJPJYEKG</a>]</li><li>Kushnir, M. M., Blamires, T., Rockwood, A. L., Roberts, W. L., Yue, B., Erdogan, E., Bunker, A. M., & Meikle, A. W. (2010). LC-MS/MS assay for androstenedione, dehydroepiandrosterone and testosterone with pediatric and adult reference intervals. <em>Clinical Chemistry</em>, <em>56</em>(7), 1138–1147. [DOI:<a href="https://doi.org/10.1373/clinchem.2010.143222">10.1373/clinchem.2010.143222</a>]</li><li>Madsen, A., Bruserud, I. S., Bertelsen, B. E., Roelants, M., Oehme, N. H. B., Viste, K., Bjerknes, R., Almås, B., Rosendahl, K., Mellgren, G., Sagen, J. V., & Juliusson, P. B. (2020). Hormone references for ultrasound breast staging and endocrine profiling to detect female onset of puberty. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>105</em>(12), e4886–e4895. [DOI:<a href="https://doi.org/10.1210/clinem/dgaa679">10.1210/clinem/dgaa679</a>]</li><li>Wu, A. H. B. (2006). <em>Tietz Clinical Guide to Laboratory Tests, 4th Edition.</em> St Louis: Saunders/Elsevier. 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