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Assess Testosterone/Estradiol Balance

Enter serum testosterone and estradiol levels (any common units) to compute the T/E2 ratio, a helpful marker for male fertility, hypogonadism, and hormone therapy monitoring.

Testosterone (ng/dL)

550

Reference: 300–1000 ng/dL

Estradiol (pg/mL)

30.0

Reference: 10–40 pg/mL

T/E2 ratio

18.3

Physiologic range: Ratio 10–25 is typical for eugonadal males. Interpret alongside absolute hormone levels and symptoms.
Ratios complement absolute hormone levels. Investigate symptoms (libido, erectile function, gynecomastia, bone density) and underlying conditions (obesity, aromatase activity, medications).

How to Use This Calculator

1

Obtain fasting morning labs

Draw testosterone and estradiol between 7–10 AM to minimize diurnal variation.

2

Convert to consistent units

The calculator converts nmol/L ↔ ng/dL and pmol/L ↔ pg/mL to produce a standardized ratio.

3

Integrate with clinical findings

Use ratios with symptoms, SHBG, LH/FSH, and metabolic markers to guide therapy decisions.

Formula

Testosterone (ng/dL) = Testosterone (nmol/L) × 28.818

Estradiol (pg/mL) = Estradiol (pmol/L) × 0.272

T/E2 ratio = Testosterone (ng/dL) ÷ Estradiol (pg/mL)

Target ratios: 10–25 for eugonadal males; adjust targets for females or hormone therapy protocols.

Full Description

The testosterone-to-estradiol ratio reflects the balance between androgen production and aromatization. In men, low ratios may signal obesity-related estrogen excess, liver disease, or androgen deficiency—manifesting as decreased libido, erectile dysfunction, or gynecomastia. High ratios may indicate low estradiol, which can impair bone mineral density. Evaluate alongside absolute hormone levels, sex hormone-binding globulin (SHBG), gonadotropins, and clinical presentation before initiating treatment.

Frequently Asked Questions

Does BMI affect the ratio?

Yes. Adipose tissue aromatizes testosterone to estradiol, lowering the ratio. Weight loss often improves balance.

Should I adjust testosterone therapy based on the ratio?

Monitor ratios during therapy. Persistent low ratios may require aromatase inhibitors; high ratios may need estradiol supplementation. Decide with an endocrinologist.

Can medications affect estradiol levels?

Yes. Anabolic steroids, aromatase inhibitors, ketoconazole, and liver-modifying drugs alter estradiol metabolism.

Is the ratio useful in women?

Interpret cautiously. Female hormonal cycles cause wide fluctuations; use phase-specific references and focus on absolute hormone levels.