Summary: A hydroxylated metabolite of ESTRADIOL or ESTRONE that has a hydroxyl group at C3, 16-alpha, and 17-beta position. Estriol is a major urinary estrogen. During PREGNANCY, a large amount of estriol is produced by the PLACENTA. Isomers with inversion of the hydroxyl group or groups are called epiestriol.

Top Publications

  1. Jaisamrarn U, Triratanachat S, Chaikittisilpa S, Grob P, Prasauskas V, Taechakraichana N. Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy. Climacteric. 2013;16:347-55 pubmed publisher
    The aim of this study was to demonstrate the efficacy of an ultra-low-dose vaginal estriol 0...
  2. Bukowski R, Uchida T, Smith G, Malone F, Ball R, Nyberg D, et al. Individualized norms of optimal fetal growth: fetal growth potential. Obstet Gynecol. 2008;111:1065-76 pubmed publisher
    ..3% compared with 19.7%, 24.9%, 29.8%, respectively, all P<.05). Growth potential norms based on the physiologic determinants of birth weight are a better discriminator of aberrations of fetal growth than traditional norms. II. ..
  3. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?. Postgrad Med. 2009;121:73-85 pubmed publisher
    The use of bioidentical hormones, including progesterone, estradiol, and estriol, in hormone replacement therapy (HRT) has sparked intense debate...
  4. Chollet J, Carter G, Meyn L, Mermelstein F, Balk J. Efficacy and safety of vaginal estriol and progesterone in postmenopausal women with atrophic vaginitis. Menopause. 2009;16:978-83 pubmed publisher
    The aim of this study was to assess the efficacy and safety of intravaginal estriol and progesterone on atrophic vaginitis in postmenopausal women.
  5. Shackleton C, Marcos J, Arlt W, Hauffa B. Prenatal diagnosis of P450 oxidoreductase deficiency (ORD): a disorder causing low pregnancy estriol, maternal and fetal virilization, and the Antley-Bixler syndrome phenotype. Am J Med Genet A. 2004;129A:105-12 pubmed
    ..Longitudinal monitoring of the second pregnancy revealed that estriol excretion failed to increase normally, reaching a maximum 0...
  6. Griesser H, Skonietzki S, Fischer T, Fielder K, Suesskind M. Low dose estriol pessaries for the treatment of vaginal atrophy: a double-blind placebo-controlled trial investigating the efficacy of pessaries containing 0.2mg and 0.03mg estriol. Maturitas. 2012;71:360-8 pubmed publisher
    The aim of the study was to confirm the superior efficacy of estriol containing pessaries compared to placebo in the treatment of vaginal atrophy.
  7. Varvarigou A, Liatsis S, Vassilakos P, Decavalas G, Beratis N. Effect of maternal smoking on cord blood estriol, placental lactogen, chorionic gonadotropin, FSH, LH, and cortisol. J Perinat Med. 2009;37:364-9 pubmed publisher
    ..The disturbed endocrine equilibrium of the fetus induced by tobacco smoking could have adverse consequences on the fetus and child since fetal brain is a target organ for hormonal actions. ..
  8. Ozkinay E, Terek M, Yayci M, Kaiser R, Grob P, Tuncay G. The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005;112:234-40 pubmed
    ..To evaluate the effectiveness of live lactobacilli in combination with low dose oestriol for restoration of the vaginal flora after anti-infective treatment...
  9. Dugoff L. First- and second-trimester maternal serum markers for aneuploidy and adverse obstetric outcomes. Obstet Gynecol. 2010;115:1052-61 pubmed publisher
    ..This article reviews the relationships between these markers and adverse obstetric outcomes. In addition, potential management strategies and future areas of research are discussed. ..

More Information


  1. Donders G, Van Bulck B, Van de Walle P, Kaiser R, Pohlig G, Gonser S, et al. Effect of lyophilized lactobacilli and 0.03 mg estriol (Gynoflor®) on vaginitis and vaginosis with disrupted vaginal microflora: a multicenter, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest. 2010;70:264-72 pubmed publisher
    To evaluate the efficacy of lyophilized lactobacilli in combination with 0.03 mg estriol when compared to metronidazole in the treatment of bacterial vaginal infections...
  2. Caldwell D, Mastrocco F, Anderson P, Lange R, Sumpter J. Predicted-no-effect concentrations for the steroid estrogens estrone, 17?-estradiol, estriol, and 17?-ethinylestradiol. Environ Toxicol Chem. 2012;31:1396-406 pubmed publisher
    ..derive predicted-no-effect concentrations (PNECs) for the steroid estrogens (estrone [E1], 17?-estradiol [E2], estriol [E3], and 17?-ethinylestradiol [EE2]) appropriate for use in risk assessment of aquatic organisms...
  3. Ramsey P, Andrews W. Biochemical predictors of preterm labor: fetal fibronectin and salivary estriol. Clin Perinatol. 2003;30:701-33 pubmed
    ..two FDA-approved biochemical tests are available in the United States: (1) fetal fibronectin and (2) salivary estriol. The presence of a positive fetal fibronectin test in the midtrimester of pregnancy is strongly associated with ..
  4. Liu H, Loo K, Palaszynski K, Ashouri J, Lubahn D, Voskuhl R. Estrogen receptor alpha mediates estrogen's immune protection in autoimmune disease. J Immunol. 2003;171:6936-40 pubmed
    ..These findings are central to the design of selective ER modifiers which aim to target biologic responses in specific organ systems. ..
  5. Summers A, Huang T, Meier C, Wyatt P. The implications of a false positive second-trimester serum screen for Down syndrome. Obstet Gynecol. 2003;101:1301-6 pubmed
    ..We did not find an increased risk for other chromosomal abnormalities, congenital abnormalities, or other adverse obstetric outcomes. ..
  6. Endres L, Krotz S, Grobman W. Isolated low second-trimester maternal serum beta-human chorionic gonadotropin is not associated with adverse pregnancy outcome. Am J Obstet Gynecol. 2003;189:755-7 pubmed
    ..5 multiples of the median, alpha-fetoprotein values of >0.5 and <2.0 multiples of the median, and estriol values of >0.6 and <2.0 multiples of the median...
  7. Buhling K, Eydeler U, Borregaard S, Schlegelmilch R, Suesskind M. Systemic bioavailability of estriol following single and repeated vaginal administration of 0.03 mg estriol containing pessaries. Arzneimittelforschung. 2012;62:378-83 pubmed publisher
    ..The aim was to determine the extent of a systemic exposure to estriol (CAS 50-27-1). Administration of estriol containing pessaries was daily for 21 days...
  8. Cao Z, Swift T, West C, Rosano T, Rej R. Immunoassay of estradiol: unanticipated suppression by unconjugated estriol. Clin Chem. 2004;50:160-5 pubmed
    ..Results from this method were bimodal in distribution. We found that unconjugated estriol at concentrations >1.5 microg/L (>5...
  9. Palaszynski K, Liu H, Loo K, Voskuhl R. Estriol treatment ameliorates disease in males with experimental autoimmune encephalomyelitis: implications for multiple sclerosis. J Neuroimmunol. 2004;149:84-9 pubmed
    ..EAE disease severity in both females and males was decreased with estriol treatment as compared to placebo...
  10. Cragun D, Trumpy S, Shackleton C, Kelley R, Leslie N, Mulrooney N, et al. Undetectable maternal serum uE3 and postnatal abnormal sterol and steroid metabolism in Antley-Bixler syndrome. Am J Med Genet A. 2004;129A:1-7 pubmed
    ..During both pregnancies, mid-trimester maternal serum screening demonstrated undetectable levels of uncongugated estriol (uE3)...
  11. Hamaide A, Grand J, Farnir F, Le Couls G, Snaps F, Balligand M, et al. Urodynamic and morphologic changes in the lower portion of the urogenital tract after administration of estriol alone and in combination with phenylpropanolamine in sexually intact and spayed female dogs. Am J Vet Res. 2006;67:901-8 pubmed
    To compare the urodynamic and morphologic effects of the administration of estriol alone and in combination with phenylpropanolamine on the lower portion of the urogenital tract in female dogs.
  12. Scialli A, Fugh Berman A. The effects of oral estriol on the endometrium in postmenopausal women. Maturitas. 2003;45:147; author reply 149 pubmed
  13. Dessole S, Rubattu G, Ambrosini G, Gallo O, Capobianco G, Cherchi P, et al. Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women. Menopause. 2004;11:49-56 pubmed
    To assess the efficacy and safety of intravaginal estriol administration on urinary incontinence, urogenital atrophy, and recurrent urinary tract infections in postmenopausal women.
  14. Cano A, Estevez J, Usandizaga R, Gallo J, Guinot M, Delgado J, et al. The therapeutic effect of a new ultra low concentration estriol gel formulation (0.005% estriol vaginal gel) on symptoms and signs of postmenopausal vaginal atrophy: results from a pivotal phase III study. Menopause. 2012;19:1130-9 pubmed
    The aim of this study was to evaluate the efficacy and safety of a new low-concentration estriol formulation (0...
  15. Duric K, Skrablin S, Lesin J, Kalafatic D, Kuvacic I, Suchanek E. Second trimester total human chorionic gonadotropin, alpha-fetoprotein and unconjugated estriol in predicting pregnancy complications other than fetal aneuploidy. Eur J Obstet Gynecol Reprod Biol. 2003;110:12-5 pubmed
    To assess the value of alpha-fetoprotein (AFP), total human chorionic gonadotropin (ThCG) and unconjugated estriol in predicting certain complications of pregnancy other than fetal aneuploidy...
  16. Ay E, Kavak Z, Elter K, Gokaslan H, Pekin T. Screening for pre-eclampsia by using maternal serum inhibin A, activin A, human chorionic gonadotropin, unconjugated estriol, and alpha-fetoprotein levels and uterine artery Doppler in the second trimester of pregnancy. Aust N Z J Obstet Gynaecol. 2005;45:283-8 pubmed
    ..the predictive power of maternal serum inhibin A, activin A, human chorionic gonadotropin (hCG), unconjugated estriol (uE(3)), alpha-fetoprotein (AFP) levels and uterine artery Doppler in the second trimester of pregnancy in ..
  17. Marcos J, Craig W, Palomaki G, Kloza E, Haddow J, Roberson M, et al. Maternal urine and serum steroid measurements to identify steroid sulfatase deficiency (STSD) in second trimester pregnancies. Prenat Diagn. 2009;29:771-80 pubmed publisher
    ..combinations of 16alpha-OH-dehydroepiandrosterone sulfate (16alpha-OH-DHEAS), 11beta-hydroxyandrosterone, total estriol] and serum [combinations of 16alpha-OH-DHEAS, 11beta-hydroxyandrosterone, total estriol, unconjugated estriol (..
  18. Lappano R, Rosano C, De Marco P, De Francesco E, Pezzi V, Maggiolini M. Estriol acts as a GPR30 antagonist in estrogen receptor-negative breast cancer cells. Mol Cell Endocrinol. 2010;320:162-70 pubmed publisher
    ..17beta-estradiol (E2) is reversibly oxidized to estrone (E1) and both E2 and E1 can be irreversibly converted to estriol (E3), which also originates directly from androstenedione...
  19. Ziehn M, Avedisian A, Dervin S, O Dell T, Voskuhl R. Estriol preserves synaptic transmission in the hippocampus during autoimmune demyelinating disease. Lab Invest. 2012;92:1234-45 pubmed publisher
    ..We then determined if estriol, a candidate hormone treatment, was capable of preventing functional changes in synaptic transmission and ..
  20. Soldan S, Alvarez Retuerto A, Sicotte N, Voskuhl R. Immune modulation in multiple sclerosis patients treated with the pregnancy hormone estriol. J Immunol. 2003;171:6267-74 pubmed
    ..The hormone estriol increases during pregnancy and has been shown to ameliorate experimental autoimmune encephalomyelitis and ..
  21. Jiang X, Waterland M, Blackwell L, Wu Y, Jayasundera K, Partridge A. Sensitive determination of estriol-16-glucuronide using surface plasmon resonance sensing. Steroids. 2009;74:819-24 pubmed publisher
    For the quantitative evaluation of low levels of an estriol metabolite of estriol (estriol-16-glucuronide (E3-16G)) in liquid media, we developed a simple and highly sensitive immunoassay using a surface plasmon resonance (SPR) biosensor ..
  22. Gagnon A, Wilson R. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can. 2008;30:918-932 pubmed publisher
    ..PAPP-A (pregnancy associated plasma protein A), AFP (alphafetoprotein), hCG (human chorionic gonadotropin), estriol, unconjugated estriol, inhibin, inhibin-A, maternal serum screen, triple marker screen, quadruple screen, ..
  23. Vranken G, Reynolds T, Van Nueten J. Medians for second-trimester maternal serum markers: geographical differences and variation caused by median multiples-of-median equations. J Clin Pathol. 2006;59:639-44 pubmed
    ..The log-linear equation is observed to give a good fit and can be suggested as a tool for calculating median MoM values for Belgian laboratories that use Access biochemical prenatal markers. ..
  24. Lyytinen H, Pukkala E, Ylikorkala O. Breast cancer risk in postmenopausal women using estrogen-only therapy. Obstet Gynecol. 2006;108:1354-60 pubmed
    ..All Finnish women older than age 50 years using oral or transdermal estradiol (n=84,729), oral estriol (n=7,941), or vaginal estrogens (n=18,314) for at least 6 months during 1994-2001 were identified from the ..
  25. Akarasereenont P, Tripatara P, Chotewuttakorn S, Palo T, Thaworn A. The effects of estrone, estradiol and estriol on platelet aggregation induced by adrenaline and adenosine diphosphate. Platelets. 2006;17:441-7 pubmed
    ..Here, we investigated the effects of various forms of estrogen, including estrone (E1), estradiol (E2) and estriol (E3), on platelet aggregation induced by standard agonists (adrenaline and adenosine diphosphate)...
  26. Raz R, Colodner R, Rohana Y, Battino S, Rottensterich E, Wasser I, et al. Effectiveness of estriol-containing vaginal pessaries and nitrofurantoin macrocrystal therapy in the prevention of recurrent urinary tract infection in postmenopausal women. Clin Infect Dis. 2003;36:1362-8 pubmed
    We compared the efficacy and safety of estriol-containing vaginal pessary use with those of oral nitrofurantoin macrocrystal (NM) therapy for preventing urinary tract infection (UTI) in postmenopausal women with recurrent UTI...
  27. Acevedo R, Parnell P, Villanueva H, Chapman L, Gimenez T, Gray S, et al. The contribution of hepatic steroid metabolism to serum estradiol and estriol concentrations in nonylphenol treated MMTVneu mice and its potential effects on breast cancer incidence and latency. J Appl Toxicol. 2005;25:339-53 pubmed
    ..Research has suggested that the increased production of the estrogenically active 16-hydroxy products such as estriol (E3) may be involved in increased susceptibility to breast cancer...
  28. Sadick H, Riedel F, Oulmi J, Hormann K, Bergler W. [Argon plasma coagulation and topically applied estriol. Long-term results in the treatment of hereditary hemorrhagic telangiectasia of the nasal mucosa]. HNO. 2003;51:118-24 pubmed
    ..treatment of the bleeding telangiectasia with argon plasma, an additional postoperative long-term treatment with estriol nose-ointment was performed and the results were analysed...
  29. Weintrob N, Drouin J, Vallette Kasic S, Taub E, Marom D, Lebenthal Y, et al. Low estriol levels in the maternal triple-marker screen as a predictor of isolated adrenocorticotropic hormone deficiency caused by a new mutation in the TPIT gene. Pediatrics. 2006;117:e322-7 pubmed
    ..serum analyte test that measures levels of alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol for the detection of Down syndrome and open neural-tube defects...
  30. Podust L, Yermalitskaya L, Lepesheva G, Podust V, Dalmasso E, Waterman M. Estriol bound and ligand-free structures of sterol 14alpha-demethylase. Structure. 2004;12:1937-45 pubmed
    ..Here, we report CYP51 structures in ligand-free and estriol bound forms...
  31. Jelliffe Pawlowski L, Baer R, Currier R. Second trimester serum predictors of preterm birth in a population-based sample of low-risk pregnancies. Prenat Diagn. 2010;30:727-33 pubmed publisher
    ..with an abnormal level of alpha-fetoprotein (AFP), human chorionic gonatotropin (hCG), and/or unconjugated estriol (uE3) compared to pregnancies with normal biomarker levels...
  32. Lagiou P, Samoli E, Lagiou A, Hsieh C, Adami H, Trichopoulos D. Maternal height, pregnancy estriol and birth weight in reference to breast cancer risk in Boston and Shanghai. Int J Cancer. 2005;117:494-8 pubmed
    ..with breast cancer risk in adult life and is positively associated with the principal pregnancy estrogen estriol. Birth weight is lower among Chinese women than among Caucasian women, but paradoxically, pregnancy estriol ..
  33. Smith R, Smith J, Shen X, Engel P, Bowman M, McGrath S, et al. Patterns of plasma corticotropin-releasing hormone, progesterone, estradiol, and estriol change and the onset of human labor. J Clin Endocrinol Metab. 2009;94:2066-74 pubmed publisher
    ..associations of rates of change of circulating maternal CRH in midpregnancy with preterm delivery, CRH with estriol (E3) concentrations in late pregnancy, and predelivery changes in the ratios of E3, estradiol (E2), and P...
  34. Lampinen Salomonsson M, Bondesson U, Petersson C, Hedeland M. Differentiation of estriol glucuronide isomers by chemical derivatization and electrospray tandem mass spectrometry. Rapid Commun Mass Spectrom. 2006;20:1429-40 pubmed
    This paper describes a way of differentiating between the three isomers of estriol glucuronide by the use of chemical derivatization and liquid chromatography/electrospray tandem mass spectrometry (MS/MS)...
  35. Watson C, Jeng Y, Kochukov M. Nongenomic actions of estradiol compared with estrone and estriol in pituitary tumor cell signaling and proliferation. FASEB J. 2008;22:3328-36 pubmed publisher
    Physiological estrogens, including estrone (E(1)), estradiol (E(2)), and estriol (E(3)), fluctuate with life stage, suggesting specific roles for them in biological and disease processes...
  36. Suri R, Hellemann G, Cohen L, Aquino A, Altshuler L. Saliva estriol levels in women with and without prenatal antidepressant treatment. Biol Psychiatry. 2008;64:533-7 pubmed publisher
    ..This study measured saliva levels of estriol, a hormone that increases exponentially in the few weeks before spontaneous labor, in pregnant women with and ..
  37. Klebanoff M, Meis P, Dombrowski M, Zhao Y, Moawad A, Northen A, et al. Salivary progesterone and estriol among pregnant women treated with 17-alpha-hydroxyprogesterone caproate or placebo. Am J Obstet Gynecol. 2008;199:506.e1-7 pubmed publisher
    The objectives of the study was to determine whether salivary progesterone (P) or estriol (E3) concentration at 16-20 weeks' gestation predicts preterm birth or the response to 17alpha-hydroxyprogesterone caproate (17OHPC) and whether ..
  38. Marshall I, Ugrasbul F, Manginello F, Wajnrajch M, Shackleton C, New M, et al. Congenital hypopituitarism as a cause of undetectable estriol levels in the maternal triple-marker screen. J Clin Endocrinol Metab. 2003;88:4144-8 pubmed
    ..panhypopituitarism, in whom deficient fetal steroidogenesis was suspected prenatally because of undetectable estriol levels measured in the maternal triple-marker screen. No fetal abnormalities were detected by ultrasonography...
  39. Yamauchi H. Effects of night work on urinary excretion rates of 6-sulfatoxymelatonin, norepinephrine and estriol in pregnant women. Ind Health. 2004;42:268-76 pubmed
    ..concentrations of 6-sulfatoxymelatonin and norepinephrine were measured by enzyme-linked immunosorbent assay and estriol by radioimmunoassay...
  40. Elskus A. Estradiol and estriol suppress CYP1A expression in rainbow trout primary hepatocytes. Mar Environ Res. 2004;58:463-7 pubmed
    ..from juvenile rainbow trout (Oncorhynchus mykiss) with vehicle, 17beta-estradiol, or the estrogen metabolite, estriol, alone and in combination with each other and with the potent CYP1A inducer, benzo[a]pyrene (B[a]P)...
  41. Yamasaki R, Ohyagi Y, Kawajiri M, Shigeto H, Ikezoe K, Furuya H, et al. [A patient with mitochondrial encephalomyopathy presenting gynecomastia with elevation of serum estriol level]. Rinsho Shinkeigaku. 2004;44:291-5 pubmed
    ..9 pg/ml, normal, 20-59), normal estrone (24.0 pg/ml, normal<30.0) and mildly increased estriol (6.03 pg/ml, normal<5.0) were found...
  42. Sadick H, Naim R, Ramin N, Oulmi J, Hormann K, Karl H, et al. Plasma surgery and topical estriol: effects on the nasal mucosa and long-term results in patients with Osler's disease. Otolaryngol Head Neck Surg. 2003;129:233-8 pubmed
    ..goal was to report on the long-term results and effect of argon plasma coagulation (APC) surgery and topical estriol in patients with Osler's disease who had recurrent epistaxis...
  43. Mucci L, Lagiou P, Tamimi R, Hsieh C, Adami H, Trichopoulos D. Pregnancy estriol, estradiol, progesterone and prolactin in relation to birth weight and other birth size variables (United States). Cancer Causes Control. 2003;14:311-8 pubmed
    ..been hypothesized to affect breast cancer risk in the offspring, we have evaluated the association of pregnancy estriol (E3), estradiol (E2), progesterone and prolactin in maternal serum samples collected during the 16th and 27th ..
  44. Odibo A, Sehdev H, Stamilio D, Macones G. Evaluating the thresholds of abnormal second trimester multiple marker screening tests associated with intra-uterine growth restriction. Am J Perinatol. 2006;23:363-7 pubmed
    ..markers evaluated include alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and unconjugated estriol (uE3)...
  45. Huttly W, Rudnicka A, Wald N. Second-trimester prenatal screening markers for Down syndrome in women with insulin-dependent diabetes mellitus. Prenat Diagn. 2004;24:804-7 pubmed
    ..The other markers were not significantly different in women with and without IDDM. There remains a case for adjusting AFP and uE3 levels in women with IDDM in prenatal screening programmes for Down syndrome. ..
  46. Huang R, Kaji Y, Fukuda S, Oshika T. Experimental use of estriol for visualizing the vitreous body in the anterior chamber after posterior capsule rupture in animal models. J Cataract Refract Surg. 2009;35:1260-5 pubmed publisher
    To compare the efficacy and safety of estriol and triamcinolone acetonide suspensions in visualizing the prolapsed vitreous body in the anterior chamber after posterior capsule rupture in animal models...
  47. Dugoff L, Hobbins J, Malone F, Vidaver J, Sullivan L, Canick J, et al. Quad screen as a predictor of adverse pregnancy outcome. Obstet Gynecol. 2005;106:260-7 pubmed
    ..levels of maternal serum alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE3), and inhibin A (the quad screen) on obstetric complications by using a large, prospectively collected ..
  48. Jacobson H, Lemanski N, Narendran A, Agarwal A, Bennett J, Andersen T. Hormones of pregnancy, alpha-feto protein, and reduction of breast cancer risk. Adv Exp Med Biol. 2008;617:477-84 pubmed publisher
    ..It has been reasoned that hormones (either estradiol E2 or estriol E3), progesterone (P) or human chorionic gonadotropin (hCG) in the serum of pregnant women might lead to that ..
  49. Shackleton C, Marcos J, Palomaki G, Craig W, Kelley R, Kratz L, et al. Dehydrosteroid measurements in maternal urine or serum for the prenatal diagnosis of Smith-Lemli-Opitz syndrome (SLOS). Am J Med Genet A. 2007;143A:2129-36 pubmed
    ..7-PT/PT), 8-dehydropregnanetriol/PT (8-PT/PT), the sum of these two (7 + 8-PT/PT), and dehydroestriol/estriol (DHE3/E3)...
  50. Malone F, Canick J, Ball R, Nyberg D, Comstock C, Bukowski R, et al. First-trimester or second-trimester screening, or both, for Down's syndrome. N Engl J Med. 2005;353:2001-11 pubmed
    ..quadruple screening (measurement of alpha-fetoprotein, total human chorionic gonadotropin, unconjugated estriol, and inhibin A at 15 through 18 weeks of gestation)...
  51. Glaser R, Zava D, Wurtzbacher D. Pilot study: absorption and efficacy of multiple hormones delivered in a single cream applied to the mucous membranes of the labia and vagina. Gynecol Obstet Invest. 2008;66:111-8 pubmed publisher
    ..This pilot study examined the extent of absorption of a single cream containing estriol, estradiol, progesterone, DHEA, and testosterone...
  52. Ruiz R, Saade G, Brown C, Nelson Becker C, Tan A, Bishop S, et al. The effect of acculturation on progesterone/estriol ratios and preterm birth in Hispanics. Obstet Gynecol. 2008;111:309-16 pubmed publisher
    To examine the Hispanic acculturation paradox by identifying the effect of acculturation on serum progesterone and estriol levels, the progesterone/estriol ratio, and preterm birth...
  53. Jean A, Mansukhani M, Oberfield S, Fennoy I, Nakamoto J, Atwan M, et al. Prenatal diagnosis of congenital lipoid adrenal hyperplasia (CLAH) by estriol amniotic fluid analysis and molecular genetic testing. Prenat Diagn. 2008;28:11-4 pubmed
    ..CLAH was diagnosed prenatally by measuring amniotic fluid estriol, adrenal, and gonadal hormone levels, and by mutation analysis for the c.201-202 delCT mutation in StAR...