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PharmGKB · ClinPGx

Estrogen Metabolism Pathway, Pharmacokinetics

PA145011118 Last updated September 2024 Zeruesenay Desta, Anne Nguyen, David Flockhart, Todd Skaar, Rebecca Fletcher, R…
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Estrogen Metabolism Pathway, Pharmacokinetics pathway diagram
Estrogen Metabolism Pathway, Pharmacokinetics — pathway diagram from PharmGKB / ClinPGx
Click to enlarge

About this pathway

The liver is a site for biosynthesis of estrogens but it is also the main site for further biotransformation of them. Once the estrogens are synthesized by aromatase in peripheral tissues including the liver, they will be released to the circulation. Estrone is in equilibrium with estradiol and 17-b-hydroxysteroid dehydrogenase (17bHSD) in this respect. The estrogens are taken up by the liver where they will be biotransformed further in to different metabolites. The major oxidative routes of estrone and estradiol are 2- and 4-hydroxylation by cytochrome P450 (CYP) 2B1, 1A and 3A. Other minor oxidative pathways are also identified (not shown in the pathway). The 2- and 4-hydroxy derivatives (and other metabolites) will be further converted to 2- and 4-methoxy metabolites by catechol-O-methyltransferase (COMT). While the hydroxylated metabolites appear to result in DNA damage and contribute to the tumerogenic effect of estrogen, the methoxy-derivatives appear to exhibit beneficial cardiovascular effects. Estrone and estradiol and their metabolites undergo sulfation by sulfotransferases (SULTs) and glucuronidation by glucoronyltransferases (UGTs). Estrone and estradiol sulfates could be deconjugated by sulfatases (STs).

Reactions & interactions (26)

  • Biochemical Reaction
    estradiol 2-hydroxyestradiol
  • Biochemical Reaction
    4-hydroxyestradiol 4-methoxyestradiol
  • Biochemical Reaction
    estradiol 4-hydroxyestradiol
  • Biochemical Reaction
    testosterone estradiol
  • Biochemical Reaction
    estrone estradiol
  • Biochemical Reaction
    androstenedione testosterone
  • Biochemical Reaction
    estrone estrone sulfate
  • Biochemical Reaction
    androstenedione estrone
  • Biochemical Reaction
    2-hydroxyestradiol 2-methoxyestradiol
  • Catalysis
    CYP3A4 Biochemical Reaction
  • Catalysis
    CYP1A1 Biochemical Reaction
  • Catalysis
    CYP1A2 Biochemical Reaction
  • Catalysis
    CYP1B1 Biochemical Reaction
  • Catalysis
    CYP3A5 Biochemical Reaction
  • Catalysis
    COMT Biochemical Reaction
  • Catalysis
    CYP1A1 Biochemical Reaction
  • Catalysis
    CYP3A5 Biochemical Reaction
  • Catalysis
    CYP1B1 Biochemical Reaction
  • Catalysis
    CYP3A4 Biochemical Reaction
  • Catalysis
    CYP1A2 Biochemical Reaction
  • Catalysis
    CYP19A1 Biochemical Reaction
  • Catalysis
    HSD17B1 Biochemical Reaction
  • Catalysis
    HSD17B1 Biochemical Reaction
  • Catalysis
    SULT1A1 Biochemical Reaction
  • Catalysis
    CYP19A1 Biochemical Reaction
  • Catalysis
    COMT Biochemical Reaction

Edit history (3)

  • 2005-08-20 Create
  • 2011-04-18 Update
  • 2024-09-06 Update Updated figure to remove obsolete CYP3A and replace with CYP3A4. Updated summary sentence.
Estrogen Metabolism Pathway, Pharmacokinetics pathway diagram (enlarged)