Is abnormally elevated estradiol an expected finding in patients with PCOS?

High levels of estrogen can occur in PCOS, which can be prolonged due to lack of ovulation and insufficient amounts of progesterone. Particularly as these levels are expected to fluctuate throughout the cycle, I would not say there is a cut off necessarily for concern but would consider referring to GYN if seemingly more abnormal.

In PCOS, estradiol is usually in the normal range or only mildly elevated, not markedly high. If estradiol is really high, other causes should be evaluated for, such as estrogen-secreting ovarian tumors or other rare conditions. Routine estradiol testing is not recommended for diagnosing PCOS, since levels vary with the menstrual cycle and are not specific.