Androgens, or androgen hormones, belong to the group of steroidal sex hormones. The role of androgens differs depending on the gender and is to control the proper sexual development of men and women. What is the correct concentration of androgens in women and what is in men?

Androgens , i.e.androgen hormonesare androstenedione, dehydroepiandrostenedione (DHEA), dihydrotestosterone (DHT) and testosterone.

The adrenal glands are responsible for their production and secretion in both sexes, while in men this role is additionally played by Leydig cells in the testes, and in women to a small extent by the ovaries.

Determining their concentration in the blood serum is important, among others, in the diagnosis of hypogonadism in men, excessive baldness, adrenal diseases, such as adrenal hyperplasia, neoplastic diseases of the gonads and adrenal glands, as well as the causes of female infertility, menstrual disorders or the occurrence of excessive body hair.

Androgen hormones (Androgens): Features

Androgen hormones are present in both sexes, but they are much more important in men, because they are associated with the development and shaping of male sexual organs during prenatal life and the production of secondary sexual characteristics.

These include, among others, the silhouette typical for men and the proportions of the body structure, the development of muscle tissue greater than in women, the characteristic distribution of adipose tissue, a low tone of voice, as well as the occurrence of body hair typical of the male sex.

  • Androstenedion

Androstenedione is an androgen hormone with a weak biological effect. In peripheral tissues, it is converted to a strong androgen, which is testosterone, and this is why it is said about the androgenic effect of androstenedione.

It is produced mainly in the adrenal glands under the influence of the hormone ACTH (adrenocorticotropic hormone), produced and secreted by the anterior lobe of the human pituitary gland.

Determination of the concentration of androstenedione in the blood serum is mainly used in the diagnosis of adrenal diseases such as congenital adrenal hyperplasia (CAH), virilizing tumor, tumorvirilizing, Cushing's disease or neoplastic diseases, as well as hormonal disorders, virilization and causes of infertility in women.

  • DHEA-S

Dehydroepiandrostenedione sulfate is a steroidal sex hormone produced, like androstenedione, by the adrenal cortex. It plays a weak androgenic role in the human body. Determination of DHEA-S concentration is mainly used in endocrinology, for the diagnosis of adrenal gland diseases.

  • Testosterone

Testosterone is an important androgenic hormone, in men 95% of the circulating hormone comes from the testicles and 5% from peripheral conversion.

It is responsible, inter alia, for the determination of sex in human fetal life, the development of male sexual characteristics, as well as the level of libido and human sex drive.

Under its influence, typical male features are shaped, such as the height and shape of the figure, fat tissue distribution, low tone of voice or characteristic hair growth.

  • Dihydrotestosterone (DHT)

Dihydrotestosterone (DHT) is a highly active sex hormone that is formed by the conversion of testosterone.

In men, 20% of circulating DHT comes from the testicles and 80% from the peripheral conversion. The conversion of testosterone into DHT occurs under the influence of the enzyme alpha-reductase, which is found, among others, in the skin.

This hormone can affect sensitive, weakened hair follicles, be responsible for their shrinkage and hair loss.

The main functions of dihydrotestosterone include participation in male sex determination during human fetal life, as well as the influence on the regulation of androgen secretion by acting on the hypothalamic-pituitary-gonadal axis.

Androgens (androgen hormones) in women

Androgen hormones, especially androstenedione and dihydrotestosterone, in the female body mainly play the role of precursors to female sex hormones, i.e. estrogens. They are mainly responsible for the initiation and control of the sexual maturation process in girls, as well as for the level of libido, sex drive and fertility of mature women.

Androgens - indications for testing in women

  • Existence of excessive hair in androgen-sensitive areas typical for men, i.e. hirsutism. Hard, dark hair can appear around the upper lip and chin, forearms, thighs, chest, abdomen, back, and also around the genitals. To assess the severity of hirsutism and the need for further diagnostics, the Ferriman-Gallwey scale is used, which is used to determine the presence of excessive hair in 9 points of the body ina scale of 1 (single hair) to 4 (thick hair). Hirsutism is diagnosed when a woman scores more than 8 points together.
  • The occurrence of male tertiary sexual characteristics in women, i.e. virilization (also known as masculinization). The main symptoms of this condition include excessive hair in areas typical for men (beard, mustache, chest, inner thighs), reduction of the mammary glands, enlargement of the clitoris, lowering of the voice tone, increased muscle mass, and the occurrence of troublesome acne. In addition, many women complain of seborrheic dermatitis, male pattern baldness (hair falls out around the temporal angles, forehead and on the top of the head, bends appear) and menstrual disorders.
  • Difficulties with getting pregnant despite having regular intercourse (3-4 times a week) without the use of contraceptives. If a woman does not become pregnant for one year, she is diagnosed with infertility.

Androgens (androgen hormones) in men

Androgen hormones play an important role in the male body from the moment of conception. It is testosterone that is responsible for the development of the male characteristics of the fetus, it induces the differentiation of the Wolff ducts into male accessory glands, epididymis and exiting pathways.

In addition, androgens are responsible for the proper development of male sexual characteristics (body structure, height, facial hair, body hair), low voice tone, sex drive and spermatogenesis.

Androgens - indications for testing in men

  • decreased sex drive (decreased libido)
  • erectile dysfunction
  • infertility (If your partner cannot get pregnant despite regular sexual intercourse 3-4 times a week without using contraceptives for at least one year, both male and female fertility problems should be excluded)
  • male pattern baldness, i.e. androgenic hair loss on the whole body
  • adipose tissue begins to accumulate in places typical for women, i.e. thighs, hips, arms and breasts
  • premature puberty and emergence of secondary male sex characteristics in boys

Androgens - causes of increased concentration in women

Androgenic hormones are produced in the adrenal cortex and gonads, therefore the diseases of these organs should be taken into account in the diagnosis of increased levels of sex hormones in the blood. The most common pathologies causing abnormal hormonal test results are:Adrenal gland disorders

  • congenital adrenal hyperplasia
  • neoplastic tumors located in the adrenal glands, hormonally active (producing hormones)
  • virilizing tumor
  • Cushing's syndrome

Gonadal disorders

  • polycystic ovary syndrome (PCOS)
  • neoplastic tumors located in the ovaries and testes, hormonally active (producing hormones)

Drugs

  • anticonvulsants used in the treatment of epilepsy
  • glucocorticosteroids
  • certain diuretics used to treat high blood pressure

Androgens - preparation for the test

The androgen concentration in peripheral blood serum should be tested in the morning. The patient does not need to fasting to obtain reliable results, but should avoid vigorous physical exertion for the few days preceding the test.

It is worth mentioning that women should perform a sex hormone test at the beginning of the menstrual cycle, preferably in the 3rd to 10th. day of the cycle.

The laboratory technician should be informed about the hormonal medications taken by the patient, which include contraceptives, and many women forget about them.

Androgens (androgen hormones) - the course of the study

The concentration of androstenedione is determined in the venous blood serum. After disinfecting the skin in the area of ​​the elbow, venous blood is collected from the ulnar vein using a sterile, disposable needle.

After removing the needle, press the injection site with a sterile gauze for at least 10 minutes and do not lift the upper limb upwards, it will prevent an unsightly bruise.

Testing the concentration of sex steroid hormones can be performed free of charge in the medical laboratory upon presentation of a referral from a doctor, or for a fee.

The cost of a privately commissioned test oscillates around PLN 50 for determining the concentration of DHEA-S (dehydroepiandrostenedione sulphate). You need to pay about PLN 30 for the testosterone concentration.

Prices may vary significantly between institutions offering laboratory tests, so it is worth choosing the most advantageous offer for the patient. You should wait a few working days for the results of sex hormone tests.

Androgens (androgen hormones) - laboratory norms

Each medical laboratory sets its own ranges of androgen hormone levels, which may vary slightly between institutions. For this reason, in order to control the concentration of hormones in the blood serum and be able to compare the results with each otherdeterminations, tests should be carried out in the same laboratory.

WomenMen
testosterone0.52-2.43 nmol / l (15-70 ng / dl)9.0-34.7 nmol / l (260-1000 ng / ml)
free testosterone<29,5 pmol/l (<8,5 ng/l)174-792 pmol / l (50-210 ng / l)
androstendion1.4-9.4 nmol / l (40-270 ng / dl)2.8-9.8 nmol / l (80-280 ng / dl)
dihydroepiandrostenedione (DHEA)7-31 nmol / l (200-900 ng / dl)7-31 nmol / l (200-900 ng / dl)
dihydroepiandrostenedione sulfate (DHEA-S)2-10 µmol / l (75-370 µg / dl)3-12 µmol / l (110-470 µg / dl)

Androgens (androgen hormones) - treatment

Based on a single blood androgen concentration determination, it is not possible to make an accurate diagnosis and introduce any treatment.

Only after a thorough examination of the patient, reading his medical records, clinical condition and examining the test results, ordering any additional laboratory tests and imaging tests, the doctor is able to make a diagnosis and offer the patient a treatment, which usually consists in treating the disease basic and symptomatic treatment.

Diseases caused by hormonal changes are de alt with by a specialist endocrinologist.

Women who have elevated levels of androgens in their blood have the most complaints of excessive hair.

Hormonal drugs can reduce the amount of new hair, and existing hair can be reduced thanks to both temporary (e.g. wax) and permanent (laser hair removal) depilation.

Men most often visit a doctor because of excessive hair loss.

Male pattern baldness and its progression can be inhibited or slowed down thanks to a pharmaceutical drug from the steroid group, which is responsible for inhibiting the local conversion of testosterone to its active form in the hair follicles.

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