Androstenedione is one of the sex hormones. It belongs to the androgens (steroid hormones) which are produced in both sexes in the adrenal glands and, in addition, in the testes of men and the ovaries of women. What is the role of androstenedione? What are the indications for testing the level of androstenedione and what are the standards of this hormone for women and men?
Androstenedioneis a glucocorticoid hormone belonging to the group of androgens, i.e. sex hormones, similar to dehydroepiandrostenedione (DHEA), dihydrotestosterone (DHT) and testosterone.
Both androstenedione and DHEA have a weak biological effect. In peripheral tissues, however, they are converted to a strong androgen, which is testosterone, and this is why they are said to have androgenic effects.
The role of adrenal androgens differs depending on gender and is in controlling the proper sexual development of men and women.
Determining their concentration in the blood serum is important in the diagnosis of adrenal hyperplasia, adrenal neoplastic diseases, as well as the causes of female infertility.
Where is androstenedione produced?
The hormone is secreted by the reticular layer of the adrenal cortex, as well as by the ovaries and testes. The production of androstenedione in the adrenal glands is stimulated by ACTH, an adrenocorticotropic hormone produced and secreted by the anterior lobe of the human pituitary gland.
Role of androstedion
In women, androstenedione and other adrenal androgens are mainly responsible for the appearance of pubic and axillary hair.
In men, however, scientists speculate that adrenal androgens only play a role in the early stages of male genital development, and that testosterone later takes on the androgenic role, which is produced in much greater amounts in the testes.
Testosterone is an important hormone responsible for, among other things, sex determination in human womb, the development of male sexual characteristics, as well as the level of libido and human sex drive.
Test of androstedione concentration - indications
Determining the concentration of androstenedione is most often used in the diagnosis of adrenal diseases, such as:
- Congenital Adrenal Hyperplasia (CAH)
- virilizing tumor
- Cushing's disease
- cancer
The very result of the laboratory test, however, does not allow for such a serious diagnosis, you should visit your doctor to extend the diagnosis with appropriate additional laboratory tests and imaging diagnostics.
The physician should order the determination of the level of androstenedione and other androgens in women with male tertiary sexual characteristics, i.e. virilization. The main symptoms of this condition include:
- excessive hair in areas typical for men (beard, mustache, chest, inner thighs)
- breast reduction
- clitoral enlargement
- lowering the voice
- increase muscle mass
- bothersome acne
- male pattern baldness
- menstrual disorders
Testing the concentration of androstenedione may be important in the diagnosis of hormonal disorders and the causes of infertility in women.
Increased concentration of the hormone can be observed in diseases such as:
- Policystic Ovary Syndrome (PCOS)
- some cancers of the ovaries and testicles.
Examination of androstedione - preparation
Serum androstenedione concentration should be tested one week before or one week after the expected menstruation.
If the test is performed for urgent indications, the patient should inform the nurse collecting the blood sample on which day of the menstrual cycle it is now, as this may affect the subsequent interpretation of the result.
The patient does not need to fasting for a reliable assessment of blood hormone levels, but should avoid vigorous exercise for the few days preceding the test.
It is worth mentioning that the level of androstenedione secretion is subject to the circadian rhythm (it increases in the morning, it is the lowest at night), therefore you should report for the test in the morning, preferably between 7:00 and 10:00 in the morning.
Determination of androstenedione concentration should be performed in conjunction with the assessment of the levels of other sex hormones, incl. testosterone, dehydroepiandrostenedione and progesterone.
Examination of androstedione - course
The concentration of androstenedione is determined in the venous blood serum.
After disinfecting the skin around the elbow fossa, venous blood is collected from a vein in the arm with 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, this will preventunsightly bruise.
The concentration of androstenedione, DHEA, DHEA-S in the blood is determined in medical laboratories by radioimmunological (RIA) or immunoenzymatic (ELISA) methods, and you should wait for a few working days for the results.
The cost of testing each of these hormones is similar and, depending on the laboratory, is around PLN 50.
Norms of androstenedione in women and men
| WOMEN | MEN | |
| DHEA | 7-31 nmol / l (200-900 ng / dl) | 7-31 nmol / l (200-900 ng / dl) |
| DHEA-S | 2-10 mocromol / l (75-370 microg / dl) | 3-12 micromol / l (110-470 microg / dl) |
| androstendion | 1.4-9.4 nmol / l (40-270 ng / dl) | 2.8-9.8 nmol / l (80-280ng / dl) |
Increased concentration of androstenedione
Very high concentrations of androstenedione, DHEA and DHEA-S detected in laboratory tests, depending on the sex and age of the patient subjected to the test, may indicate, among others:
- Policystic Ovary Syndrome (PCOS)
- adrenal cancer
- virilizing tumors of the adrenal glands
- congenital adrenal hyperplasia.
The results should be presented to the referring physician, who will decide on the need for further diagnostics and possible extension of it with imaging tests, such as ultrasound examinations (USG), computed tomography (CT) or magnetic resonance imaging (MRI).
In women, the excessive secretion of androstenedione and other adrenal hormones may result in virilization and hirsutism (male hirsutism on the chest, face, abdomen, inner thighs).
In boys, too high concentration of androgenic hormones (caused e.g. by a tumor of the adrenal cortex) leads to alleged premature puberty with excessive development of secondary male sexual characteristics.
Physiologically, the concentration of androstenedione increases:
- morning
- during intense physical exertion
- during the menstrual cycle (Graaf's follicle produces androstenedione)
- during pregnancy
Reduced concentration of androstenedione
Reduced androstenedione concentration can be observed in people suffering from adrenal insufficiency, endocrine diseases related to the extinction of ovarian function or hematological diseases such as sickle cell anemia.
Abnormal androstenedione level - treatment
Remember that the patient should be treated and not the result of the laboratory test,therefore detecting only elevated or lowered levels of androstenedione in the blood does not en title the initiation of any treatment.
Only after a thorough examination of the patient, 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 involves treating the underlying disease.