Screening for androgen deficiency in women: methodological and interpretive issues

Area of Science:

• Endocrinology
• Reproductive Health
• Clinical Chemistry

Background:

• Accurate assessment of androgen levels in women is crucial for diagnosing various conditions.
• Existing methodologies for measuring serum androgens present significant challenges in interpretation.
• Discrepancies among laboratories highlight the need for standardized androgen measurement protocols.

Purpose of the Study:

• To elucidate the complexities and challenges associated with obtaining and interpreting female androgen levels.
• To compare different laboratory methods and analytical techniques for serum androgen assessment.
• To identify optimal conditions for reliable measurement of testosterone and DHEAS in women.

Main Methods:

• Comprehensive review of existing literature on serum androgen analysis in women.
• Comparison of data from various laboratories and analytical methods.
• Utilized normal control populations from literature and compared with in-house quality control data.

Main Results:

• Significant disagreement exists among investigators and laboratories regarding the optimal method for measuring serum testosterone (T) in women.
• Measurement of dehydroepiandrosterone sulfate (DHEAS) levels is considerably less controversial and more standardized.
• Androgen levels naturally decrease with age, but current reference ranges are inaccurate due to lack of screening for sexual dysfunction in control groups.

Conclusions:

• For premenopausal women, serum testosterone (T) should be measured in the morning and during the mid-menstrual cycle.
• Serum dehydroepiandrosterone sulfate (DHEAS) can be measured at any time, offering greater flexibility.
• Development of accurate age-related androgen levels requires control populations screened for sexual dysfunction.