Study of the source(s) of hyperandrogenism in women with idiopathic hirsutism

22 women with Idiopathic Hirsutism (IH) were studied in terms of their basal levels of total (tT) and free (fT) testosterone, dehydroepiandrosterone sulphate (DHEA-S) estradiol, androstenedione (Adione), LH and FSH. The gonadotropin response to GnRH was also studied. These studies were repeated after treatment for 30 days with buserelin, i. n., 900 micrograms/dya. It was observed that the reduction in fT after buserelin varied from nil to 79% of decrease over the baseline values. The suppression of fT (and also of tT and Adione) was normally distributed. Therefore, there was no evidence to suggest the presence of a non-suppressible "adrenal group" and of a suppressible "ovarian group". Interesting, and hitherto unreported, findings were the significant correlations between the percentual reduction of fT and tT and the pre-buserelin LH responses to GnRH. It is therefore suggested that both LH response to GnRH and androgen suppression after buserelin are markers of the degree of ovarian contribution to the androgen pool. Neither of these parameters correlated with basal tT, fT, Adione or body mass index, casting some doubts on the theorization that the LH hyperresponsiveness observed in IH or PCO are secondary to conditions that predispose to increased exposure to androgen-derived estrogens.