Testosterone or dihydrotestosterone: what should be evaluated in hirsutism?

Area of Science:

• Endocrinology
• Reproductive Health
• Dermatology

Background:

• Hirsutism is a condition characterized by excess androgenic effects in women.
• Dihydrotestosterone (DHT) is a potent androgen, but its role in hirsutism diagnosis is not well-established.
• Previous studies on DHT levels in hirsutism have yielded equivocal results.

Purpose of the Study:

• To investigate and compare serum dihydrotestosterone levels in women with hirsutism versus healthy controls.
• To determine if DHT measurement is a relevant factor in the evaluation of hirsutism.

Main Methods:

• A case-control study involving 101 women with hirsutism and 101 healthy controls.
• Serum levels of total testosterone, free testosterone, and dihydrotestosterone were measured using chemiluminescent immunoassay.
• Data on age, BMI, menstrual status, scalp hair density, and ovarian ultrasound findings were collected and analyzed.

Main Results:

• Significantly higher levels of free testosterone and dihydrotestosterone were observed in women with hirsutism (P < 0.001).
• No significant difference in total testosterone levels was found between the groups (P = 0.628).
• Elevated DHT levels correlated with menstrual irregularity, decreased scalp hair density, and polycystic ovaries on ultrasound (P < 0.05).

Conclusions:

• Serum dihydrotestosterone levels are significantly elevated in women with hirsutism.
• Despite not being routinely measured, elevated DHT is an important factor in hirsutism.
• Further research may clarify the role of DHT in hirsutism diagnosis and management.