Plasma androgens, progestins, and prolactin in hirsutism

Blood samples were obtained from 158 hirsute women for determination of dehydroepiandrosterone-sulfate (DS), testosterone (T), progesterone (P), 17 alpha-hydroxy-progesterone (17P) and prolactin (PRL). The percent frequency of elevated level of these hormones in hirsute women was: DS: 35%, T: 55%, P: 25%, 17P: 53% and PRL: 6%. The mean (+/-SE) levels of DS (2.36+/-0.1 microgram/ml) and T (714+/-21 pg/ml) in hirsute women were elevated, both in the pre- and postovulatory phases; while 17P in hirsute women was decreased in the postovulatory phase (1.59+/-0.48 ng/ml) and increased in the preovulatory phase (1.51+/-0.18 ng/ml) when they were compared with their respective controls. PRL in postovulatory hirsute women was also lower (12.0+/-1.1 ng/ml) than the control. Sixty patients were subjected to a 2-wk dexamethasone (DXM) suppression test to determine the source of androgen excess. The results of DXM suppression test suggested that the sources of androgen excess in hirsute women were: ovarian: 33% adrenal: 25%, mixed (ovarian plus adrenal): 35%, and none: 7%. The results also suggested that excess progestins in hirsute women were attributed to either ovarian (P) or adrenal (17P) hypersecretion. Correlation analysis between these hormones showed a significant (P less than 0.05) correlation only between P vs. 17P, T vs. 17P, and T vs. DS.