Testosterone concentrations and oligomenorrhea in women with acne

Androgen excess is frequently associated with oligomenorrhea as well as acne. Oligomenorrhea in hirsute women has been demonstrated to be associated with higher active testosterone levels than found in eumenorrheic hirsute women. This study was designed to evaluate whether similar findings are present in women with acne. Forty-four consecutive women with acne were evaluated by measuring their levels of total testosterone, biologically active testosterone, and free testosterone. The women with oligomenorrhea and acne had significantly higher levels of biologically active testosterone than those with eumenorrhea and acne. This implies that biological active testosterone should be measured in oligomenorrheic women with acne and, if elevated, consideration should be given to antiandrogen therapy.

Data were collected from 44 consecutive Caucasian women aged 14 to 38 years. The patients were separated into two groups based on menstrual history. Group 1 had regular menses, and group 2 had oligomenorrhea, defined as menstrual intervals of greater than 36 days. All patients had blood samples drawn on their initial office visit, regardless of the phase of the menstrual cycle, and the levels of total testosterone (TT), biologically active testosterone (BT), and free testosterone (FT) were obtained.

The serum TT level was 87 +/- 41.3 ng/dL (range, 31-150 ng/dL) in oligomenorrheic women and 56 +/- 27.5 ng/dL (range 8-107 ng/dL) in eumenorrheic women. There was no statistically significant difference. The serum BT level in oligomenorrheic women was 33 +/- 16.9 ng/dL (range, 11-51 ng/dL) and in eumenorrheic women 19 +/- 13.6 ng/dL (range, 11-51 ng/dL). This difference was statistically significant (p < 0.05). The serum FT level in oligomenorrheic women was 18 +/- 9.4 pg/mL (range, 1-29 pg/mL) and in eumenorrheic women 10 +/- 7.1 pg/mL (range, 1-32 pg/mL). This difference was not statistically significant (Table 1).

Women with acne and oligomenorrhea, similar to women with hirsutism and oligomenorrhea, have higher levels of biologically active testosterone than those with normal menses.