Age-Specific Reference Ranges for Serum Testosterone and Androstenedione Concentrations in Women Measured by Liquid Chromatography-Tandem Mass Spectrometry

Häring, R.; Hannemann, Anke; John, Ulrich; Radke, Dörte; Nauck, Matthias; Wallaschofski, Henri; Owen, Laura; Adaway, Jo; Keevil, Brian; Brabant, Georg

doi:10.1210/jc.2011-2134

Cited by 162 publications

(113 citation statements)

References 37 publications

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“…Therefore only women who had not used hormonal contraception for at least 3 months were included in the study and there was a 3-cycle run-in period with COC use alone prior to the DHEA/placebo treatment period. The observed qualitative changes of the (precursor) androgens and SHBG after COC use alone are in agreement with previous studies [1,2,[17][18][19][20][21], but the quantitative suppression of total T and free T by 62% and 86%, respectively is more pronounced than reported in the literature previously (mean of 31% and 61%, respectively) [1]. Importantly, all COC users experienced a decrease of their total and free T.…”

Section: Discussionsupporting

confidence: 92%

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects

et al. 2015

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Section: Discussionsupporting

confidence: 92%

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects

et al. 2015

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“…6 In cross-sectional studies, concentrations of total testosterone have been reported to be lower in postmenopausal compared with premenopausal women, 7,8 whereas in longitudinal studies, either no change 9 or a 15% to 30% fall have been reported. 10,11 In the present study of women from the general population, we observed the expected fall in estradiol coinciding with menopause, whereas testosterone concentrations were largely unchanged from the age of 20 to >80 years.Median plasma estradiol and testosterone concentrations were in the present study relatively high in both pre-and postmenopausal women. The reason for this is unknown; however, Figure 2.…”

supporting

confidence: 44%

Extreme Concentrations of Endogenous Sex Hormones, Ischemic Heart Disease, and Death in Women

Benn

Voss

Holmegard

et al. 2015

ATVB

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Objective-Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting.To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of ischemic heart disease and death in women. Approach and Results-In a nested prospective cohort study, we measured plasma estradiol in 4600 and total testosterone in 4716 women not receiving oral contraceptives or hormonal replacement therapy from the 1981 to 1983 examination of the Copenhagen City Heart Study. During ≤30 years of follow-up, 1013 women developed ischemic heart disease and 2716 died. In women with a plasma estradiol below the fifth percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk of ischemic heart disease was 44% (95% confidence interval, 14%-81%) higher; however, plasma estradiol concentrations did not associate with death. Also, in women with a plasma testosterone concentration at or above the 95th percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk was 68% (34%-210%) higher for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. Conclusions-In women, extreme low concentrations of endogenous estradiol were associated with high risk of ischemic heart disease, and extreme high concentrations of endogenous testosterone were associated with high risk of ischemic heart disease and death. compared with younger women, percentiles of sex hormones were generated in 10-year age groups. Materials and MethodsMaterials and methods are available in the online-only Data Supplement. ResultsIn this nested cohort study, we included 4716 women from the 1981 to 1983 examination of the Copenhagen City Heart Study, which in total examined 12 698 individuals (7018 women and 5680 men) and is a prospective general population study, initiated in 1976 to 1978 with follow-up examinations in 1981 to 1983, 1991 to 1994, and 2001 to 2003. Among the 7018 women, plasma was available on 6023; however, as 247 women receiving oral contraceptives and 1060 receiving hormonal replacement therapy at baseline were excluded, plasma estradiol and testosterone measurements were available in 4600 and 4716 women for the present study. Baseline characteristics of these women are shown in the Table. Plasma Estradiol and TestosteroneFor plasma estradiol and testosterone concentrations, the median value was 445 pmol/L (interquartile range, 280-760; 95% confidence interval, 160-2170) in premenopausal and 150 pmol/L (120-180; 60-240) in postmenopausal women (Figure 1). For plasma testosterone concentrations, the corresponding values were 1.9 nmol/L (1.6-2.3; 1.1-3.1) in premenopausal and 1.9 nmol/L (1.5-2.3; 1.1-3.1) in postmenopausal women. Plasma estradiol and testosterone concentrations were relatively high in ...

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“…Although normal androgen cut-off levels have not been precisely established for menopause, it is generally accepted that they do not exceed those of premenopausal women (6,13). However, androgen levels are consistently higher in patients with nontumorous hyperandrogenism compared with nonhyperandrogenic postmenopausal women (14,15).…”

Section: Causes Of Hyperandrogenism After Menopausementioning

confidence: 99%

“…This state of relative androgen excess is biochemically best identified with the measurement of serum testosterone levels that only rarely exceed those found in premenopause (i.e. !40 ng/dl or 1.38 nmol/l) (6). After menopause, even such testosterone levels may lead to the development or re-appearance of hyperandrogenic symptoms clinically evident mainly in the skin as the appearance of a few terminal hairs in the face and decrease in body and scalp hair (7).…”

Section: Introductionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

Markopoulos

Kassi

Alexandraki

et al. 2015

European Journal of Endocrinology

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Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from either the adrenals and/or the ovaries, clinically manifested as the appearance and/or increase in terminal hair growth or the development of symptoms/signs of virilization. In either settings, physicians need to evaluate such patients and exclude the presence of the relatively rare but potentially life-threatening underlying tumorous causes, particularly adrenal androgen-secreting tumors. It has been suggested that the rapidity of onset along with severity of symptom and the degree of androgen excess followed by relevant imaging studies may suffice to identify the source of excessive androgen secretion. However, up to date, there is no consensus regarding specific clinical and hormonal indices and/or imaging modalities required for diagnostic certainty. This is particularly relevant as the aging population is increasing and more cases of postmenopausal women with clinical/biochemical evidence of hyperandrogenism may become apparent. Furthermore, the long-term sequels of nontumorous hyperandrogenism in postmenopausal women in respect to cardiovascular morbidity and mortality still remain unsettled. This review delineates the etiology and pathophysiology of relative and absolute androgen excess in postmenopausal women. Also, it attempts to unravel distinctive clinical features along with specific hormonal cut-off levels and/or appropriate imaging modalities for the facilitation of the differential diagnosis and the identification of potential long-term sequels.

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Age-Specific Reference Ranges for Serum Testosterone and Androstenedione Concentrations in Women Measured by Liquid Chromatography-Tandem Mass Spectrometry

Cited by 162 publications

References 37 publications

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects

Extreme Concentrations of Endogenous Sex Hormones, Ischemic Heart Disease, and Death in Women

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

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