Testosterone Concentrations In Women Research Articles

Associations between blood sex steroid concentrations and risk of major adverse cardiovascular events in healthy older women in Australia: a prospective cohort substudy of the ASPREE trial

SummaryBackgroundBlood testosterone concentrations in women decline during the reproductive years and reach a nadir in the seventh decade, after which concentrations increase and are restored to those of reproductive-aged women early in the eighth decade. We aimed to establish the association between the concentration of testosterone in the blood and risk of major adverse cardiovascular events (MACE) and all-cause mortality in healthy older women.MethodsSHOW was a prospective cohort substudy of the longitudinal randomised ASPREE trial. Eligible participants were women aged at least 70 years from Australia with unimpaired cognition, no previous MACE, and a life expectancy of at least 5 years. Participants who were receiving hormonal or steroid therapy were ineligible for inclusion. We measured serum concentrations of sex steroids with liquid chromatography–tandem mass spectrometry and of SHBG with immunoassay. We compared lower concentrations of sex hormones with higher concentrations using four quartiles. Primary endpoints were risk of MACE and all-cause mortality, the associations of which with sex steroid concentrations were assessed using Cox proportional hazards regression that included age, body-mass index, smoking status, alcohol consumption, diabetes, hypertension, dyslipidaemia, impaired renal function, and treatment allocation in the ASPREE trial (aspirin vs placebo). ASPREE is registered with ClinicalTrials.gov, NCT01038583.FindingsOf the 9180 women recruited to the ASPREE trial between March 10, 2010, and Dec 31 2014, 6358 participants provided sufficient biobank samples at baseline and 5535 were included in the final analysis. Median age at entry was 74·0 years (IQR 71·7–77·7). During a median 4·4 years of follow-up (24 553 person-years), 144 (2·6%) women had a first MACE (incidence 5·9 per 1000 person-years). During a median 4·6 years of follow-up (3·8–5·6), 200 women died (7·9 per 1000 person-years). In the fully adjusted models, higher concentrations of testosterone were associated with a lower incidence of MACE (quartile 4 vs quartile 1: hazard ratio 0·57 [95% CI 0·36–0·91]; p=0·02), as were higher concentrations of DHEA (quartile 4 vs quartile 1: 0·61 [0·38–0·97]; p=0·04). For oestrone, a lower risk of MACE was seen for concentrations in quartile 2 only, compared with quartile 1 (0·55 [0·33–0·92]; p=0·02). In fully adjusted models, no association was seen between SHBG and MACE, or between any hormone or SHBG and all-cause mortality.InterpretationBlood concentrations of testosterone and DHEA above the lowest quartile in older women were associated with a reduced risk of a first-ever MACE. Given that the physiological effects of DHEA are mediated through its steroid metabolites, if the current findings were to be replicated, trials investigating testosterone therapy for the primary prevention of ischaemic cardiovascular disease events in older women would be warranted.FundingThe National Health and Medical Research Council of Australia, US National Institute on Aging, the Victorian Cancer Agency, the Commonwealth Scientific and Industrial Research Organisation, and Monash University.

Evaluation of TSH, T3, T4 and Testosterone Concentrations in Women with Poly Cystic Ovary Syndrome (PCOS) in Babylon City-IRAQ

Evaluation of TSH, T3, T4 and Testosterone Concentrations in Women with Poly Cystic Ovary Syndrome (PCOS) in Babylon City-IRAQ

A comparison of salivary testosterone measurement using immunoassays and tandem mass spectrometry

Enzyme immunoassays (EIAs) are widely used to measure salivary testosterone. However, little is known about how accurately different EIAs assess testosterone, partially because estimates across various EIAs differ considerably. We compared testosterone concentrations across EIAs of three commonly used manufacturers (DRG International, Salimetrics, and IBL International) to liquid chromatography tandem mass spectrometry (LC–MS/MS). Relative to EIAs from Salimetrics and IBL International, EIAs supplied by DRG International provided the closest approximation to LC–MS/MS testosterone concentrations, followed closely by EIAs from Salimetrics, and then IBL. Additionally, EIAs tended to inflate estimates of lower testosterone concentrations in women. Examining our results and comparing them to existing data revealed that testosterone EIAs had decreased linear correspondence with LC–MS/MS in comparison to cortisol EIAs. Overall, this paper provides researchers with information to better measure testosterone in their research and more accurately compare testosterone measurements across different methods.

CN-06 * IS HYPOPITUITARISM CLINICALLY RELEVANT IN GLIOMA PATIENTS? - A CROSS-SELECTIONAL TRIAL IN PATIENTS WITH HIGH-GRADE GLIOMAS

BACKGROUND: The outcome of patients with malignant high-grade glioma (HGG) has improved significantly during the last decade. In most patients the radiation field includes parts of the hypothalamus and/or the pituitary gland, which may cause a complex pattern of neuroendocrine dysfunction. The objective to this cross-sectional study was to evaluate the prevalence of secondary and tertiary hypothyroidism in patients following standard therapy of HGG. METHODS: Serum concentrations of pituitary and peripheral thyroid and sexual hormones were measured in 258 subjects (122 female, 136 male) with HGG. All patients had been treated with standard radio-chemotherapy (radiation up to 60 Gy, followed by adjuvant chemotherapy with temozolomide) up to ten years before testing. RESULTS: TSH was reduced in 22% and increased in 18% of all cases (n = 258). Circulating fT4 and fT3 levels were lowered in 5% and 20%, but increased in 10% and 3%, respectively. With regards to the sexual hormones, we observed an interesting hormonal profile in men (n = 123). Pituitary hormones LH, FSH and prolactin were increased in 64%, 62% and 47% of all men. However, circulating testosterone levels were decreased in 40% of men ≤ 50 years and 16% of men > 50 years. In contrast, LH and FSH concentrations were below the lower reference limit in 75% of women > 50 years, but only in 6% of women ≤ 50 years. Serum progesterone and estrogen levels were lowered in 39% and 36% of women ≤ 50 years and in 43% and 0% of women > 50 years. Of note, 78% of women ≤ 50 years and 78% of women > 50 years featured increased circulating testosterone levels. CONCLUSIONS: Standard treatment for HGG results in multiple changes of the pituitary-endocrine axis. Expecially the finding on increased testosterone concentrations in women is striking and warrants further investigation.

Phthalate exposure and reproductive hormone concentrations in pregnancy

Some phthalate chemicals can affect hormone physiology in utero, resulting in adverse reproductive health outcomes in animal models. It is unknown whether these exposures are related to circulating maternal hormone concentrations during pregnancy. We used multivariate linear regression to estimate associations between phthalate metabolite concentrations and concurrent serum-free and total testosterone and estradiol (E2) levels in 180 pregnant women in the Study for Future Families. We also examined associations between prenatal serum hormone concentrations and anogenital outcome in infants. All analyses were adjusted for appropriate confounding variables. Total testosterone, free testosterone, and E2 concentrations ranged from 8 to 406 ng/dl, 0.03 to 1.2 ng/dl, and 529 to 40 600 pg/ml respectively. We observed an inverse association between log-sum di-2-ethylhexyl phthalate (DEHP) metabolite concentrations and lower log-total testosterone concentrations (-0.15, 95% CI -0.26, -0.04) and log-free testosterone (-0.15, 95% CI -0.27, -0.03). This relationship persisted regardless of fetal sex. Similarly, we observed an inverse association between log monobutyl phthalate (MBP) concentrations and log-total and -free testosterone concentrations in women carrying male fetuses. Monoethyl phthalate (MEP) concentrations were positively associated with log-total and -free testosterone concentrations in women carrying male fetuses (0.09, 95% CI 0.003, 0.17 and 0.10, 95% CI 0.01, 0.19 respectively). Prenatal hormone concentrations were not significantly associated with infant anogenital outcomes. Our preliminary data suggest that DEHP metabolite, MBP, and MEP exposures during pregnancy are associated with prenatal sex steroid hormone concentrations, but sex steroid hormone concentrations were not associated with infant reproductive outcomes.

Intravaginal prasterone (DHEA) provides local action without clinically significant changes in serum concentrations of estrogens or androgens

In order to avoid the risks of non-physiological systemic exposure, serum concentrations of estradiol (E2) and testosterone (as measured by mass spectrometry-based assays) should remain below the 95th centiles measured at 9.3pg/ml and 0.26ng/ml for these respective sex steroids in normal postmenopausal women. To document the possibility of achieving this therapeutic objective, we have measured individual 24h serum E2 and testosterone concentrations in women with vulvovaginal atrophy (VVA) receiving daily intravaginal administration of a clinically effective dose of 6.5mg prasterone (dehydroepiandrosterone, DHEA).Serum E2 and testosterone, as well as DHEA and nine of its other metabolites, were assayed at ten time intervals over 24h on the first and seventh days of daily vaginal administration of 6.5mg prasterone.No significant change from baseline of average 24h serum E2 or testosterone concentrations was observed. Moreover, average 24h serum DHEA remained within the normal postmenopausal range. Estrone sulfate and the androgen metabolites androsterone glucuronide and androstane-3α, 17β-diol glucuronide did not change, thus confirming the absence of any biologically relevant systemic exposure to estrogens and androgens, respectively.Serum concentrations of metabolites of both estrogens and androgens remain within the normal postmenopausal range following daily intravaginal administration of 6.5mg prasterone. As other studies have shown, local formation of sex steroids in peripheral tissues without significant release of E2 or testosterone in the circulation can be achieved with intravaginal prasterone. Thus, prasterone is a promising physiological and attractive solution to treating VVA symptoms.

Polycystic ovary syndrome and the differential diagnosis of hyperandrogenism

Key content The presence of clinical or biochemical evidence of hyperandrogenism is a defining feature of polycystic ovary syndrome (PCOS). As the criteria for diagnosing PCOS becomes more inclusive, there is an increased risk of misdiagnosing women with other causes of hyperandrogenism. Biochemical testing for serum testosterone concentrations in women has important limitations. Patients with concerning features should be investigated for other causes of hyperandrogenism. Learning objectives To review the different criteria for diagnosing PCOS and the repercussions for disease prevalence. To learn about the differential diagnosis of hyperandrogenism. To learn about the limitations of biochemical testing for testosterone in women. Ethical issues Hyperandrogenism causing hirsutism and virilisation can have significant effects on physical and psychological wellbeing. Misdiagnosis can delay appropriate treatment and may affect future fertility.

Marriage and motherhood are associated with lower testosterone concentrations in women

Testosterone has been hypothesized to modulate the trade-off between mating and parenting effort in males. Indeed, evidence from humans and other pair-bonded species suggests that fathers and men in committed relationships have lower testosterone levels than single men and men with no children. To date, only one published study has examined testosterone in relation to motherhood, finding that mothers of young children have lower testosterone than non-mothers. Here, we examine this question in 195 reproductive-age Norwegian women. Testosterone was measured in morning serum samples taken during the early follicular phase of the menstrual cycle, and marital and maternal status were assessed by questionnaire. Mothers of young children (age≤3) had 14% lower testosterone than childless women and 19% lower testosterone than women who only had children over age 3. Among mothers, age of the youngest child strongly predicted testosterone levels. There was a trend towards lower testosterone among married women compared to unmarried women. All analyses controlled for body mass index (BMI), age, type of testosterone assay, and time of serum sample collection. This is the first study to look at testosterone concentrations in relation to marriage and motherhood in Western women, and it suggests that testosterone may differ with marital and maternal status in women, providing further corroboration of previous findings in both sexes.

Assessment of theca cell function: a prerequisite to androgen or luteinizing hormone supplementation in poor responders

Poor responders are a heterogeneous population, with some patients displaying a diminished ovarian reserve and others a poor ovarian reserve with preserved granulosa cell function. Androgen and LH/hCG supplementation has been advocated for poor responders, mainly those >40 years old. Although androgens synergistically act with FSH to support folliculogenesis, and ovarian androgen secretion declines with age, there is still no evidence that androgen therapy is actually effective to improve ovarian FSH sensitivity. The main reason seems to be that theca cell function has not been appropriately assessed in patients at risk of poor response. The definition of theca insufficiency is hampered by methodologic shortcomings in routine bioassays. Provocative tests for theca cells might help to identify those patients who could benefit from androgen supplementation. The lack of data regarding theca cells in these patients might contribute to explaining the absence of evidence for a positive effect of androgen therapy.

Testosterone concentrations, using different assays, in different types of ovarian insufficiency: a systematic review and meta-analysis

Increasing age and post-menopausal status are associated with decreasing androgen concentrations in females. Women with premature loss of ovarian function, such as primary ovarian insufficiency (POI) or iatrogenic menopause may be at increased risk for diminished testosterone levels at a relatively young age. Differentiation between a hypoandrogenic or normoandrogenic state in women with premature loss of ovarian function is problematic due to trueness and precision problems using various testosterone assays. The current meta-analysis was conducted to evaluate current literature reporting serum total testosterone concentrations under these conditions, including stratification for various testosterone assays. A systematic review and meta-analysis of controlled observational studies were performed. The electronic databases of Pubmed, Embase and the Cochrane Library were systematically searched until October 2011 for comparative studies on total testosterone concentrations in women with spontaneous POI or iatrogenic menopause compared with controls. The literature search, data extraction and critical appraisal, using the Newcastle-Ottawa Scale, were performed by two independent investigators. The effect measure was the weighted mean difference (WMD) with 95% confidence interval (95% CI) in a random effects model. A total of 206 articles for spontaneous POI and 1358 for iatrogenic menopause were reviewed, of which 9 and 17 papers, respectively, were selected for final analysis. Both groups demonstrated significantly lower total testosterone concentrations compared with controls [WMD (95% CI) -0.38 (-0.55 to -0.22) nmol/l, and -0.29 (-0.39 to -0.18) nmol/l, respectively], but with substantial between-study heterogeneity. Subgroup analysis for assay type was statistically significant for spontaneous POI only. Sensitivity analyses of high-quality studies did not change the results, and resulted in a substantial decrease in heterogeneity in spontaneous POI studies. The current meta-analysis demonstrates that total testosterone concentrations are decreased in women with spontaneous POI or iatrogenic menopause. The potential implications of hypoandrogenism in these women remain to be elucidated.

Sex-based comparisons of myofibrillar protein synthesis after resistance exercise in the fed state

We made sex-based comparisons of rates of myofibrillar protein synthesis (MPS) and anabolic signaling after a single bout of high-intensity resistance exercise. Eight men (20 ± 10 yr, BMI = 24.3 ± 2.4) and eight women (22 ± 1.8 yr, BMI = 23.0 ± 1.9) underwent primed constant infusions of l-[ring-(13)C(6)]phenylalanine on consecutive days with serial muscle biopsies. Biopsies were taken from the vastus lateralis at rest and 1, 3, 5, 24, 26, and 28 h after exercise. Twenty-five grams of whey protein was ingested immediately and 26 h after exercise. We also measured exercise-induced serum testosterone because it is purported to contribute to increases in myofibrillar protein synthesis (MPS) postexercise and its absence has been hypothesized to attenuate adaptative responses to resistance exercise in women. The exercise-induced area under the testosterone curve was 45-fold greater in men than women in the early (1 h) recovery period following exercise (P < 0.001). MPS was elevated similarly in men and women (2.3- and 2.7-fold, respectively) 1-5 h postexercise and after protein ingestion following 24 h recovery. Phosphorylation of mTOR(Ser2448) was elevated to a greater extent in men than women acutely after exercise (P = 0.003), whereas increased phosphorylation of p70S6K1(Thr389) was not different between sexes. Androgen receptor content was greater in men (main effect for sex, P = 0.049). Atrogin-1 mRNA abundance was decreased after 5 h recovery in both men and women (P < 0.001), and MuRF-1 expression was elevated in men after protein ingestion following 24 h recovery (P = 0.003). These results demonstrate minor sex-based differences in signaling responses and no difference in the MPS response to resistance exercise in the fed state. Interestingly, our data demonstrate that exercise-induced increases in MPS are dissociated from postexercise testosteronemia and that stimulation of MPS occurs effectively with low systemic testosterone concentrations in women.

Testosterone Reference Ranges in Normally Cycling Healthy Premenopausal Women

At present, there are no well-accepted reference ranges for serum testosterone concentrations in women. The aim of this study was to determine the reference ranges for serum testosterone and sex hormone-binding globulin (SHBG) in premenopausal women with normal menstrual cycles. We measured serum total, free, and bioavailable testosterone and SHBG concentrations in 161 healthy, normally cycling women (18-49 years). Morning blood samples were collected during follicular, mid-cycle, and luteal phases of the menstrual cycle and analyzed using validated methods. Mean, median, and weighted average hormone levels across menstrual cycle phases as well as percentiles for a typical 30-year-old woman were determined. Age-related serum levels of total, free, and bioavailable testosterone and SHBG levels in normally cycling premenopausal women. Serum testosterone concentrations exhibited an age-related decline, whereas SHBG remained relatively stable across studied age ranges. Reference ranges for total, free, and bioavailable testosterone and SHBG were established using 5th and 95th percentiles. The estimated 5th and 95th percentiles for a 30-year-old woman were: testosterone, 15-46 ng/dL (520-1595 pmol/L); free testosterone, 1.2-6.4 pg/mL (4.16-22.2 pmol/L); calculated free testosterone, 1.3-5.6 pg/mL (4.5-19.4 pmol/L); bioavailable testosterone, 1.12-7.62 ng/dL (38.8-264.21 pmol/L); and SHBG 18-86 nmol/L. The variations of hormones and SHBG across menstrual cycle were consistent with previous literature. Reference ranges for free, total, and bioavailable testosterone and SHBG were established in premenopausal women using validated immunoassays and an adequate number of subjects consistent with recommendations by the National Committee for Clinical Laboratory Standards. The increase in testosterone in the mid-cycle period is relatively small compared with the overall variability, so these reference ranges can be applied irrespective of the day in the menstrual cycle the sample has been taken.

Diabesity: aims of treatment and the multidisciplinary practice team

Practice NursingVol. 22, No. 6 Diabetes Evidence-Based Management 32Diabesity: aims of treatment and the multidisciplinary practice teamChinnadorai Rajeswaran, Jo Bissell, Ravi Bachuwar, Balasubramanian Thiagarajan SrinivasanChinnadorai RajeswaranSearch for more papers by this author, Jo BissellSearch for more papers by this author, Ravi BachuwarSearch for more papers by this author, Balasubramanian Thiagarajan SrinivasanSearch for more papers by this authorChinnadorai Rajeswaran; Jo Bissell; Ravi Bachuwar; Balasubramanian Thiagarajan SrinivasanPublished Online:29 Sep 2013https://doi.org/10.12968/pnur.2011.22.6.315AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesAndersson B, Marin P, Lissner Let al. (1994) Testosterone concentrations in women and men with NIDDM. 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Measurement of serum testosterone in women; what should we do?

All immunoassays for female serum testosterone give falsely high results in some samples. The effect is variable and cannot be predicted for any given sample. Inaccurate calibration or interference by cross-reacting substances is almost certainly the cause of the problem, but for many immunoassays, the exact nature of the interferent is not known. Some of the interference can be removed by employing an extraction step prior to immunoassay. The advent of fast simple and sensitive liquid chromatography tandem mass spectrometry methods offers an exciting alternative to immunoassay for serum testosterone measurement. It is recommended that all high serum testosterone concentrations in women are checked, before reporting, by a method which is accurate (i.e. minimal bias to isotope dilution gas chromatography mass spectrometry [ID-GCMS] method) and is not subject to interference. Action should also be taken by assay users, manufacturers, regulators and professional bodies to ensure accurate standardization and comparability of assays.

Gender-Specific Differences in Sex Hormones and Cytokines in Patients Undergoing Major Abdominal Surgery

Experimental and clinical evidence suggests that gender has a profound influence on outcome after inflammatory hits caused by such events as trauma. We conducted this prospective clinical study to evaluate the influence of gender on the release of pro- and anti-inflammatory cytokines in the circulation and after lipopolysaccharide (LPS) ex vivo stimulation. We also measured the course of sex hormones in the acute phase response after surgery and assessed their correlation with cytokine release. We measured the serum concentrations of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-alpha), testosterone, estradiol, prolactin, procalcitonin, and sex hormone-binding globulin, as well as the release of IL-6, TNF-alpha, and IL-10 after LPS ex vivo stimulation of whole blood in 26 patients without complications after major or minor abdominal surgery. There was a gender-specific pattern of decreasing testosterone concentrations in men and increasing testosterone concentrations in women. Increasing estradiol concentrations were seen in both men and women. The ex vivo-stimulated and systemic IL-6, IL-8, IL-10, and TNF-alpha cytokine release was not gender specific. There was a marked prolactin peak after the induction of anesthesia before the commencement of surgery. In contrast to the release of pro- and anti-inflammatory cytokines, sex hormones show a gender-specific pattern during the acute phase response 1 week after abdominal surgery.

Testosterone Concentrations in Women and Men With NIDDM

OBJECTIVE--To evaluate androgen concentrations in relation to insulin resistance in men and women with and without NIDDM. Recent studies have indicated the potential importance of the regulation of insulin sensitivity by androgens in both women and men. Low sex hormone binding globulin (SHBG) concentration is an independent risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM) in women and is strongly associated statistically with signs of insulin resistance. RESEARCH DESIGN AND METHODS--We compared measurements of anthropometric variables and SHBG, steroid hormone, and insulin concentrations of women and men who have NIDDM with those of control subjects. RESULTS--Women with NIDDM had somewhat higher plasma insulin concentrations, lower SHBG, and higher free testosterone values than did control subjects with similar body mass index (BMI). Women with NIDDM had marginally higher waist-to-hip ratios (WHR). Plasma insulin concentrations correlated positively with BMI, WHR, and free testosterone and negatively with SHBG. In multivariate analyses, insulin concentrations remained positively associated with BMI and free testosterone. Men with NIDDM had higher fasting plasma insulin concentrations than did the nondiabetic control subjects. Testosterone and SHBG were lower in the diabetic men than in both control groups. The derived value of free testosterone was not different between groups. Univariate correlation analyses revealed tight statistical couplings between plasma insulin on the one hand and SHBG and testosterone concentrations (negative) on the other. In multivariate analyses, only the insulin-testosterone association remained. Women with NIDDM have high levels of free testosterone and low levels of SHBG. Insulin resistance is closely correlated with these signs of hyperandrogenicity as well as with obesity. Men with NIDDM also have low levels of SHBG and, in contrast to women, low testosterone values. Insulin values correlate negatively with these hormonal factors. Based on the results of experimental work and intervention studies, we suggest that these androgen abnormalities might be causally related to insulin resistance in NIDDM.

The effect of a specific emotional stressor on prolactin, cortisol, and testosterone concentrations in women varies with their trait anxiety

The psychological and the hormonal response to a specific emotional stressor (a video film on treatment of infertility, pregnancy, and delivery) was investigated in 30 women and the responses were correlated with their trait anxiety level. The experiment included a resting period before and after the stressor. The psychological response, i.e., the change in state anxiety, was in phase with the stressor and varied with the trait anxiety level. The endocrinological response, i.e., the time courses of prolactin, cortisol, and testosterone, was not in phase but varied with the trait anxiety level. It is suggested that psychological phenomena as anticipation, mental assimilation, and reflection could explain these findings, and that these should be taken into account when investigating the so-called "psychological" infertility.

Androstenedione, testosterone, and free testosterone concentration in women of various occupations.

Abstract Serum androstenedione (A), testosterone (T), testosterone‐binding globulin (TBG), and free testosterone concentration (FTC) were correlated with occupational status in fifty‐five normal females. With some variation among age groups, A, T, and FTC were positively associated with occupation, mean levels being higher in students and professional, managerial, and technical workers compared to clerical workers and housewives. A and FTC also associated significantly with the degree of job complexity in relation to people, whereas T significantly correlated with the degree of job complexity in relation to things. These data most likely reflect biological and environmental causes in a hormone‐behavior feedback relationship. The genetic potential for increased androgen secretion may affect certain personality characteristics related to career‐orientation in females, i.e., those labeled “masculine” by this culture, such as assertiveness and independence. Moreover, the positive or negative stress associated with an occupation could stimulate or inhibit androgen secretion.

Maternal peripheral testosterone levels during the first half of pregnancy

Peripheral serum testosterone levels were determined in 180 women during weeks 7 to 20 of pregnancy with a specific radioimmunoassay. After a normal pregnancy and delivery 90 serum samples were randomly selected from mothers of boys and 90 serum samples from mothers of girls. The testosterone concentrations were correlated with the sex of the fetuses. The mean testosterone level ± S.D. in pregnant women with female fetuses was 597 ± 167 pg. per milliliter. In pregnant women with male fetuses the testosterone concentrations were on the average significantly higher (p < 0.01), with a mean value of 828 ± 298 pg. per milliliter. The course of the testosterone concentrations in women with male fetuses showed an increase beginning in week 7, reaching a maximum during weeks 9 to 11, followed by a decrease until weeks 15 to 20. During weeks 9 to 11 of pregnancy fetal sex determination was possible in 28 per cent of the males and in 5 per cent of the females, with a probability of 95.5 per cent.

Serum testosterone concentrations in women throughout the menstrual cycle and following HCG administration

Serum testosterone (T) concentrations, measured by a specific, precise, and sensitive radioimmunoassay in 40 women with apparently normal menstrual cycles averaged 34.6 ± 10.3 (S.D.) ng. per cent and ranged from 14 to 59 ng. per cent. Mean serum T concentrations, assayed daily in eight women throughout an entire ovulatory cycle, were highest around the midcycle LH peak and higher during the follicular than during the luteal phase of the cycles. Averages of daily serum T concentrations, when determined for each individual woman for the entire cycle, varied significantly among the eight subjects studied, ranging from 23.1 to 39.0 ng. per cent. Coefficients of variation of serum T levels in these eight individual cycles averaged 22 per cent. HCG administration to three of these eight women during the luteal phase of their subsequent cycle resulted in a significant rise of serum T concentrations in only one subject. These data indicate that mean serum T concentrations in normal women are subject to small but significant changes during the course of the menstrual cycle. Despite these cyclic changes, as well as day-to-day variations, serum T concentrations in normal women largely fall into a relatively narrow range. Repeated serum T concentrations which consistently exceed 55 ng. per cent (2 S.D. above the mean) may be regarded as documentation of androgen excess.