The ovary-suppression test in the evaluation of hyperandrogenemia.
Forty hyperandrogenemic women were investigated in order to determine whether the source of androgen excess could be attached to a dysfunction of the ovary or the adrenal cortex with a higher degree of accuracy when both steroid-producing organs were subjected to a supposedly specific suppression test. Dexamethasone (DXM) was administered at a dose of 2 mg for 2 days. The ovary-suppression test (OST) was carried out after a combined preparation containing 35 micrograms of ethinyl estradiol and 2 mg of cyproterone acetate (EE-CPA) had been taken for 2-3 weeks. Before and after the tests, the serum levels of testosterone (T), free testosterone (fT), DHEA-S and SHBG were determined. Serum T was lowered by DXM and EE-CPA to the same degree: the latter was more effective with respect to fT. DHEA-S responded much better to DXM than to EE-CPA. The basal level of SHBG was below the lower limit of the norm in 45% of the women. This indicates that hyperandrogenemia can be associated with normal and subnormal levels of SHBG. T and/or fT were elevated in all 40 women. DHEA-S was higher than normal in only 22 of the 40. DXM normalized the DHEA-S level in all but 1 case. In another 18 women, serum T and fT remained unaffected by DXM. This indicates an ovarian source of androgen excess in these cases. The number of cases was reduced from 18 to 4 when the OST was carried out. Even though DXM and EE-CPA are not completely organ-specific in action, the combination of both suppression tests seems to allow a higher degree of discrimination to be made between an ovarian and an adrenal component of hyperandrogenemia than is possible with either test alone.
Taubert
H D
HD
Department of Obstetrics and Gynecology, J. W. Goethe University, Frankfurt am Main, West Germany.
Dericks-Tan
J S
JS
D000293:Adolescent; D000311:Adrenal Glands / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D000728:Androgens / Q000097:blood*; D015992:Body Mass Index; D001835:Body Weight; D003534:Cyproterone / Q000031:analogs & derivatives / Q000494:pharmacology; D017373:Cyproterone Acetate; D003907:Dexamethasone / Q000494:pharmacology; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005260:Female; D006628:Hirsutism / Q000209:etiology; D006801:Humans; D009839:Oligomenorrhea / Q000209:etiology; D010053:Ovary / Q000187:drug effects / Q000378:metabolism*; D011374:Progesterone / Q000032:analysis; D012044:Regression Analysis; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000032:analysis
D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004997:Ethinyl Estradiol; D011374:Progesterone; D017373:Cyproterone Acetate; D003907:Dexamethasone; D003534:Cyproterone