Undetectable salivary testosterone in young women with premature ovarian failure.
BACKGROUND
The extent of androgen deficiency in young women with premature ovarian failure (POF) is unclear.


OBJECTIVE
Cross-sectional study of androgen status in young women with POF.


METHODS
Twenty women with POF: six had Turner syndrome (group A); eight had iatrogenic POF either secondary to bilateral oophorectomy or treatment of malignancy (group B); and six had idiopathic POF (group C). The median age was 30.5 years (range 19-39); in groups B and C the median duration of ovarian failure was 10.0 years (range 1-35).


METHODS
After a 2-month wash-out period without sex steroid replacement (SSR), serum testosterone (T), androstenedione (A4), dehydroepiandrosterone (DHEAS), SHBG, salivary testosterone (SalT) and the free androgen index [FAI = (serum T/SHBG) x 100] were measured.


RESULTS
Median serum A4 was 4.6 nmol/l (10th, 90th centiles, 3.6, 5.1) and DHEAS was 3.2 micromol/l (10th, 90th centiles, 2.3, 9.3). Although median serum T was relatively low at 1.4 nmol/l (10th, 90th centiles, 1.1, 1.7), median SHBG was also low at 34 nmol/l (10th, 90th centiles 22.2, 67.5) and the median calculated FAI was within the normal range at 3.7 (10th, 90th centiles, 2.3, 7.0). However, SalT was undetectable in almost all subjects in the three groups of POF.


CONCLUSIONS
Serum T and SHBG are relatively low in young women with POF and their FAI is therefore within the normal range. However, SalT, which measures free testosterone, is consistently low to undetectable in these young women with POF. The reliability of the FAI as a marker of androgen deficiency remains questionable.
Mason
A
A
Bone and Endocrine Research Group, Royal Hospital for Sick Children, Glasgow, UK.
Wallace
A M
AM
Macintyre
H
H
Teoh
Y P
YP
Bath
L E
LE
Critchley
H O
HO
Kelnar
C J H
CJ
Wallace
W H B
WH
Ahmed
S F
SF
D000328:Adult; D000735:Androstenedione / Q000097:blood; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D006801:Humans; D010052:Ovariectomy; D016649:Primary Ovarian Insufficiency / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000032:analysis / Q000097:blood / Q000172:deficiency*; D014424:Turner Syndrome / Q000378:metabolism
D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone