Determinants of serum total and free testosterone levels in women over the age of 65 years.
BACKGROUND
Little is known about testosterone (T) levels and their determinants in women of late postmenopausal age.


OBJECTIVE
We describe levels of total and free T and selected factors that influence these levels in a random sample of older women.


METHODS
Levels of serum total T and free T by microdialysis were measured using ultrasensitive assays in 347 community-dwelling women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to define factors associated with total and free T levels.


RESULTS
In adjusted models: 1) total T levels declined with age until 80, whereas free T levels did not vary by age; 2) women with bilateral oophorectomy had 23% lower total T and 16% lower free T levels than those with at least one intact ovary; 3) oral estrogen users had total and free T levels that were 47% lower than never users; 4) obese women had 47% higher total T and 20% higher free T levels, and overweight women had 24% higher total T and 14% higher free T levels, than normal weight women; and 5) free T levels were 51% higher in black women. Corticosteroid users had 75% lower total T and 43% lower free T levels than nonusers.


CONCLUSIONS
Bilateral oophorectomy, estrogen use, corticosteroid use, and low body mass index are independent risk factors for lower T levels in women aged 65 yr and over. Although highly prevalent in women of this age, the physiological significance of low T levels in late postmenopausal women requires further investigation.
Cappola
Anne R
AR
Division of Endocrinology, Diabetes, and Metabolism, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6021, USA. acappola@cceb.med.upenn.edu
Ratcliffe
Sarah J
SJ
Bhasin
Shalender
S
Blackman
Marc R
MR
Cauley
Jane
J
Robbins
John
J
Zmuda
Joseph M
JM
Harris
Tamara
T
Fried
Linda P
LP
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000097:blood* / Q000453:epidemiology*; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D010052:Ovariectomy; D010053:Ovary / Q000502:physiology; D017698:Postmenopause / Q000097:blood*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013739:Testosterone / Q000097:blood* / Q000172:deficiency
D013739:Testosterone