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THE EFFECT OF ENDOGENOUS PROGESTERONE ON SERUM LEVELS OF 5α‐REDUCED ANDROGENS IN HIRSUTE WOMEN
Author(s) -
DEWIS P.,
NEWMAN M.,
ANDERSON D. C.
Publication year - 1984
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1984.tb03225.x
Subject(s) - medicine , endocrinology , luteal phase , testosterone (patch) , sex hormone binding globulin , androstenedione , hirsutism , androgen , dihydrotestosterone , menstrual cycle , alpha (finance) , hormone , polycystic ovary , insulin , insulin resistance , construct validity , nursing , patient satisfaction
SUMMARY This study was to examine indirectly the effect of endogenous progesterone, a known competitor for 5α‐reductase, on androgen metabolism in target organs in hirsute women. Serum levels of progesterone, testosterone (T), androstene‐dione (A), dihydrotestosterone (DHT) and 5α‐androstane 3α17β‐diol (3α‐diol) and sex hormone binding globulin (SHBG) were assessed serially over a four week period in normal women, six hirsute women with regular menstrual cycles, eight hirsute women with oligomenorrhoea (and presumptive polycystic ovaries) and seven non‐hirsute women with oligomenorrhoea. Serum T and A levels were significantly higher than normal in both hirsute and non‐hirsute women with oligomenorrhoea, while serum SHBG was significantly lower than normal in the two groups of hirsute women. The calculated free T level was higher than normal in all three groups of patients. DHT levels were not significantly different from normal in any of the three groups of patients. The 3α‐diol level showed considerable overlap with normal in all groups of patients and was only significantly higher than normal in hirsute women with oligomenorrhoea (P & lt;005). There was a small fall in DHT in the late luteal phase of the cycle of those women with a sustained rise in serum progesterone in the second half of the cycle, but no change in serum 3α‐diol. These studies suggest that serum 3α‐diol may not be as good an indicator of peripheral androgen metabolism in hirsute women as previously reported and that a rise in serum progesterone has only a minimal effect on circulating levels of the active 5α‐reduced androgen metabolites. Although in vitro 3α‐diol has been shown to be a potent inhibitor of 5α‐reductase this casts doubt on its role in this regard in vivo.