Endocrine Abstracts

Androgens play an important part in follicular development, sexual behavior, maintenance of skeletal homeostasis, normal affect and cognitive function. The negative influence of androgen deficiency is widely discussed in postmenopausal women. However, there is a cohort of young women with gonadal steroid deficit caused by the disorders of central regulation. It is well known that these patients are in lack of estrogens however their androgen status is not detailed.

We examined 25 women with hypogonadotropic hypogonadism (HH – group 1), age from 18 to 45 (mean 29 years 1 months), mean duration of HH 5 years 3 months, 12 of these patients had isolated HH (subgroup 1a), 13 women had HH associated with the other types of hypophyseal deficiency (subgroup 1b). Ten healthy women were included in control group (group 2). Concentrations of serum testosterone, SHGB and free testosterone were measured in all patients.

The mean concentrations of testosterone were 0.43±0.12 ng/ml in group 1 and 1.02±0.15 ng/ml in group 2 (P=0.019). The mean levels of SHBG were 161.75±27.57 pmol/l and 82.35±19.55 pmol/l respectively (P=0.111), whereas mean free testosterone concentrations were 0.02±0.005 pmol/dl in group 1 and 0.14±0.028 pmol/dl in group 2 (P<0.0001).

Though the concentrations of total and free testosterone in subgroup 1a and in subgroup 1b were low there was the significant difference between them: mean levels of total testosterone 0.78±0.09 ng/ml and 0.09±0.01 ng/ml respectively P<0.0001, mean levels of free testosterone 0.04±0.01 pmol/dl and 0.01±0.001 pmol/dl respectively P=0.005. Mean SHGB concentrations were significantly higher in subgroup 1a compared to 1b: 224.0±30.56 pmol/l and 99.50±23.43 pmol/l, P=0.012.

Thus the patients with hypogonadotropic hypogonadism have lack of androgens (particularly free testosterone) compared to healthy women. This deficiency is significantly more evident in patients with combined hypophyseal deficiency. These patients are on the list for the androgen replacement therapy.