Circulating Androgen Levels in Women with Premature Ovarian Insufficiency

Objective: The objective of our study was to assess the androgen status in women with premature ovarian insufficiency (POI) compared to age-matched regularly menstruating women. Material and Methods: Sixty-two women with POI and 62 healthy women with regular menstrual cycles as the control group participated in this case control study. The information about their clinical characteristics were collected. Serum hormone parameters included total testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), dehydroepian-drosterone (DHEA), and androstenedione (AS). Levels of follicle stimulating hormone (FSH), estradiol and AMH were also measured. Additionally, the free androgen index (FAI), and bioavailable testosterone were calculated. Results: The levels of total testosterone, calculated androgen indices (bioavailable testosterone, FAI), SHBG and DHEA did not differ between POI group and the control group. The levels of DHEAS and AS were significantly lower in POI group compared with the controls (p=0.002; p=0.036, respectively). In our study, only 15 of the 62 women with POI (24%) used HRT. DHEAS levels were significantly higher in the control group compared to the women with POI who did or did not use HRT (p=0.002). BMI correlated positively with FAI (r= 0.318, p< 0.001) and with bioavailable testosterone (r= 0.241, p= 0.008). An inverse correlation was found between age and DHEAS levels (r= -0.209, p= 0.002). Conclusion: Our findings indicate that the androgen profile in women with POI is similar to those observed in healthy controls with the exception of serum DHEAS levels. This study showed that androgen decline seen in POI may be primarily related to an adrenal defect.