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Androstenedione

35 Azn
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Androstenedione is a precursor of the sex hormones testosterone and estrone, produced in the Leydig cells of the testes, theca cells of the ovaries, and the reticular zone of the adrenal cortex in both men and women.

  • Further conversion of androstenedione into testosterone occurs in peripheral tissues, primarily in the gonads.
  • Although androstenedione is weaker than other androgens (primarily testosterone), its significance increases in conditions causing virilization syndromes.
  • Measuring androstenedione levels is used for the differential diagnosis and monitoring of these conditions.
  • Weak androgens, including androstenedione, play a key role in metabolism, particularly in individuals with naturally low testosterone levels (e.g., adolescent boys).
  • In postmenopausal women, androstenedione is the primary steroid hormone.
  • Avoid alcohol for 24 hours before the test.
  • Discontinue oral contraceptives30 days before testing.
  • Avoid physical and emotional stress for 72 hours before the test.
  • Do not smoke for 3 hours before the test.

Indications for Testing

Diagnosis of Virilization Syndromes:

  • Polycystic ovary syndrome (PCOS)
  • Cushing’s syndrome
  • Congenital adrenal hyperplasia (CAH)
  • Androgen-producing tumors (ovarian, testicular, adrenal adenomas/carcinomas)

Other Clinical Indications:

  • Signs of hyperandrogenism, such as:
    • Hirsutism (excess hair growth on the upper lip, chin, or midline of the abdomen)
    • Severe acne
    • Deepening of the voice
    • Clitoromegaly
    • Increased muscle mass
  • Evaluation of children with signs of gender dysphoria (ambiguous external genitalia with both male and female characteristics)

Causes of Increased Androstenedione Levels

  • Excessive ovarian production of androstenedione, seen in:
    • Polycystic ovary syndrome (PCOS)
    • Sertoli-Leydig cell tumors
  • Excess adrenal production of androstenedione, seen in:
    • Congenital adrenal hyperplasia (CAH)
    • Cushing’s syndrome
    • Adrenal adenoma/carcinoma
  • Alzheimer’s disease
  • Recent abortion


    Causes of Decreased Androstenedione Levels

  • Physiological (age-related) decline in male reproductive function
  • Osteoporosis