Androstenedione

Androstenedione measurement is of most use in the differential diagnosis of disorders of female hyperandrogenism (in combination with measurement of gonadotrophins, SHBG and other sex steroids). This is often undertaken (1) in children being investigated for premature adrenarche / pubarche and (2) investigation of infertility or hirsutism in older women. Measurement in males is of less significance, as DHEA and androstenedione are only mildly androgenic. In rare cases, peripheral conversion of androgens to oestrogens can result in gynaecomastia. Androstenedione is elevated in many cases of congenital adrenal hyperplasia (CAH); although, its measurement should not be considered a front line investigation, as other individual steroids are more specific for CAH-subtypes e.g. 17-hydroxyprogesterone in suspected 21-hydroxylase deficiency. Androstenedione measurement can also be undertaken to assess CAH treatment efficacy. In addition, androstenedione and DHEAS measurements may be useful in the evaluation of steroid secretion by gonadal and adrenal tumors in both children and adults.