Androstenedione testing is employed to assess the performance of the adrenal glands, ovaries, or testicles, and to measure the production of hormones associated with the development of male sex organs and physical traits (androgens).
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Androstenedione levels may serve the following purposes:
- Differentiate between adrenal gland and ovarian or testicular androgen-secreting conditions when DHEAS and testosterone test results are abnormal.
- Aid in diagnosing tumors in the adrenal gland's outer layer (cortex) and ectopic tumors outside the adrenal gland secreting ACTH. This helps distinguish these conditions from ovarian or testicular tumors and cancers.
- Contribute to the diagnosis of congenital adrenal hyperplasia (CAH) and monitor treatment progress. This complements other tests such as testosterone and 17-hydroxyprogesterone.
- Assist in diagnosing polycystic ovarian syndrome (PCOS) and ruling out other causes of infertility, amenorrhea (lack of menstrual periods), and hirsutism (excess body and facial hair) in women with abnormal results on tests for DHEAS, testosterone, and other hormones like FSH, LH, prolactin, and estrogen.
- Explore and diagnose the cause of male physical characteristics (virilization) in young girls and early (precocious) puberty in young boys.
- Help determine the cause of delayed puberty and investigate suspected ovarian or testicular failure.
Androstenedione is prescribed, either independently or in conjunction with other hormone tests, in cases where there is suspicion of excess (or, less frequently, deficient) androgen production. This testing is conducted when a healthcare provider aims to assess the functioning of an individual's adrenal gland, ovaries, or testicles.
It is requested in situations such as:
- When female infants exhibit external sex organs that are not distinctly male or female, a condition known as ambiguous external genitalia.
- In instances where young girls manifest male physical characteristics, potentially linked to conditions like congenital adrenal hyperplasia (CAH) or other disorders associated with elevated androgens.
- When young boys display signs of precocious puberty, characterized by premature development of features like an enlarged penis, increased muscularity, pubic hair, and a deeper voice well before the expected age of puberty.
- In cases of delayed puberty, there is a need to investigate the underlying cause.
- For women experiencing infertility or presenting symptoms such as a deeper voice, acne, excess facial and/or body hair, irregular menstruation, male pattern baldness, or increased muscularity.
Additionally, Androstenedione is periodically measured to assist in monitoring glucocorticoid replacement therapy for congenital adrenal hyperplasia (CAH), evaluating its efficacy over time.
A blood sample is collected from a vein in your arm. Also, For menstruating women, there might be specific guidelines regarding the timing of the sample collection. When a woman experiences symptoms such as excess facial and body hair (hirsutism), acne, absence of monthly menstrual periods (amenorrhea), fewer than 6-8 menstrual cycles per year (oligomenorrhea), or infertility; when a boy is undergoing very early (precocious) puberty or a girl is exhibiting signs of virilization; in cases of delayed puberty; during the diagnosis of congenital adrenal hyperplasia (CAH); and periodically during the treatment of CAH.
A normal androstenedione level, in conjunction with other normal androgen levels and adrenal tests, suggests typical adrenal gland function. However, in the presence of an adrenal tumor or cancer, an androstenedione level may still be normal or elevated, depending on the hormones it secretes. In polycystic ovarian syndrome (PCOS), androstenedione levels might be elevated, but they can also be normal since this disorder is primarily associated with ovarian androgen production, particularly testosterone.
An elevated androstenedione level indicates increased production from the adrenal glands, ovaries, or testicles. Minor fluctuations in concentration are generally within the normal range. An increase may point to conditions such as adrenal tumor, adrenal cancer, adrenal hyperplasia, or congenital adrenal hyperplasia (CAH). However, an elevated level is not diagnostic of a specific condition; it typically signals the need for further testing to identify the underlying cause.
A low androstenedione level may result from adrenal gland dysfunction, adrenal insufficiency, or ovarian or testicular failure.
For individuals with CAH undergoing glucocorticoid steroid treatment, normal androstenedione levels often indicate effective suppression of excess androgen production. Conversely, elevated levels suggest the need for adjustments in treatment. Ongoing monitoring is crucial for managing conditions and ensuring treatment efficacy. Interpretation of these results should be conducted by a healthcare professional considering the complete clinical context.
Not necessarily. The nature and intensity of symptoms can differ among individuals and may also vary with age. Adult men, having already developed masculine secondary sexual characteristics, typically may not exhibit symptoms in response to increased androstenedione levels.
Certainly, the measurement of androstenedione levels, also known as "andro," can be included in testing for sports doping. Illegally taken by some athletes as a performance-enhancing drug, androstenedione is converted by the body into an anabolic steroida synthetic form of testosterone. While intended to aid in muscle development, similar to other anabolic steroids, its use can impede bone growth, impact the heart, and, in certain instances, lead to liver damage.
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