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Hormones · Blood

Androstanediol glucuronide

Breakdown product of the strong male hormone DHT; an indirect measure of the action of male hormone in the skin and hair.

At a glance

  • Measured in blood
  • In 1 test panel
  • No special preparation

Androstanediol glucuronide

  • Explanation
  • Result
  • Reliability
  • Who it is for
  • Test panels
  • Sources

Explanation

Androstanediol glucuronide: what is measured?

In the skin and hair follicles, testosterone is converted into dihydrotestosterone (DHT), the strongest form of male hormone. When DHT is broken down, androstanediol is formed, which the body links to glucuronic acid so that it can be removed via the kidneys. This linked form (androstanediol glucuronide, also 3-alpha-diol-G) is stable in the blood and was seen as a measure of the action of male hormone in the skin. Later research showed that a large part of it comes from the liver and the adrenal glands, and not only from the skin.

What can it detect?

  • Conversion of male hormone in the skin, in women with excess hair growth (hirsutism) or acne
  • Use of testosterone or anabolic substances
  • The effect of medicines that block the conversion to DHT, such as finasteride or dutasteride

Result

What does the result mean?

Androstanediol glucuronide too high

In women, a raised value may fit excess hair growth or acne, whether or not due to PCOS; however, in many women with excess hair growth the value is normal, and vice versa. Overweight and the use of testosterone, DHEA or anabolic substances raise the value. Men naturally have higher values than women. Without symptoms, a raised value has little meaning.

Androstanediol glucuronide too low

A low value fits the use of medicines that block the conversion of testosterone to DHT, such as finasteride or dutasteride, and hormonal contraception or anti-androgens. In men, a low value can go together with a low testosterone. After menopause and at an older age, the value is naturally lower. A low value on its own causes no symptoms.

After an abnormal result

With excess hair growth or acne and an abnormal value, the GP usually has testosterone and SHBG measured and looks at the periods and at signs of PCOS. With rapidly developing masculinization or a strongly raised testosterone, referral follows to a gynecologist or an endocrinologist (internist specializing in hormones). An abnormal value without symptoms usually does not lead to further testing.

Reliability

How reliable is the test?

Androstanediol glucuronide has limited predictive value. The link with excess hair growth is weak: the value overlaps strongly between women with and without symptoms, and there are no agreed cut-off values. To show too much male hormone, the Dutch PCOS guideline advises calculated free testosterone as the first step, possibly supplemented with androstenedione and DHEA-S; these say more when there is an abnormality. Excess hair growth itself is diagnosed with a physical examination.

What can affect the result?

  • Hormonal contraception, anti-androgens and 5-alpha-reductase inhibitors (finasteride, dutasteride) lower the value; for hormone testing, the PCOS guideline advises stopping hormonal contraception for at least 3 months.
  • Testosterone, DHEA and anabolic substances raise the value.
  • The value depends on sex, age and body weight; reference values differ per laboratory and measurement method.

Who it is for

Who is the test useful for?

Useful for

The result is at most meaningful as an addition in women with excess hair growth or acne, alongside testosterone, SHBG and, if needed, androstenedione and DHEA-S, which say more when there is an abnormality. Not suitable as a measure of 'hormone balance', hair loss or muscle building. In people without symptoms, a single value says little.

How common is it?

Excess hair growth occurs in about 5 in 100 women; the most common cause of too much male hormone is PCOS. How often an abnormal androstanediol glucuronide occurs in people without symptoms is not known.

Thuisarts.nl (Too much hair growth) and Maastricht UMC+, Department of Endocrinology

Drawbacks and risks

  • A raised value without symptoms can cause unnecessary worry or unnecessary hormone testing; a normal value does not rule out too much male hormone.

Get tested

Androstanediol glucuronide: test panels

Androstanediol glucuronide is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

  • Androstanediol-glucuronide (3α-diol)

    Blood draw

    Androstanediol-glucuronide (3α-diol)

    3α‑diol‑G; androgen metabolite.

    € 89,00

Evidence

Sources

This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.

More about risks and results
  • NVOG, Richtlijn PCOS (adaptatie internationale richtlijn, 2023): module Biochemisch hyperandrogenisme
  • Maastricht UMC+, afdeling Endocrinologie: Hirsutisme
  • Thuisarts.nl: Te veel haargroei (overbeharing)
  • NVKC, allesovertesten.nl: Testosteron

More explanations

Other tests: Hormones

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  • 17-hydroxypregnenolone
  • 2-hydroxy-estrone (2OH-estrone)
  • 2-methoxy-estrone
  • 4-hydroxy-estrone (4OH-estrone)
  • 4-methoxy-estrone
  • ACTH
  • Adrenaline
  • AMH
  • Androstenedione
  • Cortisol
  • Cortisol
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