Blood draw
Androstenedione
Androstenedione; androgenic status.
€ 41,00
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Hormones · Blood
Androstenedione
Precursor of testosterone from the adrenal glands and sex glands; measured for too much male hormone in women.
At a glance
- Measured in blood
- In 1 test panel
- Check the preparation
Explanation
Androstenedione: what is measured?
Androstenedione is a steroid hormone that is made in the adrenal glands and in the ovaries or testicles. The body can convert it into testosterone and into estrogen. Together with DHEA-S and testosterone, the value shows whether extra production of male hormones comes mainly from the adrenal glands or from the ovaries. The value is highest in the morning, which is why blood is preferably drawn early in the morning.
What can it detect?
- Too much male hormone in women with excess hair growth, acne, irregular periods or signs of masculinization
- Distinguishing between extra production in the adrenal glands and in the ovaries, together with DHEA-S and testosterone
- Congenital adrenal hyperplasia (CAH): an inherited disorder in the production of adrenal hormones, and monitoring of its treatment
- Rarely: a tumor of the adrenal gland, ovary or testicle that makes male hormones
Result
What does the result mean?
Androstenedione too high
A slightly raised androstenedione is most common in PCOS, with symptoms such as irregular periods, acne and excess hair growth. A raised value together with a raised DHEA-S points more toward extra production in the adrenal glands, for example in a mild form of CAH that only causes symptoms after puberty. In people with CAH who are treated with hydrocortisone, a raised value usually means that the dose or the time of intake needs to be adjusted. DHEA supplements and anabolic substances also raise the value. Rarely: a strongly raised value with rapidly developing masculinization fits a hormone-producing tumor; this needs prompt testing.
Androstenedione too low
A low androstenedione usually causes no symptoms and rarely has a clear meaning. It fits the use of corticosteroids or hormonal contraception, which suppress the production of male hormones. With reduced function of the adrenal glands or the pituitary gland, the value is also low, but then mainly cortisol is abnormal. After menopause and at an older age, the value is naturally lower.
After an abnormal result
With a raised value, the GP assesses the symptoms, medicines and supplements and the other male hormones, and if needed has 17-hydroxyprogesterone measured to detect CAH. If PCOS is suspected, an assessment of the cycle follows and possibly an ultrasound via the gynecologist. With a strongly raised value or rapidly developing masculinization, prompt referral follows to an endocrinologist (internist specializing in hormones) or gynecologist.
Reliability
How reliable is the test?
Androstenedione is a supplementary test, not a stand-alone test for a diagnosis. When PCOS is suspected, the Dutch PCOS guideline (NVOG, 2023) advises first measuring calculated free testosterone; androstenedione and DHEA-S have only limited value for that diagnosis, but can help if free testosterone is not abnormal or if another cause is suspected. In CAH, the specialist uses androstenedione together with 17-hydroxyprogesterone. In people without symptoms, a slightly abnormal value is hard to interpret.
What can affect the result?
- Timing: the value is highest early in the morning; a sample taken at that time is best compared with the reference values.
- Hormonal contraception interferes with the assessment of male hormones; the PCOS guideline advises stopping for at least 3 months beforehand, with a non-hormonal alternative.
- DHEA supplements, androstenedione preparations and anabolic substances raise the value; corticosteroids lower it.
- Reference values differ per laboratory, measurement method, age and sex; only compare a result with the values of the same laboratory.
Preparation
- Have your blood taken in the morning. Do you have a menstrual cycle? Then choose day 3 to 7 of your cycle.
Who it is for
Who is the test useful for?
Useful for
Useful for women with excess hair growth, acne, irregular periods or signs of masculinization, as an addition to testosterone and SHBG, especially if free testosterone is not abnormal. Also usable in people with CAH to monitor treatment, in consultation with the treating specialist. Not useful for people without symptoms and not as a measure of muscle building or vitality.
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. The severe, inherited form of CAH is diagnosed in 12 to 15 children a year in the Netherlands, nowadays usually through the newborn heel prick; the mild form only becomes noticeable in adulthood. Hormone-producing tumors of the adrenal gland or ovary are rare.
Thuisarts.nl (Too much hair growth) and Maastricht UMC+, Department of Endocrinology
Drawbacks and risks
- A slightly raised value without symptoms can lead to unnecessary worry about the adrenal glands and to unnecessary follow-up testing.
Get tested
Androstenedione: test panels
Androstenedione is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
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- NVKC, allesovertesten.nl: Androsteendion
- NVOG, Richtlijn PCOS (adaptatie internationale richtlijn, 2023): module Biochemisch hyperandrogenisme
- Maastricht UMC+, afdeling Endocrinologie: Congenitale bijnierhyperplasie
- Maastricht UMC+, afdeling Endocrinologie: Hirsutisme
- Thuisarts.nl: Te veel haargroei (overbeharing)