Transient hyperandrogenemia and its relation to ovulation.

OBJECTIVE

To study serum androgen levels in relation to ovulation.

DESIGN

Prospective, controlled clinical study.

SETTING

Outpatient endocrine department of a public central hospital.

PATIENT(S): Forty-eight consecutive young, nonobese, hirsute women.

INTERVENTION(S): Endocrine evaluation between days 2 and 5 and between days 22 and 25 of a spontaneous menstrual cycle.

MAIN OUTCOME MEASURE(S): Levels of FSH, LH, E2, P, androstenedione (A), total testosterone (T), DHEAS, and 17alpha-hydroxyprogesterone (17-OHP).

RESULT(S): Hyperandrogenemia occurred equally in a persistent (56%) or a transient form (44%). Transient hyperandrogenemia was more common in the early follicular phase in ovulatory cycles and in the second phase in delayed or anovulatory cycles (63% and 37% versus 10% and 90%, respectively). In delayed or anovulatory cycles, A, total T, and DHEAS increased significantly during the delayed follicular phase.

CONCLUSION(S): In delayed or anovulatory cycles, transient hyperandrogenemia occurs late in the follicular phase because of previous ineffective steroidogenesis. In contrast, in ovulatory cycles, transient hyperandrogenemia occurs mainly in the early follicular phase. After ovulation, effective aromatization attenuates the condition. During evaluation and medical treatment of hirsutism, physicians should consider the common occurrence of transient hyperandrogenemia and its relation to ovulation.