Androgen Conjugates: Physiology and Clinical Significance

The document from 1993 discusses the challenge of identifying markers for skin sensitivity to androgens in women with hirsutism, a condition characterized by excessive hair growth due to increased androgen production or enhanced skin sensitivity to these hormones. While serum levels of testosterone, androstenedione, and DHEAS are often elevated in hirsute women, they do not reliably indicate skin sensitivity. The enzyme 5α-reductase, which converts testosterone to the more potent DHT, plays a role in modulating skin sensitivity, but serum DHT levels do not correlate well with hirsutism severity. The review suggests that androstanediol glucuronide and possibly other androgen conjugates, which are metabolized from DHT, may serve as better biochemical markers for cutaneous androgen metabolism and action. Some studies indicate that these conjugates primarily originate from adrenal precursors and could be markers of adrenal hyperandrogenism. The review aims to critically evaluate the physiological significance of androgen conjugates and determine whether they reflect cutaneous androgen metabolism or are simply associated with hirsutism due to the overproduction of androgen precursors.