Is It Necessary to Measure Free Testosterone to Assess Hyperandrogenemia in Women? The Role of Calculated Free and Bioavailable Testosterone

The study evaluated the necessity of measuring free testosterone (FT) using reference measurement procedures (RMPs) versus calculated values like calculated free testosterone (cFT), calculated bioavailable testosterone (cBT), and the free androgen index (FAI) in assessing hyperandrogenemia in women with hirsutism or polycystic ovary syndrome (PCOS). It was found that cFT and cBT are reliable markers for assessing hyperandrogenemia, making the complex and time-consuming RMPs potentially unnecessary for routine clinical evaluation. The study compared these calculated parameters in women with hirsutism, PCOS, and a control group, suggesting that calculated values could effectively reflect the clinical situation without the need for direct FT measurement.