Helpful Diagnostic Markers of Steroidogenesis for Defining Hyperandrogenemia in Hirsute Women

In a 2008 study involving 464 hirsute women, researchers found that 77.6% met the clinical criteria for hyperandrogenemia, with 78.1% of these having hyperandrogenic hirsutism. The study revealed that androstendione and dehydroepiandrostendione (DHEA) are significant markers for diagnosing hyperandrogenemia, while dehydroepiandrostendionesulfate (DHEAS) was not useful. Despite normal total testosterone (T) concentrations in 72% of patients with secondary hirsutism and a normal free androgen index (FAI) in 55%, these measures alone were deemed insufficient for a complete clinical workup. The study also indicated that adrenal disorders or congenital adrenal hyperplasia (CAH) might be more common in hirsute women than previously thought, with more than 90% of participants showing criteria for adrenal enzyme deficiencies or polycystic ovary syndrome (PCOS). The authors suggested that DHEA and androstendione should be included in the diagnostic process for hyperandrogenemia.