Estrogen-Androgen Imbalance in Patients with Hirsutism and Amenorrhea

The study measured hormone levels in 12 patients with hirsutism and amenorrhea, comparing them to 10 normal men and 5 normal women. It found that only 4 patients had elevated testosterone levels, with the group's mean testosterone being 35% higher than normal. Estradiol levels were significantly lower, at 35% of normal follicular phase levels. Sex hormone binding globulin (SHBG) levels were 40% of normal, while unbound estradiol and testosterone were 130% and 160% of normal, respectively. Despite high unbound fractions, unbound estradiol was half of normal levels. Nine patients had higher unbound testosterone, averaging twice that of normal women. The study suggested that low unbound estradiol/testosterone ratios and hypoestrogenism might contribute to hirsutism by enhancing testosterone's effect on hair growth, with low SHBG levels reflecting this imbalance.