Estrogen-Androgen Imbalance in Patients with Hirsutism and Amenorrhea

    July 1974 in “ The Journal of Clinical Endocrinology & Metabolism ”
    Dan Tulchinsky, INDER J. CHOPRA
    TLDR Low estrogen and high testosterone may cause excessive hair growth in women.
    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.
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