Prostate-Specific Antigen as a Marker of Hyperandrogenism in Women and Its Implications for Antidoping

The document from 2016 reviews the use of Prostate-Specific Antigen (PSA) as a biomarker for hyperandrogenism in women and its potential application in antidoping efforts. It notes that PSA levels are significantly higher in women with hyperandrogenic conditions such as polycystic ovary syndrome (PCOS) and that women with PCOS have urinary PSA concentrations nearly 200 times higher than those without the condition. The development of highly sensitive assays for PSA has improved the ability to measure low levels of PSA, which could help in detecting the use of illegal androgenic steroids among female athletes. The document also acknowledges the challenges of using PSA in antidoping, including cost, potential contamination, and the prevalence of PCOS among athletes, but suggests that ultrasensitive PSA assays could be valuable for the athlete's biological passport and for ensuring fair competition.