Salivary Testosterone in Hirsutism: Correlations with Serum Testosterone and the Degree of Hair Growth

The study examined 64 hirsute women, dividing them into two groups based on their serum LH/FSH ratio. It found that in women with a LH/FSH ratio of 3.0 or less (49 women), there was a significant correlation between free testosterone and androstenedione levels with the clinical grade of hirsutism, while sex hormone binding globulin (SHBG) showed an inverse correlation. However, no such correlations were observed in women with a LH/FSH ratio greater than 3.0 (15 women). The study concluded that correlations between hirsutism and hyperandrogenism were evident, particularly in those with a lower LH/FSH ratio, as indicated by various calculated indices for hyperandrogenism.

The study explored the relationship between androgens and female hirsutism and infertility, highlighting that most circulating androgens in women are formed by conversion of secreted precursors rather than direct secretion. It found that moderately severe male-pattern hirsutism is often linked to elevated free plasma androgen levels, with 85% of cases showing this characteristic. Low testosterone binding globulin (Te BG) levels were common in hirsutism, leading to higher free plasma androgen levels. The study suggested that ovarian overproduction of androgens is more closely related to infertility than adrenal overproduction, as excessive androgens can interfere with ovulation. It concluded that hyperandrogenism is a major factor in hirsutism for 90% of cases, while in 10%, increased hair follicle sensitivity plays a significant role.