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Androgen Testing

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What Are Androgens?

Androgens are typically thought of as male hormones, but they also play an important role in women. In men, androgens support sperm production and the development of male secondary sex characteristics. Women produce androgens in their ovaries and adrenal cortex. Almost all of the androgens a woman makes are immediately converted into estrogen. Estrogen promotes the development of female secondary sex characteristics. It is also involved in thickening the endometrium and regulating the menstrual cycle. The androgens that are not converted into estrogen play a role in sex drive and slowing bone loss.

Why Would You Have Androgen Levels Checked?

In women, excess androgen production is the most common cause of anovulatory (failure to ovulate) infertility. If you are having trouble getting pregnant, your androgen levels will be checked to see if they could be preventing you from getting pregnant. Women who begin to display masculine physical features (such as increased body hair or a deepening voice) would also have their androgen levels checked. You would also have your androgen levels checked if your fertility doctor suspects you have polycystic ovary syndrome (PCOS).

When Are Androgen Levels Checked?

Androgen can be checked at any time of the menstrual cycle. Levels are stable across the cycle. They can also be checked at any time in men.

What Do Androgen Levels Mean?

Androgen tests are done to find out the level of different androgens in your blood. A testosterone test is most common. You may also have your dehydroepiandrosterone sulfate (DHEAS) level checked if you have symptoms that warrant it. Your fertility doctor will make this decision with you.

Almost all women who have elevated androgen levels have an underlying cause that can be identified. Approximately 80 to 90 percent of women with high androgen levels have PCOS. Congenital adrenal hyperplasia, Cushing syndrome, and tumors on the ovaries or adrenal glands are all rare but possible causes of increased androgen levels.

Fertility Treatment and Increased Androgen Levels

PCOS is the most common cause of excess androgen levels. There is no cure for PCOS, but controlling it will often improve fertility. Your fertility doctor may have you make dietary changes and exercise more regularly to try to reduce symptoms. Weight loss, even small amounts, can help balance your hormones, which can help get your menstrual cycle and ovulation going. You may also be given anti-androgens or medication to help lower your insulin, both of which can improve ovulation. Fertility drugs can often help start ovulation, too.

Your fertility doctor will try to identify and treat the underlying cause of your increased androgen levels. For example, if you have excess androgen levels because of an (usually benign) ovarian tumor, your fertility doctor may decide to surgically remove the tumor to correct the problem.

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