Androstenedione is used to evaluate the function of the adrenal gland and the ovaries or the testicles as well as the production of hormones related to the development of male sex organs and physical characteristics (androgens). It is most commonly used to determine the cause of symptoms of excess androgens in a woman who has an elevated testosterone level, along with a few other laboratory tests for this purpose.
An androstenedione level may be used to:
Evaluate adrenal gland function and to distinguish between androgen-secreting conditions that are caused by the adrenal glands from those that originate in the ovaries or testicles, if results of DHEAS and testosterone testing are abnormal
Help diagnose tumors in the outer layer (cortex) of the adrenal gland or tumors outside of the adrenal gland that secrete ACTH (ectopic) and separate these conditions from ovarian or testicular tumors and cancers
Androstenedione may be ordered, along with or following other hormone tests, whenever excess (or, more rarely, deficient) androgen production is suspected and/or when a doctor wants to evaluate a person's adrenal gland, ovarian, or testicular function.
It may be ordered when a female infant has external sex organs that are not clearly male or female (ambiguous external genitalia) or when a young girl develops male physical features that may be due to CAH or another condition associated with excess androgens.
Androstenedione may be measured when young boys show signs of precocious puberty – the development of an enlarged penis, muscularity, pubic hair, and/or a deeper voice – well before the age of normal puberty. It may also be ordered when puberty is delayed.
It may be measured when a woman has infertility or symptoms that can vary in severity and may include:
A deeper voice
Excess facial and/or body hair
Lack of or irregular menstruation
Male pattern baldness
Androstenedione is ordered periodically to help monitor glucocorticoid replacement therapy for CAH.
A normal androstenedione level, along with other normal androgen levels and other normal adrenal tests, may indicate that the adrenal gland is functioning normally. However, an androstenedione level may be normal or elevated when an adrenal tumor or cancer is present, depending upon the hormones it is secreting. With polycystic ovarian syndrome, androstenedione may be elevated but may also be normal as this disorder is usually related to ovarian androgen production (primarily testosterone).
An elevated level of androstenedione indicates increased adrenal, ovarian or testicular production. Small fluctuations in concentration are usually normal. An increased level may indicate an adrenal tumor, adrenal cancer, adrenal hyperplasia, or congenital adrenal hyperplasia (CAH). An increased level is not diagnostic of a specific condition; it usually indicates the need for further testing to pinpoint the cause.
A low level of androstenedione may be due to adrenal gland dysfunction, adrenal insufficiency, or to ovarian or testicular failure.
In those with CAH who are being treated with glucocorticoid steroids, normal levels of androstenedione tend to indicate that treatment is effective in suppressing excess androgen production, while elevated levels indicate the need for treatment adjustment.
Drugs such as clomiphene, levonorgestrel, corticotrophin, and metyrapone can increase concentrations of androstenedione, while corticosteroids such as dexamethasone can decrease them. Androstenedione is not used to monitor these medications.
If a radioimmunoassay method is used to measure androstenedione, then a radioactive scan performed within one week prior to testing may invalidate test results.
Androstenedione concentrations increase in boys undergoing puberty, for about two years prior to significant increases in testosterone. Androstenedione levels are not usually used to monitor this process.
Adrenal androstenedione is the major source of androgens for postmenopausal women.
This article was last reviewed on June 27, 2013. | This article was last modified on August 16, 2013.
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