Adrenal and Ovarian Contributions to the Elevated Free Plasma Androgen Levels in Hirsute Women

Abstract

Hirsute women have been studied to explore the possibility that overproduction of androgens by the ovary might be more directly associated with amenorrhea than overproduction by the adrenal. Dexamethasone was administered in order to suppress ACTH secretion, and hence, ACTH-dependent androgen production by the adrenal. Human chorionic gonadotropin was administered in order to stimulate ovarian androgen production. Androgen production was evaluated by measuring indexes of free (unbound) plasma androgen levels and several intermediates in androgen metabolism. Following dexamethasone administration, the levels of free androgens were significantly higher (p < 0.01) in hirsute women with amenorrhea than in other hirsute or normal women. The failure of dexamethasone to suppress plasma free androgens to normal levels in amenorrheic, hirsute women is probably due to overproduction of androgen by the ovaries of such subjects. This conclusion was supported by the finding that gonadotropin reproduced the androgenic ...