Androstenedione, LC/MS/MS

The Androstenedione, LC/MS/MS test contains 1 test with 1 biomarker.

Brief Description: The Androstenedione test is a valuable tool in assessing and understanding hormonal balance, particularly related to the production of androgens, which are sex hormones like testosterone. This test helps healthcare providers gain insights into various conditions and disorders that involve hormonal imbalances.

Also Known As: AD Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Androstenedione test ordered?

When excessive androgen production is suspected or when a doctor wants to assess a patient's testicular, ovarian, or adrenal function, androstenedione may be prescribed along with or after other hormone tests.

It may be requested when a young girl acquires masculine physical characteristics that could be caused by CAH or another illness involving excess androgens, such as when a female infant has external sex organs that are not unmistakably male or female.

When young boys exhibit symptoms of premature puberty, such as the development of a larger penis, muscularity, pubic hair, and/or a deeper voice, long before the age of typical puberty, androstenedione may be measured. If puberty is delayed, it can also be ordered.

When a woman experiences infertility or symptoms that might range in intensity and might include:

• A deeper voice
• Acne
• excessive body hair or facial hair
• irregular or nonexistent menstruation
• Male pattern baldness
• Muscularity

For the purpose of monitoring glucocorticoid replacement therapy for CAH, androstenedione is routinely prescribed.

What does an Androstenedione blood test check for?

Androstenedione is one of several androgens, or "masculine" sex hormones, that cause secondary male physical traits such a deep voice and facial hair to develop as well as the beginning of sexual differentiation between males and girls. Although it is thought of as a "male" sex hormone, both men and women have it in their blood. It is a precursor that the body can turn into more potent androgens like testosterone or into the female hormone estrogen. The amount of androstenedione in the blood is determined by this test.

The ovaries in women, the testicles in men, and the adrenal glands in both produce androstenedione. The pituitary hormone adrenocorticotropic hormone stimulates the release of androstenedione by the adrenal gland. A woman's menstrual cycle and the day will affect the level of androstenedione in her blood, which follows a "diurnal pattern." Androstenedione can be helpful as a marker of adrenal gland function, androgen production, as well as the function of the ovaries or testicles because of where it comes from. When the findings of other tests, like those for testosterone or 17-hydroxyprogesterone, are found to be abnormal, an androstenedione test is frequently carried out.

Children who have an excess of androstenedione and other androgens may have sex organs that are unclearly male or female, excessive body hair, irregular menstrual cycles in girls, and early puberty in boys.

Androstenedione can be produced in excess as a result of adrenal tumors, ACTH-producing tumors, and adrenal hyperplasia. While elevated levels may not be obvious in adult men, they can cause physical traits that are clearly masculine and prevent women from having monthly menstrual cycles.

Lab tests often ordered with an Androstenedione test:

When an Androstenedione test is ordered, it's often part of a broader evaluation of hormonal balance and reproductive health. Here are some tests commonly ordered alongside it:

1. 17-Hydroxyprogesterone:

   • Purpose: To measure the level of 17-hydroxyprogesterone, a precursor to androstenedione.
   • Why Is It Ordered: To evaluate adrenal gland function, particularly in diagnosing congenital adrenal hyperplasia (CAH).

2. DHEA-Sulfate (DHEA-S):

   • Purpose: To measure the level of dehydroepiandrosterone sulfate, another androgen produced by the adrenal glands.
   • Why Is It Ordered: To assess adrenal gland function and to help determine the source of androgen excess.

3. Testosterone (Total and Free):

   • Purpose: To measure the levels of testosterone in the blood.
   • Why Is It Ordered: To evaluate androgen excess or deficiency, which can contribute to various conditions like PCOS, infertility, and virilization.

4. Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH):

   • Purpose: To measure the levels of these hormones, which are critical in regulating the menstrual cycle and ovulation.
   • Why Is It Ordered: To assess ovarian function, particularly in conditions like PCOS where the LH to FSH ratio may be altered.

5. Estradiol:

   • Purpose: To measure the level of estradiol, a form of estrogen.
   • Why Is It Ordered: To evaluate ovarian function and estrogen production, which can be related to various reproductive disorders.

6. Cortisol:

   • Purpose: To measure the level of cortisol in the blood.
   • Why Is It Ordered: To assess adrenal gland function, as disorders affecting the adrenal glands can impact androstenedione levels.

7. Prolactin:

   • Purpose: To measure the level of prolactin, a hormone produced by the pituitary gland.
   • Why Is It Ordered: To rule out prolactinoma or other conditions that can affect menstrual function and hormonal balance.

These tests, when ordered alongside an Androstenedione test, provide a comprehensive view of hormonal health and are crucial for diagnosing and managing conditions like PCOS, CAH, and other disorders involving androgen excess or deficiency. The specific combination of tests will depend on the individual’s symptoms, clinical presentation, and medical history.

Conditions where an Androstenedione test is recommended:

The Androstenedione test is ordered to assess and diagnose various conditions, including:

• Polycystic Ovary Syndrome (PCOS): Elevated levels of androstenedione can contribute to the symptoms of PCOS, such as irregular menstrual cycles, hirsutism, and acne.

• Adrenal Disorders: Certain adrenal gland disorders, such as congenital adrenal hyperplasia (CAH), can cause excessive androstenedione production.

• Hormonal Imbalances: Imbalances between androgens and estrogens can lead to a range of symptoms, including fertility issues and changes in secondary sexual characteristics.

How does my health care provider use an Androstenedione test?

Androstenedione is used to assess the synthesis of hormones linked to the growth of male sex organs and physical traits in males as well as the function of the adrenal gland, the ovaries, or the testicles. Along with a few other laboratory tests, it is most frequently used to identify the source of symptoms of excess androgens in a woman who has excessive testosterone levels.

One can utilize an androstenedione level to:

• If findings of DHEAS and testosterone testing are abnormal, evaluate adrenal gland function and to distinguish between androgen-secreting problems that are caused by the adrenal glands from those that originate in the ovaries or testicles.
• help distinguish these disorders from ovarian or testicular tumors and cancers and aid in the diagnosis of tumors in the outer layer of the adrenal gland or tumors outside the adrenal gland that release ACTH.
• Tests for testosterone and 17-hydroxyprogesterone, as well as monitoring CAH treatment, can be used, for example, to identify congenital adrenal hyperplasia.
• assist in making the diagnosis of polycystic ovarian syndrome in women who have abnormal results from tests for DHEAS, testosterone, and other hormones like FSH, LH, prolactin, and estrogen, as well as in excluding other causes of infertility, irregular menstrual cycles, and excessive body and facial hair.
• Look into and identify the causes of early puberty in young boys and young girls, as well as male physical traits in young girls.
• Investigate any ovarian or testicular failure that may be the cause of delayed puberty and ascertain its cause.

What do my Androstenedione test results mean?

Along with other normal androgen levels and other normal adrenal tests, a normal androstenedione level may be a sign that the adrenal gland is operating normally. However, depending on the hormones an adrenal tumor or cancer is secreting, an androstenedione level may be normal or high when present. Androstenedione may be raised in polycystic ovarian syndrome, but it also may be normal because this condition is typically associated with ovarian androgen production.

Increased synthesis of adrenal, ovarian, or testicular hormones is indicated by raised levels of androstenedione. Small concentration variations are typically normal. A higher level could be a sign of congenital adrenal hyperplasia, an adrenal tumor, an adrenal cancer, or an adrenal hyperplasia. Increased levels typically signal the need for additional testing to determine the root of the problem rather than being diagnostic of a specific condition.

Adrenal dysfunction, adrenal insufficiency, ovarian or testicular failure, as well as adrenal dysfunction, can all contribute to low levels of androstenedione.

Normal levels of androstenedione seem to suggest that treatment is successful in reducing excessive androgen production in CAH patients receiving glucocorticoid steroids, but increased levels suggest the need for treatment modification.

Most Common Questions About the Androstenedione test:

Purpose and Applications

Why is the Androstenedione test ordered?

The Androstenedione test is primarily ordered to assess the adrenal gland's function and to evaluate the production of androgens, which are male hormones. This test helps in diagnosing conditions like polycystic ovary syndrome (PCOS), tumors, congenital adrenal hyperplasia, and other disorders related to androgen production.

Who can benefit from the Androstenedione test?

Individuals displaying signs of excessive male hormones like hirsutism (excessive hair growth in women), severe acne, amenorrhea (absence of menstrual periods), or virilization (development of male physical characteristics in women) might benefit from this test.

Clinical Significance

What do abnormal results in the Androstenedione test indicate?

Elevated levels of androstenedione can indicate adrenal tumors, PCOS, or congenital adrenal hyperplasia. In contrast, low levels might indicate adrenal insufficiency or an issue with the sex hormone-producing organs.

How is the Androstenedione test used in conjunction with other tests?

The Androstenedione test might be ordered alongside other tests like testosterone, DHEAS, and 17-hydroxyprogesterone to provide a comprehensive view of androgen production and to pinpoint the origin of an androgen excess or deficiency.

Interpretation

How do age and developmental factors impact the Androstenedione levels?

Androstenedione levels can vary across different life stages. Levels are usually low in childhood, increase during puberty, peak in young adulthood, and then gradually decline as a person ages. Thus, age-appropriate reference ranges are crucial in interpreting the results.

Clinical Limitations

Are there certain situations or conditions that can influence Androstenedione test results?

Yes, factors like the menstrual cycle phase, pregnancy, stress, and certain medications (like antiepileptic drugs or hormone therapies) can influence androstenedione levels. It's essential for individuals to inform their healthcare provider about any medications they are on and their menstrual cycle phase, if applicable.

Additional Considerations

If my Androstenedione test results are abnormal, what's the next step?

If your Androstenedione test results are outside the typical range, your healthcare provider might recommend additional tests to determine the underlying cause. Depending on the suspected condition, you might need imaging tests, genetic testing, or other hormone tests for a comprehensive evaluation.

How does the Androstenedione test fit into the broader assessment of hormone disorders?

The Androstenedione test is one piece of the puzzle when evaluating hormone disorders. It provides specific information about the levels of androstenedione in the body, which, when considered alongside other test results and clinical symptoms, can help diagnose a range of conditions linked to hormone imbalances.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.