THE EFFECT OF ENDOGENOUS PROGESTERONE ON SERUM LEVELS OF 5α-REDUCED ANDROGENS IN HIRSUTE WOMEN

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Abstract
The effect of endogenous progesterone, a known competitor for 5.alpha.-reductase was examined indirectly on androgen metabolism in target organs in hirsute women. Seurm levels of progesterone, testosterone (T), androstenedione (A), dihydrotestosterone (DHT) and 5.alpha.-androstane-3.alpha.,17.beta.-diol (3.alpha.-diol) and sex hormone binding globulin (SHBG) were assessed serially over a 4 wk period in normal women, 6 hirsute women with regular menstrual cycles, 8 hirsute women with oligomenorrhea (and presumptive polycystic ovaries) and 7 non-hirsute women with oligomenorrhea. Serum T and A levels were significantly higher than normal in both hirsute and non-hirsute women with oligomenorrhea, while serum SHBG was significantly lower than normal in the 2 groups of hirsute women. The calculated free T level was higher than normal in all 3 groups of patients. DHT levels were not significantly different from normal in any of the 3 groups of patients. The 3.alpha.-diol level showed considerable overlap with normal in all groups of patients and was only significantly higher than normal in hirsute women with oligomenorrhea (P < 0.05). There was a small fall in DHT in the late luteal phase of the cycle of those women with a sustained rise in serum progesterone in the 2nd half of the cycle, but no change in serum 3.alpha.-diol. Serum 3.alpha.-diol may not be as good an indicator of peripheral androgen metabolism in hirsute women as previously reported and a rise in serum progesterone has only a minimal effect on circulating levels of the active 5.alpha.-reduced androgen metabolites. Although in vitro 3.alpha.-diol has been shown to be a potent inhibitor of 5.alpha.-reductase this casts doubt on its role in this regard in vivo.

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