Androstenedione Test – Purpose, Function, Normal Range, and Results

Overview

The Androstenedione Test is a blood test that measures the level of androstenedione, a type of steroid hormone in your body.
Androstenedione is a precursor hormone, which means it is a building block that your body uses to make testosterone (a male hormone) and estrogen (a female hormone).

Doctors often recommend this test to evaluate hormonal imbalances, especially when symptoms suggest conditions such as excess hair growth (hirsutism), acne, irregular periods, infertility, or early puberty.

What is the Androstenedione Test?

The Androstenedione Test helps measure the amount of this hormone circulating in your blood.
Since androstenedione acts as a precursor for both male and female sex hormones, it provides valuable information about how well the adrenal glands, ovaries, or testes are functioning.

Why the Test is Done

Doctors use the Androstenedione test to:

• Diagnose hormonal disorders such as PCOS (Polycystic Ovary Syndrome).
• Detect adrenal gland diseases like Congenital Adrenal Hyperplasia (CAH).
• Identify tumors in the ovaries, testes, or adrenal glands.
• Evaluate early or delayed puberty in children.
• Investigate causes of infertility or menstrual irregularities in women.

Where is Androstenedione Produced in the Body?

Androstenedione is produced naturally by three organs in the endocrine system:

• Adrenal glands – small glands located above each kidney.
• Ovaries – in females, they produce androstenedione and convert it into estrogen.
• Testes – in males, they convert androstenedione into testosterone.

The production begins with cholesterol, which is converted into androstenedione through a series of chemical reactions inside these organs. Once produced, it either circulates directly in the blood or is converted into testosterone or estrone (a type of estrogen).

Main Functions and Importance of Androstenedione

While androstenedione itself is not the main active hormone, it plays a vital role in maintaining hormonal balance and sexual health.

Functions of Androstenedione:

• Acts as a precursor for testosterone (male hormone) and estrone (a form of estrogen).
• Supports sexual development during puberty.
• Regulates menstrual cycle and fertility in females.
• Maintains muscle strength, libido, and energy in both sexes.
• Helps evaluate adrenal and gonadal (ovary/testis) function.

Because it reflects the combined activity of the adrenal glands and gonads, this test is particularly helpful in identifying the source of hormonal imbalance.

Causes of Low Androstenedione Levels

Low levels of androstenedione may indicate that the body is not producing enough sex hormones. This could result from gland dysfunction, hormone deficiency, or certain medications.

Common Causes of Low Androstenedione:

• Adrenal insufficiency (Addison’s disease)
• Ovarian failure or early menopause
• Hypopituitarism – when the pituitary gland doesn’t make enough stimulating hormones
• Use of steroid medications (long-term)
• Genetic enzyme deficiencies affecting hormone synthesis
• After menopause (natural decline in females)

Symptoms of Low Androstenedione

• Persistent fatigue and low energy
• Low libido (reduced sexual drive)
• Irregular or absent menstrual periods
• Infertility or difficulty conceiving
• Delayed puberty in children
• Reduced body hair and muscle mass

If androstenedione levels are very low, doctors may also check cortisol, DHEA, and testosterone levels to pinpoint the cause.

Causes of High Androstenedione Levels

High androstenedione levels mean that the body is producing too much androgen (male-type hormone), which can cause symptoms of virilization in women and early puberty in children.

Common Causes of High Androstenedione:

• Polycystic Ovary Syndrome (PCOS) – most common cause in women.
• Congenital Adrenal Hyperplasia (CAH) – a genetic disorder affecting hormone production.
• Adrenal gland tumors – overproduce androgens.
• Ovarian tumors – can release excessive androstenedione.
• Cushing’s syndrome – excessive cortisol production disrupting hormone balance.
• Premature adrenarche – early adrenal activity in children.
• Use of anabolic steroids or hormone supplements.

Symptoms of High Androstenedione

• Excess facial or body hair (hirsutism)
• Severe acne and oily skin
• Irregular or missed menstrual cycles
• Voice deepening and enlarged clitoris (in females)
• Infertility
• Early puberty signs in boys or girls
• Hair thinning or baldness (androgenic alopecia)

In such cases, additional tests like DHEA-S, testosterone, and LH/FSH ratio are performed for accurate diagnosis.

Reference Ranges

Normal androstenedione levels vary depending on age, sex, and reproductive stage.
These ranges may differ slightly among laboratories.

⚠️ In females, levels may rise mid-menstrual cycle and decline after menopause.

Sample Type and Test Details

• Sample Type: Serum (blood sample)
• Tube Type: Red Top (Plain Tube) or Serum Separator Tube
• Fasting: Not required (unless part of a hormone panel)
• Collection Time: Can be done at any time of the day

The sample is sent to the laboratory where hormone levels are measured using advanced methods like immunoassay or mass spectrometry.

Test Preparation

• Usually, no fasting is needed.
• Inform your doctor about any hormonal medications, birth control pills, or steroids, as these can affect results.
• For women, the doctor may schedule the test on a specific day of the menstrual cycle for better accuracy.
• In children, it may be done if puberty starts too early or too late.

When to Consult a Doctor

You should consult a doctor or endocrinologist if you notice:

• Irregular periods or infertility issues
• Acne or excessive body hair (especially in females)
• Voice deepening or hair loss
• Unexplained fatigue or muscle loss
• Early signs of puberty in children

The doctor may order an Androstenedione test along with other hormone tests like DHEA-S, testosterone, LH, FSH, and cortisol to find the exact cause.

Important Word Explanations

• Androstenedione: A steroid hormone used to produce testosterone and estrogen.
• Adrenal Glands: Organs on top of the kidneys that make hormones.
• Precursor Hormone: A hormone that is converted into another active hormone.
• PCOS: A hormonal disorder causing irregular periods and high androgen levels.
• Congenital Adrenal Hyperplasia (CAH): A genetic disorder affecting hormone production.
• Hirsutism: Excess hair growth in women in male-like patterns.

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