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Testosterone or dihydrotestosterone: what should be evaluated in hirsutism?

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Abstract

Purpose

Dihydrotestosterone is a more potent androgen derived from testosterone and androstenediones, but its measurement has not been routinely recommended in women with hirsutism, and there is limited information in this regard with equivocal findings. This study aimed to evaluate serum dihydrotestosterone level in patients with hirsutism compared to women without hirsutism.

Methods

In this case–control study (during 2021–2022), serum levels of total testosterone, free testosterone, and dihydrotestosterone were evaluated in 101 women with hirsutism and 101 healthy women. Hormonal levels were measured with chemiluminescent immunoassay method. Age and hormonal levels in each group, body mass index, menstrual status, complaint of decreased scalp hair density, and ovarian ultrasound findings in hirsutism group were collected and analyzed.

Results

There was significant difference in free testosterone and dihydrotestosterone levels (P < 0.001) and no significant difference in total testosterone level between two groups (P = 0.628). Dihydrotestosterone level was significantly higher in women with hirsutism with menses irregularity, complaint of decreased scalp hair density, and presence of polycystic ovary on ultrasound (P < 0.05).

Conclusions

Measuring dihydrotestosterone level is not considered in routine evaluation of hirsutism, but we think that this significant difference shows that elevated level of dihydrotestosterone hormone in women with hirsutism is an important factor.

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Data Availability

The raw data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

The authors thank the cooperation of the Vice Chancellor of Research and Technology, Guilan University of Medical Sciences.

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Authors and Affiliations

  1. Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Abbas Darjani, Narges Alizadeh, Kaveh Gharaei Nejad, Hojat Eftekhari, Rana Rafiei & Hasan Kazemi

  2. Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran

    Elahe Rafiei

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  1. Abbas Darjani
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  2. Narges Alizadeh
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  3. Kaveh Gharaei Nejad
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  7. Elahe Rafiei
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Corresponding author

Correspondence to Rana Rafiei.

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Ethical approval

This research project was approved by the ethics committee of Guilan University of Medical Sciences (code: IR.GUMS.REC.1400.114) and supported by the Vice Chancellor of Research and Technology, Guilan University of Medical Sciences. This study was conducted in accordance with the principles for human experimentation as defined in the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Darjani, A., Alizadeh, N., Gharaei Nejad, K. et al. Testosterone or dihydrotestosterone: what should be evaluated in hirsutism?. Ir J Med Sci 192, 2823–2827 (2023). https://doi.org/10.1007/s11845-023-03366-x

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  • DOI: https://doi.org/10.1007/s11845-023-03366-x

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