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FEMALE HORMONES

FSH - LH - Estradiol

Estrogen is a group of hormones primarily responsible for the development of female sex organs and secondary sex characteristics. While estrogen is one of the major female sex hormones, small amounts are found in males. In women, follicular stimulating hormone (FSH; produced by the pituitary gland) stimulates cells (follicles) surrounding the eggs in the ovaries, causing them to produce estrogen. When the estrogen levels reach a certain level, the pituitary produces a surge of luteinizing hormone (LH), which eventually causes the release of the egg, beginning the preparation for fertilization.

There are three main estrogen fractions: estrone (E1), estradiol (E2), and estriol (E3).

Estrone (E1) is the major estrogen after menopause. It is derived from metabolites from the adrenal gland and is often made in adipose tissue (fat).

Estradiol (E2) is produced in women mainly in the ovary. In men, the testes and adrenal glands are the principal source of estradiol. In women, normal levels of estradiol provide for proper ovulation, conception, and pregnancy, in addition to promoting healthy bone structure and regulating cholesterol levels. Estradiol levels are used to help evaluate ovarian function. Estradiol helps diagnose the cause of precocious puberty in girls and gynecomastia in men. Its main use has been in the differential diagnosis of amenorrhea (for example, to determine whether the cause is menopause, pregnancy, or a medical problem). In assisted reproductive technology (ART), serial measurements are used to monitor follicle development in the ovary in the days prior to in-vitro fertilization. Estradiol is also sometimes used to monitor menopausal hormone replacement therapy.

Estriol (E3) is the major estrogen in pregnancy, with relatively large amounts produced in the placenta (from precursors produced by the fetal adrenal glands and liver). Estriol levels start to rise in the eighth week of pregnancy and continue to rise until shortly before delivery. Serum estriol circulating in maternal blood is quickly cleared out of the body. Each measurement of estriol is a snapshot of what is happening with the placenta and fetus, but there is also natural daily variation in the estriol level.

Female hormones may be measured from a blood sample drawn from a vein in your arm, a 24-hour urine sample, or (in some cases) a fresh saliva sample. However blood, urine, and saliva results are not interchangeable.

Normal Estrogens Levels in pg/mL
Prepubertal    <40

Female Cycle

 1-10 Days 61 - 394
 11-20 Days 122 - 437
21-30 Days 156 - 350
Post-Menopausal        <40
HMG Treatment for Ovulation
                               Induction 400 - 800

Estrogens & Progesterone

This test measures the level of estrogens and progesterone in the blood.

Estrogens is a group of hormones primarily responsible for the development of female sex organs and secondary sex characteristics. While estrogen is one of the major female sex hormones, small amounts are found in males. In women, follicular stimulating hormone (FSH; produced by the pituitary gland) stimulates cells (follicles) surrounding the eggs in the ovaries, causing them to produce estrogen. When the estrogen levels reach a certain level, the pituitary produces a surge of luteinizing hormone (LH), which eventually causes the release of the egg, beginning the preparation for fertilization.

On a monthly basis, the hormone estrogen causes the endometrium (the lining of the uterus) to grow and replenish itself, while a surge in lutenizing hormone (LH) leads to the release of an egg from one of two ovaries. A corpus luteum (small yellow cellular mass) then forms in the ovary at the site where the egg was released and begins to produce progesterone. This progesterone (supplemented by small amounts produced by the adrenal glands) stops endometrial growth and readies the uterus for the possible implantation of a fertilized egg.

If fertilization does not occur, the corpus luteum degenerates, progesterone levels drop, and menstrual bleeding begins. If a fertilized egg is implanted in the uterus, the corpus luteum continues to produce progesterone. After several weeks, the placenta replaces the corpus luteum as the main source of progesterone, creating relatively large amounts of the hormone throughout the rest of a normal pregnancy. Progesterone is measured to help determine the cause of infertility, track ovulation, help diagnose an ectopic or failing pregnancy, monitor the health of a pregnancy, and help diagnose the cause of abnormal uterine bleeding.

There are three main estrogen fractions: estrone (E1), estradiol (E2), and estriol (E3).

Estrone (E1) is the major estrogen after menopause. It is derived from metabolites from the adrenal gland and is often made in adipose tissue (fat).

Estradiol (E2) is produced in women mainly in the ovary. In men, the testes and adrenal glands are the principal source of estradiol. In women, normal levels of estradiol provide for proper ovulation, conception, and pregnancy, in addition to promoting healthy bone structure and regulating cholesterol levels. Estradiol levels are used to help evaluate ovarian function. Estradiol helps diagnose the cause of precocious puberty in girls and gynecomastia in men. Its main use has been in the differential diagnosis of amenorrhea (for example, to determine whether the cause is menopause, pregnancy, or a medical problem). In assisted reproductive technology (ART), serial measurements are used to monitor follicle development in the ovary in the days prior to in-vitro fertilization. Estradiol is also sometimes used to monitor menopausal hormone replacement therapy.

Estriol (E3) is the major estrogen in pregnancy, with relatively large amounts produced in the placenta (from precursors produced by the fetal adrenal glands and liver). Estriol levels start to rise in the eighth week of pregnancy and continue to rise until shortly before delivery. Serum estriol circulating in maternal blood is quickly cleared out of the body. Each measurement of estriol is a snapshot of what is happening with the placenta and fetus, but there is also natural daily variation in the estriol level.

Female hormones may be measured from a blood sample drawn from a vein in your arm, a 24-hour urine sample, or (in some cases) a fresh saliva sample. However blood, urine, and saliva results are not interchangeable.

Progesterone is a steroid hormone whose main role is to help prepare a woman’s body for pregnancy; it works in conjunction with several other female hormones.

At specific times during a woman’s menstrual cycle to determine whether/when she is ovulating; during early pregnancy if symptoms suggest an ectopic or failing pregnancy; throughout pregnancy to help determine placenta and fetal health; and in cases of abnormal uterine bleeding

Since progesterone levels vary predictably throughout the menstrual cycle, multiple (serial) measurements can be used to help recognize and manage some causes of infertility. Progesterone can be measured to determine whether or not a woman has ovulated, to determine when ovulation occurred, and to monitor the success of induced ovulation.

In early pregnancy, progesterone measurements may be used, along with human chorionic gonadotropin (hCG) testing, to help diagnose an ectopic or failing pregnancy (progesterone levels will be lower than expected), although this will not differentiate between the two conditions. Progesterone levels also may be measured throughout a high-risk pregnancy to help evaluate placenta and fetal health.

Progesterone levels may be monitored in women who have trouble maintaining a pregnancy, as low levels of the hormone can lead to miscarriage. If a woman is receiving progesterone injections to help support her early pregnancy, her progesterone levels may be monitored on a regular basis to help determine the effectiveness of that treatment.

In women who are not pregnant, progesterone levels may be used, along with other tests, to help determine the cause of abnormal uterine bleeding.

Normal Female Progesterone Levels in ng/mL
 Follicular 0.2 -   1.4
 Luteal 3.3 -  25.6
Mid-luteal  4.4 -  28.0
Postmenopausal  0.0 -   0.7
Pregnancy
      1st Trimester       

11.2 -  90.0

2nd Trimester 

25.5 -  89.4

3rd Trimester  48.4 - 422.5

Comprehension Female Hormones Panel

This Panel includes:

FSH - LH - Estradiol and Testosterone Total

Menopause Panel

The Menopause Panel includes:

  • Follicle-stimulating hormone (FSH): to learn if you are approaching or have gone through menopause;

  • Estradiol: to measure ovarian production of estrogen and to evaluate whether the menstrual cycle is normal and if you are fertile;

  • Thyroid Function Panel: to test the function of the thyroid gland, which can slow with age;

  • Lipid profile: to test for triglycerides and the good (HDL) and bad (LDL) cholesterol levels in the blood to assess for cardiovascular disease;

  • Complete blood count (CBC): to determine the adequacy of the number of red and white blood cells in the blood;

  • Liver and kidney function: to see if you can tolerate hormone replacement therapy; and if a woman has risk factors or symptoms of diabetes, you could order also a glucose test to learn whether the sugar levels in the blood are too.

Menopause

Menopause is the time in a woman’s life when her normal menstrual periods stop and she can no longer become pregnant. Menopause can occur anytime after the age of 35, but the typical age of onset is in the late 40s. A woman’s ovaries, the organs that produce eggs, stop making them and female hormones at this time.

(menopause affects your body)  

Two important hormones, estradiol and progesterone, are made by the ovaries in a cyclical fashion and help to maintain a normal menstrual cycle. When a woman approaches menopause, cyclical hormone production from the ovaries stops, leading to a cessation in monthly menstrual periods.

The menopausal change is slow and usually takes two to five years to complete. During the so-called peri-menopausal period, hormone levels can fluctuate from high to low from one month to the next. Some months a woman may have a period but then go for several months without a period. It is important to note that during this time, a woman may still be able to get pregnant.

Menopause happens naturally as a woman ages. However, menopause can also occur for other reasons, including the removal of the ovaries for cancer or other medical reasons like endometriosis, excessive exposure to radiation or chemotherapy, pituitary gland disorders, or very poor health.

A woman’s body goes through several changes during menopause. Some of the more common symptoms of menopause occur when estrogen levels start to drop. Women may experience:                                                                                                   

  • rapid mood swings ranging from depression to euphoria;

  • decreased libido and sex drive;

  • increased frequency or sudden urge to urinate;

  • vaginal dryness with pain during intercourse;

  • excessive bone loss, leading to a higher incidence of fractures of the hip and spinal column; and a higher risk for heart disease (because the levels of LDL “bad” cholesterol in the blood may rise).

  • hot flashes;

If a woman has risk factors or symptoms of diabetes, her doctor may also order a glucose tolerance test to learn whether the sugar levels in the blood are too high.

As estrogen levels drop, bones can get weaker. For guidelines on bone density testing, see the National Osteoporosis Foundation.

Some menopausal symptoms can be managed without drug treatments, such as with diet and exercise or by quitting smoking and cutting back on alcohol consumption. Some women, however, may choose to start taking hormone replacement therapy to help prevent or reduce hot flashes, mood swings, and bone loss.

Hormone replacement therapy (HRT) is the most common treatment prescribed to relieve the various symptoms of menopause. It has been and continues to be controversial, however. For more information about HRT, visit the Hormone Foundation. You should also discuss HRT with your doctor to make sure it is right for you.

Growth Hormone

Growth hormone (22,000 MW) is essential for linear growth and is necessary for normal metabolism of protein, carbohydrate, lipid and minerals. The growth promoting aspects are mediated by somatomedin  IGF-1 produced primarily in the liver in response to GH. GH causes an increase in lean body mass, a decrease in body fat, an increase in metabolic rate and a decrease in plasma cholesterol. GH is a unique hormone in that animal forms are inactive in humans. However, recombinant hGH is available for the treatment of disease. While it has been touted as a "fountain of youth", current data does not support the use of GH to reverse the changes seen in normal aging.

HGH is referred to by medical science as the master hormone. Growth hormone affects virtually all areas of the body -- influencing the growth of cells, bones, muscles and organs. When deficient in GH our symptoms include loss of muscle, decreased energy, an increase in fat, diminished sexual drive, a greater risk of cardiovascular disease and a lower life expectancy. In other words, the symptoms we call aging.

Human Growth Hormone (HgH), also called somatotropin, is produced in the anterior of the pituitary gland deep inside the brain.  It influences the growth of cells, bones, muscles and organs throughout the body.

Production of HgH peaks at adolescence when accelerated growth occurs. If growing children have too little they remain as dwarfs, while if they have too much they become giants. Ample in our youth, production of HGH falls 80% from age 21 to 61. Daily growth hormone secretion diminishes with age to the extent that a 60 year old may secrete only 25% of the HGH secreted by a 20 year old.

Human Growth Hormone Deficiency

HgH is one of many endocrine hormones, like estrogen, progesterone, testosterone, melatonin and DHEA, that all decline in production with age. While many of these hormones can be replaced to deter some of the effects of aging, HgH reaches far beyond the scope of any of these hormones. By ages 70 to 80, virtually everyone is deficient in growth hormone, resulting in SDS, or Somatotropin (growth hormone) Deficiency Syndrome.

Recombinant Human Growth Hormone has been approved for use in Growth Hormone Deficiency Syndrome.  Since measurement of hGH is difficult, the accepted method is to measure Somatomedin-C, or by its newer name, Insulin Growth Factor-1 (IGF-1).  Depending on the laboratory used to measure IGF-1 and the work of leading researchers, Somatotropin Deficiency Syndrome is defined as a value below 160 ug/ml.

Testosterone

Testosterone is a steroid hormone (androgen) made by the testes in males. Its production is stimulated and controlled by luteinizing hormone (LH), which is manufactured in the pituitary gland. In males, testosterone stimulates development of secondary sex characteristics, including enlargement of the penis, growth of body hair and muscle, and a deepening voice. It is present in large amounts in males during puberty and in adult males to regulate the sex drive and maintain muscle mass. Testosterone is also produced by the adrenal glands in both males and females and, in small amounts, by the ovaries in females. In women, testosterone is converted to estradiol, the main sex hormone in females.

In males, the testes produce the majority of the circulating testosterone. The pituitary hormone LH stimulates the testicular Leydig cells to produce testosterone. In females, the ovaries produce the majority of the testosterone.

Testosterone levels are obtained in women to help evaluate excess hair growth, virilization (male body characteristics), and irregular menstrual periods.

Insulin Level

Very useful measurement especially:

  • If you have documented hypoglycemia

  • if you have symptoms suggesting that insulin either is being inappropriately released or utilized by your body

  • if you have diabetes and your doctor wants to monitor your insulin production

  • if your Doctor wants to document insulin resistance in e person with Polycystic Ovarian Syndrome (PCOS)

  • in pre-diabetes or in the presence of heart disease (especially if you are overweight)

  • in the Metabolic Syndrom,

  • in disorders related to the pituitary or adrenal glands

Insulin is protein hormone produced by the beta cells of the pancreas. It consists of two chains (A and B) connected by disulfide bridges. Insulin and C-peptide are produced by the pancreas as the result of proteolytic cleavage of a precursor protein called proinsulin. Insulin is an anabolic hormone that stimulates the uptake of glucose into fat and muscle and promotes the formation of glycogen. Insulin stimulates protein synthesis and inhibits protein degradation.

Glucose, amino acids, and certain pancreatic and gastrointestinal hormones (eg, glucagon, gastrin, secretin) stimulate the pancreas to secrete insulin. Insulin secretion is inhibited by hypoglycemia and somatostatin. In healthy individuals insulin is secreted in a pulsatile fashion that is closely controlled by glucose levels. The primary clinical utility of insulin measurement is in the evaluation of patients with fasting hypoglycemia. Insulin levels tend to be inappropriately elevated in patients with insulin-secreting tumors.

Fasting hypoglycemia in association with markedly elevated serum insulin levels is considered diagnostic for a tumor called insulinoma. Some patients with insulin secreting tumors exhibit intermittent insulin elevations. Insulin and C-peptide levels can be useful predicting susceptibility to the development of type II diabetes. The American Diabetes Association recommendations for the diagnosis of diabetes do not include the measurement of insulin levels.

Thyroid Profile

Includes Temp Log - T3 uptake -T4 -T7 FTI

Temp Log

The symptoms of a low body temperature are classic for low thyroid function and they often get better with thyroid medicine. Body temperatures are normally lower in the morning, higher in the afternoon, and lower again in the evening. So if the temperatures are low during the day when they're supposed to be at their highest, that's better evidence that there's a problem. Temperature patterns are also important and illuminating. How patients feel can be affected not only by how high or low their temperatures are but also on how steady their temps are. One temperature reading a day is not enough to see how widely the temperature is fluctuating, but more than three a day can be too time consuming.

T3 uptake

This test measures the amount of triiodothyronine, or T3, in the blood. T3 is one of two major hormones produced by the thyroid gland (the other hormone is called thyroxine, or T4). The thyroid gland is a small butterfly-shaped organ that lies flat across your windpipe. The hormones it produces control the rate at which the body uses energy. Their production is regulated by a feedback system. When blood levels of thyroid hormones decline, the hypothalamus (an organ in the brain) releases thyrotropin releasing hormone, which stimulates the pituitary (a tiny organ below the brain and behind the sinus cavities) to produce and release thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to produce and/or release more thyroid hormones. Most of the thyroid hormone produced is T4. This hormone is relatively inactive, but it is converted into the much more active T3 in the liver and other tissues.

If the thyroid gland produces excessive amounts of T4 and T3, then the patient may have symptoms associated with hyperthyroidism, such as nervousness, tremors of the hands, weight loss, insomnia, and puffiness around dry, irritated eyes. In some cases, the patient’s eyes cannot move normally and they may appear to be staring. In other cases, the patient’s eyes may appear to bulge.

If the thyroid gland produces insufficient amounts of thyroid hormones, then the patient may have symptoms associated with hypothyroidism and a slowed metabolism, such as weight gain, dry skin, fatigue, and constipation. Blood levels of hormones may be increased or decreased because of insufficient or excessive production by the thyroid gland, due to thyroid dysfunction, or due to insufficient or excessive TSH production related to pituitary dysfunction.

  • Fatigue
  • Headaches & Migraines
  • PMS
  • Easy Weight Gain
  • Depression
  • Irritability
  • Fluid Retention
  • Anxiety & Panic Attacks
  • Hair Loss
  • Poor Memory
  • Poor Concentration
  • Low Sex Drive
  • Unhealthy Nails
  • Dry Skin & Hair
  • Cold Intolerance
  • Low Motivation
  • Low Ambition
  • Insomnia - Heat Intolerance
  • Allergies
  • Acne
  • Carpal Tunnel Syndrome
  • Hives.....and many others

About 99.7% of the T3 found in the blood is attached to a protein (primarily thyroxine-binding globulin ( TBG) but also several other proteins) and the rest is free (unattached). Separate blood tests can be performed to measure either the total (both bound and unattached) or free (unattached) T3 hormone in the blood.

When TBG is increased, T3 uptake is decreased, and vice versa. T3 Uptake does not measure the level of T3 or T4 in serum.

Increased T3 uptake (decreased TBG) is seen in chronic liver disease, protein-losing states, and with use of the following drugs: androgens, barbiturates, bishydroxycourmarin, chlorpropamide, corticosteroids, danazol, d-thyroxine, penicillin, phenylbutazone, valproic acid, and androgens. It is also seen in hyperthyroidism.

Decreased T3 uptake (increased TBG) may occur due to the effects of exogenous estrogens (including oral contraceptives), pregnancy, acute hepatitis, and in genetically-determined elevations of TBG. Drugs producing increased TBG include clofibrate, lithium, methimazole, phenothiazines, and propylthiouracil. Decreased T3 uptake may occur in hypothyroidism.

T4

T4 is one of two major hormones produced by the thyroid gland (the other is called triiodothyronine, or T3). The thyroid is a small, butterfly-shaped gland located just below the Adam's apple. This gland plays a vital role in controlling the rate at which your body uses energy.

The body has a feedback system that turns thyroid hormone production on and off. When the level of T4 in the bloodstream decreases, the hypothalamus (an organ in the brain) releases thyrotropin releasing hormone, which stimulates the pituitary gland (an organ below the hypothalamus) to release thyroid-stimulating hormone (TSH), which in turn stimulates the thyroid gland to make and/or release more T4. As blood concentrations of T4 increase, the amount of TSH released decreases.

T4 makes up nearly all of what we call thyroid hormone, while T3 makes up less than 10%. Inside the thyroid gland, T4 is produced, bound to a protein called thyroglobulin, and stored. When the body requires thyroid hormone, the thyroid gland produces some T4 or T3 and/or releases stored T4 into circulation. In the blood, T4 is present in a free (not bound) and protein-bound form (primarily bound to thyroxine-binding globulin). The concentration of free T4 is only about 0.1% of that of total T4, but the free T4 is the portion of thyroxine that is active. T4 only becomes an active thyroid hormone when it is converted into T3 in the liver or other tissues.

If the thyroid gland does not produce sufficient T4 (due to thyroid dysfunction or to insufficient TSH), then the affected patient experiences symptoms of hypothyroidism such as weight gain, dry skin, cold intolerance, irregular menstruation, and fatigue. If the thyroid gland produces too much T4, the rate of the patient’s body functions will increase and cause symptoms associated with hyperthyroidism such as increased heart rate, anxiety, weight loss, difficulty sleeping, tremors in the hands, and puffiness around dry, irritated eyes.

The most common causes of thyroid dysfunction are autoimmune-related Graves' disease causes hyperthyroidism and Hashimoto's thyroiditis causes hypothyroidism. Both hyper- and hypothyroidism can also be caused by thyroiditis (thyroid inflammation), thyroid cancer, and excessive or deficient production of TSH. The effect of these conditions on thyroid hormone production can be detected and monitored by measuring the total T4 (includes bound and free portion) or the free T4 (only unbound).

This is a measurement of the total thyroxine in the serum, including both the physiologically active (free) form, and the inactive form bound to thyroxine-binding globulin (TBG). It is increased in hyperthyroidism and in euthyroid states characterized by increased TBG (See "T3 uptake," above, and "FTI," below). Occasionally, hyperthyroidism will not be manifested by elevation of T4 (free or total), but only by elevation of T3 (triiodothyronine). Therefore, if thyrotoxicosis is clinically suspect, and T4 and FTI are normal, the test "T3-RIA" is recommended (this is not the same test as "T3 uptake," which has nothing to do with the amount of T3 in the patient's serum). 

T4 is decreased in hypothyroidism and in euthyroid states characterized by decreased TBG. A separate test for "T4" is available, but it is not usually necessary for the diagnosis of functional thyroid disorders.

T7 (FTI)

This is a convenient parameter with mathematically accounts for the reciprocal effects of T4 and T3 uptake to give a single figure which correlates with free T4. Therefore, increased FTI is seen in hyperthyroidism, and decreased FTI is seen in hypothyroidism. Early cases of hyperthyroidism may be expressed only by decreased thyroid stimulation hormone (TSH) with normal FTI.                      

TSH

  

This test measures the amount of thyroid-stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland, a tiny organ located below the brain and behind the sinus cavities. It is part of the body’s feedback system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood. Thyroid hormones help control the rate at which the body uses energy. When concentrations decrease in the blood, the hypothalamus (an organ in the brain) releases thyrotropin releasing hormone (TRH). This stimulates the release of TSH by the pituitary gland, and then TSH in turn stimulates the production and release of T4 and T3 by the thyroid gland, a small butterfly-shaped gland that lies flat against the windpipe. When all three organs are functioning normally, thyroid production turns on and off to maintain blood thyroid hormone levels.

If there is pituitary dysfunction, then increased or decreased amounts of TSH may result. If TSH concentrations are increased, the thyroid will make and release inappropriate amounts of T4 and T3 and the patient may experience symptoms associated with hyperthyroidism (overactive thyroid), such as rapid heart rate, weight loss, nervousness, hand tremors, irritated eyes, and difficulty sleeping. If there is decreased production of thyroid hormones (hypothyroidism), then the patient may experience symptoms such as weight gain, dry skin, constipation, cold intolerance, and fatigue. In addition to pituitary dysfunction, hyper- or hypothyroidism can occur if there is a problem with the hypothalamus (insufficient or excessive TRH). They may also occur with a variety of thyroid diseases that affect thyroid hormone production regardless of the amount of TSH present in the blood.

Early cases of hypothyroidism may be expressed only by increased TSH with normal T7 FTI. Currently, the method of choice for screening for both hyper- and hypothyroidism is the serum TSH. Modern methodologies ("ultra sensitive TSH") allow accurate determination of the very low concentrations of TSH at the physiological cutoff between the normal and hyperthyroid states

 TSH has been recognized as an exquisitely sensitive indicator of thyroid status. TSH assays (second or third generation) have therefore been widely adopted as the front-line thyroid function test. In ambulatory patients with intact hypothalamic and pituitary function, a normal TSH result excludes hypo or hyperthyroidism; whereas elevated and suppressed TSH results are diagnostic of hypo and hyperthyroidism, respectively.

Hirsutism Panel

DHEA - Testosterone - Andostenedione

DHEA

DHEAS may be ordered, along with other hormones, whenever excess (or more rarely deficient) androgen production is suspected and/or when your doctor wants to evaluate your adrenal gland function.

It may be measured when a woman presents with symptoms such as:hirsutism, alopecia(hair loss), amenorrhea, infertility, acne, increased muscularity, and decreased breast size.  It may also be ordered when a young girl shows signs of virilization, such as hirsutism, a deep voice, or when a female infant has ambiguous genitalia wherein the clitoris is overgrown, but the internal female organs usually appear normal.

DHEAS may also be measured when young boys show signs of precocious puberty - the development of: a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.

DHEAS, testosterone, and several other androgens are used to evaluate adrenal function and to distinguish between androgen secreting adrenal conditions from those that originate in the ovary or testes.

Low levels of DHEAS may be due to adrenal dysfunction or hypopituitarism - a condition that causes decreased levels of the pituitary hormones that regulate the production and secretion of adrenal hormones.  Normal DHEAS levels, along with other normal androgen levels, may indicate that the adrenal gland is functioning normally, or (more rarely) that the adrenal tumor or cancer present is not secreting hormones. Normal levels of DHEAS may be seen with PCOS (Polycistic Ovarian Syndrome), as this disorder is usually related to ovarian androgen production (primarily testosterone).

Elevated levels of DHEAS, in conjunction with elevations in such tests as 17-ketosteroids (which measures androgen metabolites in urine) and 17-OH progesterone may indicate an adrenocortical tumor, adrenal cancer, or adrenal hyperplasia.  Increased levels of DHEAS usually indicate the need for further testing to pinpoint the cause of the hormone imbalance, but do not often stand alone for diagnostic purposes.

DHEAS concentrations peak after puberty, and then, like other male and female hormones, the levels tend to decline as we age.

Testosterone

testosterone testing may be done if a patient has irregular or no menstrual periods, is having difficulty getting pregnant, or appears to have masculine features, such as facial and body hair, male pattern baldness, and a low voice. Testosterone levels can rise because of tumors that develop in either the ovary or adrenal gland or because of other conditions, such as polycystic ovarian syndrome (PCOS). 

Androstenedione

A steroid that produces masculine characteristics and is produced by the testis, adrenal cortex and ovaries. This hormone test is used also to help determine whether hormone overproduction may be due to PCOS, an adrenal or ovarian tumor, or an overgrowth in adrenal tissue (adrenal hyperplasia).