The age-associated decline of androgens in reproductive age and menopausal Black and White women.

CONTEXT

The effect of race and obesity on the age-associated decline of androgens in reproductive-aged and menopausal women has not been well characterized.

OBJECTIVE

Our objective was to determine the impact of racial differences and body mass index (BMI) on the change in androgen levels during a woman's reproductive and early menopausal years.

DESIGN AND SETTING

We conducted a frequency-matched cross-sectional study at a tertiary academic medical center.

PATIENTS OR OTHER PARTICIPANTS

Subjects included 260 healthy, nonhirsute and eumenorrheic, self-identified Black and White women, ages 15-60 yr.

INTERVENTIONS

A medical and reproductive history, physical exam, and blood sampling were determined in the fasting state during the early follicular phase.

MAIN OUTCOME MEASURES

Serum levels of androgens or androgen metabolites (dehydroepiandrosterone sulfate, androstenedione, and total and free testosterone) and SHBG were measured and the BMI, the waist-to-hip ratio (WHR), and the basal insulin resistance estimated by the homeostasis model assessment for insulin resistance determined.

RESULTS

After controlling for differences in BMI, insulin resistance, and WHR, Black women had lower androgen levels than age-matched White women. All androgens, or androgen metabolites, declined similarly across the reproductive lifespan and menopausal transition in both Black and White women. Race was a significant predictor of dehydroepiandrosterone sulfate, androstenedione, and total and free testosterone but not SHBG.

CONCLUSIONS

Eumenorrheic, nonhirsute Black women have a lower range of normal androgen levels than White women of the same age, BMI, WHR, and homeostasis model assessment index for insulin resistance. Race and age-adjusted data should be considered when evaluating androgen levels in women between the ages of 15 and 60 yr.