Total testosterone, free-androgen index, calculated free testosterone, and free testosterone by analog RIA compared in hirsute women and in otherwise-normal women with altered binding of sex-hormone-binding globulin.

We compared the clinical value of information on free testosterone as measured with the Coat-A-Count (Diagnostic Products Corp.) radioimmunoassay kit involving a ligand analog with that of total testosterone, the free-androgen index, and free testosterone calculated from concentrations of testosterone, sex-hormone-binding globulin, and albumin, in hirsute women, pregnant women, oral-contraceptive users, women with thyroid disease, and epileptic women taking phenytoin. Total testosterone, the free-androgen index, calculated free testosterone, and free testosterone by RIA were increased in 41-68% of hirsute women. Values for free testosterone increased in the first and third trimesters of pregnancy but remained within normal limits in all non-hirsute groups. Total testosterone was increased in patients having increased sex-hormone-binding globulin, whereas the free-androgen index and, to a lesser extent, calculated free testosterone were significantly decreased. Free testosterone measured by analog RIA not only has greater diagnostic efficiency than total testosterone, it also is technically simpler to determine than the free-androgen index and calculated free testosterone.