Diurnal change of serum androstenedione and testosterone and response to hCG and dexamethasone in women with polycystic ovaries, adrenal hyperandrogenism and unexplained hirsutism.

The diurnal change in peripheral serum concentration of androstenedione (A) and testosterone (T) and their response to dexamethasone (DXM) and hCG was measured in 6 women with unexplained hirsutism (H), and the results compared to those from 4 women with proven polycystic ovaries (PCO) and 3 women with proven adrenal hyperandrogenism (AHA). The DXM suppression study was performed on the basis of short-term tests measuring the change in the steroid levels after iv infusion of 20 mg DXM. Response to hCG was assessed by measurement of steroids in serum collected before and for 5 days after im administration of 10 000 IU hCG. The AHA group showed a greater diurnal change than the PCO and the H group. The mean post-administration levels of A and T following DXM infusion in the AHA group were relatively lower than the levels found in both the PCO group (P less than 0.05 for A, P less than 0.10 for T) and the H group (P less than 0.05 for A, P less than 0.01 for T), but were not different between the PCO and H group (P less than 0.80 for A, P less than 0.20 for T). The mean post-administration levels of these androgens following hCG injection in both the PCO group (P less than 0.02 for A, P less than 0.01 for T) and the H group (P less than 0.10 for A, P less than 0.10 for T) were relatively higher than the levels found in the AHA group. These results suggest that in most women with unexplained hirsutism normal-sized ovaries are the source of excessive androgens.