Clinical and diagnostic aspects of testosterone deficiency in women of fertile age

Background. The role of androgens in a woman has not been fully appreciated. Currently, there is no clear and gene­rally accepted definition of the concept of androgen deficiency in women by analogy with that in men. The purpose of the study was to investigate the clinical and diagnostic aspects of testoste­rone deficiency in women of fertile age. Materials and methods. The study included 60 women with testosterone deficiency without other concomitant pathology. The average age of the patients was 28.3 years. The control group consisted of 20 healthy women. The patients were divided into three groups based on their body mass index (BMI). The first group consisted of 20 overweight women (BMI 25–29.9 kg/m2), the second group — 20 women with first-degree obesity, and the third group — 20 women with second-degree obesity. Results. On the 14th day of the ovarian-menstrual cycle, the patients from the first group showed a tendency towards a decrease in the basal levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and progesterone against the background of significant hypoandrogenaemia. Patients with obesity (II degree) showed a significant decrease in basal levels of LH, FSH, estradiol, progesterone against the background of significant hypoandrogenaemia. The correlation analysis revealed a direct relationship between testosterone deficiency and obesity. Thus, the lowest testosterone values were found in patients of the third group (< 0.05 nmol/l). At the same time, the testosterone level in the patients of the first and second groups was also significantly reduced — from 0.02 to 0.05 nmol/l, respectively. The levels of dehydroepiandrosterone and 17-hydroxycorticosteroids were significantly reduced, especially in the third group — 0.3 μg/ml and 0.1 nmol/l, respectively. Conclusions. Most women of reproductive age with testosterone deficiency have hypomenorrhea with low free testosterone. A direct correlation was established between testosterone deficiency and the degree of obesity in women with androgen deficiency.