Serum testosterone levels decrease in middle age in women with the polycystic ovary syndrome

Objective: To determine whether testosterone levels change as women with the polycystic ovary syndrome (PCOS) grow older. Design: A follow-up cross-sectional study of a cohort of women with PCOS identified up to 20–25 years ago. Setting: Women with PCOS were recruited primarily from practice records between 1970 and 1990. Voter registration tapes and household directories were used to identify age-, race-, and neighborhood-matched controls. Participant(s): Eighty-four women with PCOS, 20–57 years of age, and 37 age-matched controls participating in a study of the risk for cardiovascular disease in women with PCOS. Intervention(s): Clinical data were collected by questionnaire and fasting blood samples were obtained randomly throughout the menstrual cycle. Main Outcome Measure(s): Total and non–SHBG-bound testosterone levels. Result(s): Total and non–SHBG-bound testosterone levels were similar in women with PCOS who were 20–42 years of age but were reduced by approximately 50% among women 42–47 years of age and remained stable in women older than 47 years of age. Testosterone levels were increased in younger and older women with PCOS compared with controls but were similar to controls in women 42–47 years of age. Conclusion(s): Hyperandrogenism partly resolves before menopause in women with PCOS. This change may explain the tendency of women with PCOS to cycle regularly as they grow older. Testosterone levels remain elevated in older women with PCOS, however, and may contribute to their increased risk for cardiovascular disease, endometrial cancer, and other diseases.