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Testosterone Measurements in Postmenopausal Women Should Include Both Free Testosterone and SHBG Levels: Presented at NAMS

By Jerry Ingram

MIAMI BEACH, FL -- September 24, 2003 -- When evaluating testosterone levels in postmenopausal women, clinicians may need to monitor both free testosterone and SHBG levels, because women who are receiving testosterone therapy can have supraphysiologic serum total T concentration, but normal free T concentrations, say researchers.

"The most important implication of this study is that how testosterone levels are measured in women is important. If you use total testosterone alone, you get what would seem to be an abnormally high level. If you use the free testosterone measurement then you get a level which is much physiologic so that you can replace testosterone in women to a normal physiologic level without going into what might be a harmful level," said Anthony Karpas, MD. Dr. Karpas, of the Institute for Endocrinology and Reproductive Medicine, Atlanta, Georgia, United States, presented the results of this study, here at the 14^th Annual Meeting of the North American Menopause Society.

Investigators reviewed laboratory histories of 40 women reporting good outcomes on transdermal testosterone or testosterone pellet treatment. All patients were post-hysterectomy and were on oestrogen replacement therapy.

The hormone status of the 40 participants was evaluated. Twenty women were post-hysterectomy and were receiving testosterone replacement therapy. Ten were premenopausal women diagnosed with hyperandrogenism and 10 were premenopausal women with normal hormone profiles. The patients' total testosterone, SHBG, and free testosterone levels were analysed using equilibrium free dialysis-radioimmunoassay. Total testosterone concentrations were compared to SHBG and free testosterone concentrations to evaluate whether or not total testosterone levels would consistently predict respective SHBG and free testosterone levels, researchers said.

The authors of the study found that the 20 postmenopausal patients had higher than normal total testosterone and SHBG concentrations but normal free testosterone concentrations.

"We're already seeing a testosterone patch for women going into phase II/phase III trials so I think we're going to see this treatment to be a common treatment for women in the next 5 years. This study is focused on how to interpret and deal with the diagnostic/lab aspect of the issue," concluded Dr. Karpas.


[Study title: Free Testosterone and SHBG in Postmenopausal Women. Abstract P130]

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