Androgens are hormones which are normally higher in men, than women. However in some conditions they may too high in women causing symptoms.
Mostly commonly this happens in PCOS (poly-cystic ovarian syndrome).
Common symptoms of too high androgens in women
- Hirsutism (facial hair)
- Acne. Often hormonal acne around the chin
- Hair loss
The four androgens are:
- DHEA
- Androstedione
- Testosterone
- DHT
Along with pregnenolone, cortisol, progesterone, and the estrogens, these make up the steroid hormones.
Testing Androgens
In a case of PCOS testing androgens is very important. First this can verify if androgens are elevated. It can also help to identify which type of PCOS is present. Finally,
it gives markers which allow for progress to be tracked.
There are 4 general types of PCOS:
- Insulin resistant
- Post Pill
- Inflammatory
- Adrenal
A good hormone test can help diagnose which type. Is the problem insulin? Then you want to test insulin levels. In an andrenal pattern of PCOS, only DHEA
will be elevated. The other androgens are normal.
Blood or saliva hormone tests
Hormones can be tested in either blood or saliva. Most patients will have a blood test. Advantages with blood tests are that it can run along with other basic blood work. It is more
commonly accepted by insurance.
There are also problems with blood tests. Often patient have incomplete labs with only DHEA and testosterone. The other problem I see are false negatives. Numerous times I have
seen women with elevated saliva androgens who have normal looking blood work.
Unlike blood tests, saliva is a marker of cellular hormone levels. It does a better job at showing how much hormone your cells have, not just what is circulating in blood at the moment. Saliva hormone
tests will cover all the androgens. Other hormones such as insulin and cortisol can also be tested in saliva, allowing for full testing of all the hormone involved in PCOS.
Blood sugar and PCOS
Elevated blood sugar and insulin resistanc is a common cause of PCOS. But this is not always the culprit. Testing insulin is a way to tell if this needs to be addressed or not.
