Serum Androgen Levels: What Do They Indicate?

A serum androgen test measures the amount of androgens, a group of hormones, in the liquid portion of your blood. While often called “male hormones,” androgens are naturally present and active in both males and females, just in different amounts. These sex hormones are responsible for the development of male characteristics and play a part in reproductive health for everyone. Measuring their levels provides a snapshot of the concentration of these hormones circulating in your bloodstream.

The Role of Androgens in the Body

Androgens are produced in several locations, including the testes in males, the ovaries in females, and the adrenal glands in both sexes. In males, androgens are the primary drivers of the physical changes that occur during puberty. They are responsible for the deepening of the voice, the growth of facial and body hair, and the development of muscle mass and bone growth. These hormones are also involved in the production of sperm.

While present in lower concentrations, androgens have significant functions in the female body. They contribute to bone health, influence libido, and help maintain muscle mass. Androgens are involved in more than 200 distinct actions in the female body, regulating organs like the kidneys, liver, and reproductive tract.

The regulation of these hormones is a complex process managed by glands in the brain, specifically the pituitary gland and the hypothalamus. These brain structures send signals to the testes, ovaries, and adrenal glands to control androgen production, ensuring the body has the appropriate amount needed for its various functions.

Key Types of Androgens

Testosterone is the principal androgen in both males and females. It is directly responsible for many characteristic male traits and has a wide range of effects on muscle, bone, and libido in both sexes.

Other key androgens include Dehydroepiandrosterone (DHEA) and its sulfated form, DHEA-S, which are primarily produced by the adrenal glands. Androstenedione is produced by the testes, ovaries, and adrenal cortex. These function as important precursors that can be converted into testosterone and estrogens. While not as powerful as testosterone, their levels provide information about the function of the adrenal glands and ovaries.

Measuring Serum Androgen Levels

Measuring androgen levels is accomplished through a blood test, where a sample is drawn from a vein in your arm and sent to a laboratory for analysis. The procedure is routine and carries minimal risk, with potential side effects being minor bruising or a brief stinging sensation at the needle site.

The timing of the blood draw can affect the results, as androgen levels naturally fluctuate throughout the day. For testosterone, levels are highest in the morning, so tests are often scheduled between 7 a.m. and 10 a.m. for an accurate reading of peak production. Factors like recent strenuous exercise, high stress, or illness can also temporarily alter hormone levels.

When you receive your results, they will be presented with a “reference range,” which indicates the normal span of androgen levels. These ranges are not universal; they vary based on your age, sex, and the specific laboratory that processed the test.

Causes of High Androgen Levels

Elevated androgen levels, known as hyperandrogenism, can stem from several underlying medical issues. In women, the most frequent cause is Polycystic Ovary Syndrome (PCOS), an endocrine disorder where the ovaries may produce excess androgens. Common signs of high androgen levels in women include hirsutism, which is the growth of dark, coarse hair in a male-like pattern on the face, chest, and back. Other symptoms can include acne, thinning hair on the head, and irregular or absent menstrual periods.

While PCOS is the most common culprit, other, rarer conditions can also cause high androgen levels. These include tumors on the ovaries or adrenal glands that secrete androgens and congenital adrenal hyperplasia (CAH), a group of genetic disorders that affect the adrenal glands.

Causes of Low Androgen Levels

Low androgen levels, or hypoandrogenism, can arise from a range of causes affecting both men and women. In men, this condition is often linked to issues with the testes (primary hypogonadism) or with the pituitary gland and hypothalamus in the brain (secondary hypogonadism). The natural process of aging is another common reason for declining androgen levels in men. For women, low androgen levels can be caused by the surgical removal of the ovaries, ovarian failure, or adrenal insufficiency.

Symptoms associated with low androgens include persistent fatigue, a decreased sense of well-being, and low libido in both sexes. Men may also experience a loss of muscle mass, reduced body hair, and erectile dysfunction. In women, symptoms can also include thinning hair and dry skin.