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Hormonal imbalance with high testosterone.

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What can explain the high testosterone levels in a 39 year old women. PCOS is ruled out. No hirsutism but mild acne is present, normal weight and regular menstrual cycle until two months ago. No infertility issues. On 0.025 mg.day estrogen patch for last two years.

Testosterone Total 511 ng/dl ;
Testosterone, free 63.2 pg/ml;
DHEA < 15 mcg/dL ;
Androstenedione 79 ng/DL ;
TSH 1.2 miu/l;
Cortisol 14.6 mcg/dl ;
Progesterone 0.4 ng/ml ;
Estradoil, free 1.7 pg/ml ;
Estradoil 142 pg/ml ;
FSH 17.5 miu/ml ;
LH 39.7 miu/ml ;
Prolactin 7.1 ng/ml ;


Category: Endocrinologist

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Category: Diabetologist
 23 Doctors Online


Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your case.
I will require some information in order to give you an informed opinion. Is your partner using any testosterone gel? Are you exposed to the gel?
All your level's are normal besides high testosterone levels.
You would also require to get your 17 OH Progesterone levels tested. (let me know the values if already tested )

Please reply as a follow up.

Thankyou.


Patient replied :

Dr. Muthukrishnan, partner is not using testosterone gel nor is there any other apparent reason of being exposed to testosterone.
17 OH Progesterone level were not tested, please advise what that insight that might provide
regards



Hello,

17OH progesterone levels are increased in patients who have high testosterone levels due to Congenital Adrenal Hyperplasia. May I know why the panel of tests were done ? (symptoms ? indications ?). Are these tests recommended by your Doctor. ?


Thank you


Patient replied :

The tests were ordered to determine if the acne was caused by hormones. There are no other symptoms of any other abnormalities.


Hello,
Sorry for the delay in my reply.
In that case you need not worry much. Especially since the USG is normal. Approach to a hormonal problem is always better if done step by step (avoids confusion and unnecessarycosts). My next recommendation would be to do 17OH and rule of CAH.

Thank you


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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