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Endocrine tests

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The triad of endocrine abnormalities consists of:

  • elevated luteinizing hormone with normal follicle stimulating hormone

  • elevated free testosterone:
    • a combination of increased testosterone production and reduced sex hormone binding globulin

  • insulin resistance with compensatory hyperinsulinaemia

Blood should be taken during the first week after menstruation.

Characteristically serum concentration of testosterone is above 2.5nmol/l and serum LH above 10 IU/l (1). A serum testosterone level of above 4.8 nmol/l requires exclusion of other causes of androgen hypersecretion such as an androgen-secreting adrenal or ovarian tumour, Cushing's syndrome or non-classical congenital adrenal hyperplasia (1).

Suggested differential diagnoses and screening tests (2)

  • pregnancy - pregnancy test
  • hypothyroidism - TSH
  • hyperprolactinemia - PRL
  • Cushing's syndrome - 24-hour urine free cortisol
  • late-onset CAH (congenital adrenal hyperplasia) - 17-hydroxyprogesterone
  • ovarian tumor - total testosterone
  • hyperthecosis - total testosterone
  • adrenal tumor - dehydroepiandrosterone sulfate (DHEAS)

Reference:


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