Howard L. Judd

Circulating gonadotropins, estrogens, and androgens in polycystic ovarian disease☆

Serum gonadotropin, estrogen, and androgen levels were measured in samples obtained from 19 patients with polycystic ovarian disease (PCO) and from 10 normal women on day 2 to 4 of their menstrual cycles. In patients with PCO, the mean (plus or minus S.E.) concentration was significantly higher (P smaller than 0.001) than the concentrations found in the normal subjects for LH (35 plus or minus 4.6 vs. 12.7 plus or minus 2.6 m.I.U. per milliliter), but not for FSH (10.3 plus or minus 0.7 vs. 8.7 plus or minus 0.9 m.I.U. per milliliter). Estrone (E1) levels (92 plus or minus 4 vs. 52 plus or minus 5 pg. per milliliter) were also significantly higher (P smaller than 0.001), while estradiol (E2) concentrations (58 plus or minus 4 vs. 63 plus or minus 8 pg. per milliliter) were comparable. Testosterone (T) (468 plus or minus 41 vs. 325 plus or minus 34 pg. per milliliter, P smaller than 0.05), androstenedione (delta) (2,083 plus or minus 138 vs. 1,123 plus or minus 153 pg. per milliliter, P smaller than 0.001), and dehydroepiandrosterone sulfate (3.4 plus or minus 0.4 vs. 2.0 plus or minus 0.37 mug per milliliter, P smaller 0.02) were also significantly increased over the values in normal controls. The mean dehydroepiandrosterone (DHEA) was elevated in the patients with PCO (11.3 plus or minus 1.7 vs. 7.5 plus or minus 1.2 mug per milliliter), but was not significantly different. A positive correlation was found between LH levels and both E2 and E1 concentrations in the patients with PCO. These data show a distinct profile of gonadotropin, estrogen, and androgen levels in patients with PCO.

Effect of oophorectomy on circulating testosterone and androstenedione levels in patients with endometrial cancer

Abstract With the use of specific radioimmunoassays, serum testosterone (T) and androstenedione (Δ) levels were measured before and 6 to 8 weeks after oophorectomy in 5 premenopausal and 16 postmenopausal patients with endometrial cancer. In the premenopausal patients, the mean base-line (± standard error) T and Δ levels were 274 ± 15 and 1,811 ± 95 pg. per milliliter, respectively, and fell to 118 ± 13 (T) and 911 ± 97 (Δ) pg. per milliliter. In the postmenopausal patients, the preoperative T and Δ levels were significantly lower (P

Preoperative localization of a testosterone-secreting ovarian tumor by retrograde venous catheterization and selective sampling

Abstract A 20-year-old woman was evaluated to determine the cause of rapidly progressive virilism. Serum testosterone levels were markedly elevated ranging between 6,528 and 13,554 pg. per milliliter and showed no consistent response to either dexamethasone suppression or human chorionic gonadotropin stimulation. Serum androstenedione (1,013 pg. per milliliter) and dehydroepiandrosterone (4.10 ng. per milliliter) levels were normal. Retrograde venous catheterization and selective sampling of the adrenal and ovarian veins showed an enormous step-up of testosterone (293,333 pg. per milliliter) in the right ovarian vein. A hilus cell tumor of the right ovary was found at operation. Following oophorectomy there was a rapid and sustained fall of serum testosterone and a resolution of the patients hirsutism and amenorrhea. This report demonstrates that retrograde catheterization and selective venous sampling can be effectively used preoperatively to localize androgen-secreting tumors.

Correlation of the effects of dexamethasone administration on urinary 17-ketosteroid and serum androgen levels in patients with hirsutism

Total 24 hour urinary 17-ketosteroid and serum testosterone (T), androstenedione (delta), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DS), and cortisol levels were measured before and during four days of dexamethasone administration in 28 hirsute patients and 10 women with normal ovulatory cycles. Both the base-line urinary 17-ketosteroids and serum androgen levels were significantly higher (p less than 0.05) in hirsute than in normal subjects. Cortisol levels were similar in the two groups. Dexamethasone administration resulted in a significant suppression (p less than 0.05) of all the urinary and serum androgen and cortisol levels in both groups. At the end of suppression the serum DHEA, DS and cortisol levels were similar, while the urinary 17-ketosteroids and serum T and delta levels were still significantly higher (p less than 0.05) in the hirsute than in normal women. There was poor correlation between total urinary 17-ketosteroid and serum androgen results. These finding suggest there is a dual abnormality of androgen production in hirsute patients. The adrenal glands appear to secrete increased quatities of DHEA and DA, while the ovaries appear to produce elevated amounts of T and delta.

Circulating androgen and estrogen concentrations in lizards (Iguana iguana)

To determine whether the sex of an adult reptile could be established by measuring the levels of circulating sex steroids, a study was conducted on 11 iguanas during January and February of 1975. Blood samples were obtained either by cardiac puncture or phlebotomy of the tail vessels. Serum or plasma testosterone, androstenedione, 17β-estradiol, and estrone were measured on each sample (estrone and estradiol could not be measured on all samples because of small specimen volumes). For testosterone, the mean (± SE) level was significantly higher (P < 0.001) in the males (10,167 ± 2916 pg/ml) than in the females (258 ± 46 pg/ml). There was no overlap of values between the two sexes with ranges of 2177 to 15,652 pg/ml and 66 to 431 pg/ml for the same respective animals. For the estrogens the mean levels were higher in the females for both estradiol (258 ± 46 pg/ml) and estrone (205 ± 147 pg/ml) than in the males (estradiol, 79 ± 42 pg/ml; estrone, 37 ± 2 pg/ml). Although higher levels were found in the female iguana, there was no clear division between the two sexes for both estrogens. In the majority of animals androstenedione concentration was below the level of detectability of the assay (<100 pg/ml). The level was lower than 400 pg/ml in the remainder. These data suggest that the sex of a mature iguana can be established during the breeding season by measuring circulating sex steroid levels, particularly testosterone.