TIME-DEPENDENT CHANGES IN SERUM 3-ALPHA-ANDROSTANEDIOL GLUCURONIDE CORRELATE WITH HIRSUTISM SCORES AFTER OVARIAN SUPPRESSION

The clinical utility of serum 3 alpha-androstanediol glucuronide level has been controversial. Among the concerns regarding its lack of util ity has been the finding that suppression of serum 3 alpha-androstaned iol glucuronide does not occur readily with treatment. We hypothesized that because the treatment of hirsutism requires a prolonged duration , a longer observation period is required for changes in serum 3 alpha -androstanediol glucuronide to be measured. Therefore, we studied the clinical and hormonal changes in II women treated for hirsutism with a gonadotropin-releasing hormone agonist (GnRH-a) for 1 year. A progres sive reduction in Ferriman-Gallwey stores occurred, which was signific ant at 6 weeks and was maximal at 12 months. Serum 3 alpha-androstaned iol glucuronide and another peripheral marker, androsterone glucuronid e, also fell commensurately. While there was no correlation at 3 month s, by 6 weeks a significant correlation had occurred between the suppr ession in Ferriman-Gallwey scores and the suppression of serum 3 alpha -androstanediol glucuronide and androsterone glucuronide. The suppress ion of these steroids also correlated with the suppression of nan-sex hormone-binding globulin-bound testosterone. These data confirm that m arkers of peripheral androgen action, particularly serum 3 alpha-andro stanediol glucuronide, reflect the clinical manifestation of hirsutism . However, it appears that modifications in peripheral androgen activi ty (presumably through 5 alpha-reductase activity) are time-dependent, and that serum markers reflect changes after 6 months of treatment.