Ovarian and peripheral androgen and oestrogen levels in post-menopausal women: correlations with ovarian histology.

Ovarian and peripheral plasma levels of oestrone (E1), oestradiol (E2), androstenedione (A) and testosterone (T) were assayed in 58 post-menopausal women who underwent hysterectomy and oophorectomy (35 for endometrial carcinoma and 23 for benign gynaecological diseases). No significant difference between the two groups was seen when they were matched for percentage of ideal weight. However, significant differences were found between the ovarian and peripheral levels of the four steroids investigated. To facilitate analysis of the data, 40 of these women were classified into three groups (1, 2 and 3) according to degree of stromal hyperplasia of the ovary. Group 1 comprised those with atrophic ovaries, group 2 those with slight stromal hyperplasia and group 3 those with moderate or marked stromal hyperplasia. Ovarian levels of A and T were significantly higher than peripheral levels in all three groups, but the ovarian/peripheral oestrogen differences were significant only in groups 1 and 2. The ovarian steroid levels in group 3 were significantly higher than those in groups 1 and 2 in the cases of E1 (P less than 0.01), E2 (P less than 0.001) and A (P less than 0.001), but not in that of T. It was concluded that ovaries showing marked stromal hyperplasia can produce significant amounts not only of androgens but also of E2, and hence that any evaluation of the hormonal pattern in post-menopausal women must also take into account the microscopic characteristics of the ovary.