Plasma testosterone and dihydrotestosterone in ovulatory and anovulatory cycles.

Daily plasma testosterone (T) and dihydrotestosterone (DHT) as well as plasma lueteinizing hormone, plasma estradiol (E2) and plasma progestrone (P) were measured by radioimmunoassay in seven ovulatory cycles and in three anovulatory cycles. In ovulatory cycles, plasma T ranged from 110 to 637 pg. per milliliter, while plasma DNT ranged from 10 to 246 pg. per milliliter. There is an increase in the mean plasma T during the early follicular phase of the cycle with a fall on the day of ovulation. Plasma T levels rise again during the early luteal phase and drop during the late luteal phase of the cycle. Plasma E2 rises during the follicular phase with a preovulatory surge followed by a drop after ovulation and a subsequent secondary rise. Plasma P was less than 1 ng. per milliliter during the follicular phase and increased to above 5 ng. per milliliter after ovulation, reaching levels of 20 to 25 ng. per milliliter during the luteal phase. In anovulatory cycles, there is random fluctuation with no well-defined patterns. Plasma P remained below 1 ng. per milliliter throughout the cycle. The finding of maximum T levels prior to midcycle may reflect increased T production by the ovaries in response to increasing levels of follicle-stimulating hormone. There is little fluctuation in the levels of T during the menstrual cycle. These findings obviate the need for multiple plasma T estimations in the assessment of women with hirsutism, polycystic ovarian disease, and the testicular feminization syndrome.