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Hum. Reprod. Advance Access originally published online on June 11, 2009
Human Reproduction 2009 24(9):2276-2285; doi:10.1093/humrep/dep209
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Testosterone, sex hormone-binding globulin and free androgen index among adult women: chronological and ovarian aging

M.F.R. Sowers1,4, H. Zheng1, D. McConnell1, B. Nan2, C.A. Karvonen-Gutierrez1 and J.F. Randolph, Jr3

1 Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory, Room 1846, Ann Arbor, MI 48109, USA 2 Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA 3 Department of Obstetrics and Gynecology, University of Michigan Health Sciences System, Ann Arbor, MI 48109, USA

4 Correspondence address. Tel: +1-734-936-3892; Fax: +1-734-764-6250; E-mail: mfsowers{at}umich.edu

BACKGROUND: In this study, levels and rates of change in total testosterone (T), sex hormone-binding globulin (SHBG) and free androgen index (FAI) were related to chronological age and to the final menstrual period (FMP) as an indicator of ovarian aging.

METHODS: Data were annually acquired over a 15-year period in 629 women of the Michigan Bone Health and Metabolism Study cohort. Data were censored for hormone therapy use. Endogenous androgen patterns over time were described with stochastic processes and bootstrapping.

RESULTS: With ovarian aging, T levels rose from a mean of 18 ng/dl commencing 10 years prior to the FMP to 27 ng/dl at the FMP. Over the 20-year period encompassing the FMP, modeled mean SHBG levels changed from 58 to 34 nM and the FAI ratio increased from 1.6 to 2.9 in a non-linear manner. With chronological aging, total T levels increased (P < 0.0001) from 43 to 50 years, but not thereafter. SHBG declined steadily with age with a modestly greater rate of change between 49 and 54 years. The FAI increased from 1.3 to 2.5 from 34 to 58 years.

CONCLUSIONS: T increased from approximately age 40 until the FMP whereas SHBG had rate of change patterns reflecting both chronological and ovarian aging components. These data provide new insight into the endogenous androgen patterns at mid-life.

Key words: reproductive senescence/hormone trajectories/total testosterone/androgens/ovarian aging

Submitted on November 3, 2008; resubmitted on May 8, 2009; accepted on May 12, 2009.


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