In women, testosterone tests are used primarily in cases of infertility, absence of menstruation, abnormal uterine bleeding, or if there is a suspicion of polycystic ovary syndrome or other cause of virilization (hoarse voice and hirsutism (abundance of body hair)). In general, total testosterone levels correspond to the hormone’s activity in the tissues. In some situations where SHBG levels are very abnormal, it may be preferable to interpret free or bioavailable testosterone levels. The results presented here were obtained from SHBG and total testosterone levels measured by mass spectrometer. They must be interpreted in light of clinical observations as well as LH and estradiol levels, etc.
In women, high levels of free testosterone may be caused by ovarian tumours and polycystic ovary syndrome, or by adrenal tumours or overactive adrenal glands. Sometimes this overactivity is caused by pituitary or hypothalamus disorders.
In women, a clinically relevant decrease in free testosterone combined with decreased libido can result from bilateral oophorectomy, adrenal gland insufficiency, or poor pituitary function.