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Introduction ⬇

Androstenedione is one of the major androgens produced by the ovaries in females and, to a lesser extent, in the adrenal gland in both genders. This hormone is converted to estrogens by hepatic enzymes. Levels rise sharply after puberty and peak at age 20 years.

This hormone measurement is helpful in the evaluation of conditions characterized by hirsutism (excessive hair growth in women) and virilization. In females, there is poor correlation of plasma levels with clinical severity.

Normal Findings ⬆ ⬇

Newborns: 20–290 ng/dL or 0.7–10.1 mmol/L

Prepuberty: 8–50 ng/dL or 0.3–1.7 mmol/L

Male: 75–205 ng/dL or 2.6–7.2 mmol/L

Female: 85–275 ng/dL or 3.0–9.6 mmol/L

Postmenopausal women: <10 ng/dL or 0.35 mmol/L (abrupt decline at menopause)

Different laboratories may have variation in reference values.

Procedure ⬆ ⬇

  1. Obtain a 5-mL venous blood sample in the morning and place on ice. Serum or EDTA can be used. Observe standard precautions. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered. Place specimen in a biohazard bag.

  2. In women, collect this specimen 1 week before or after the menstrual period. Record date of last menstrual period on the laboratory form.

Clinical Implications ⬆ ⬇

  1. Increased androstenedione values are associated with the following conditions:

    1. Polycystic ovary syndrome (Stein–Leventhal syndrome)

    2. Cushing syndrome

    3. Atypical ovarian tumors

    4. Ectopic ACTH-producing tumor

    5. Late-onset congenital adrenal hyperplasia

    6. Ovarian stromal hyperplasia

    7. Osteoporosis in females

  2. Decreased androstenedione values are found in the following conditions:

    1. Sickle cell anemia

    2. Adrenal and ovarian failure

Clinical Alert

>1000 ng/dL or >34.9 mmol/L suggests virilizing tumo

Interventions ⬆

Pretest Patient Care

  1. Explain purpose of test and blood-drawing procedure. Obtain pertinent history of signs and symptoms (e.g., excessive hair growth and infertility).

  2. Ensure that the patient is fasting and that blood is drawn at peak production (7:00 a.m. or 0700 hours). Lowest levels are at 4:00 p.m. or 1600 hours.

  3. Collect specimen 1 week before menstrual period in women.

  4. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Have the patient resume normal activities.

  2. Review test results; report and record findings. Modify the nursing care plan as needed. Counsel appropriately for ovarian and adrenal dysfunction.

  3. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.