HS and Biological Hyperandrogenism

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Furthermore, as far as serum levels of andro-gens and SHBG are concerned, there is no clear evidence for biochemical hyperandrogenism. On average, androgen levels (total plasma testosterone and free testosterone index due to a low SHBG) were increased, but were normal in many individual patients, and no significant decrease of SHBG could be detected [13]. In fact, SHBG is known to be regulated by factors that influence body weight and this study was not controlled for body weight, and neither was a second one which found hyperandrogenism in a subgroup of women who did not experience a premenstrual flare in their disease [9]. In a further group of 66 women with HS, among which 23 had acne, 23 were significantly obese and 19

were hirsute; testosterone and DHEAS were normal in all subjects [3]. In obese subjects, SHBG was reduced, consistent with body-mass-index-matched controls. No evidence for biochemical hyperandrogenism could be found in women with HS when compared with controls matched for age, weight, and hirsuteness [3].

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