Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women

madman · Sep 12, 2026

Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women

Guideline summary

Thread 'Laboratory Evaluation in PCOS/PMOS: Improving Accuracy, Interpretation, and Standardization'

Aug 16, 2026

* Shalender Bhasin, MD, is a Professor of Medicine at Harvard Medical School, Director of the Boston Claude D. Pepper Aging Research Center, and Director of the Center for Clinical Investigation at Brigham and Women’s Hospital. He is an internationally recognized expert in testosterone biology and has conducted many of the most important randomized controlled trials of testosterone in men and women. His laboratory has characterized the mechanisms of testosterone’s action, including the role of steroid 5-alpha reductase in adults....

Thread 'Serum Free Testosterone: Precision LC-MS/MS for PCOS Diagnosis'

Mar 9, 2025

* A standardized ED method is recommended to effectively separate FT from the serum matrix.

* With the rapid development of liquid chromatography-tandem mass spectrometry (LC-MS/MS), the ED separation combined with LC-MS/MS has become the “gold standard” for quantifying FT [4].

* Serum FT concentration can be as low as 1% of serum TT [15]. The lower limit of female serum TT reference interval could be as lowas 0.29 nmol/L [14]. Thus, to accommodate measuring female serum FT, the LLMI for an LCMS/MS method would ideally be lower than 3 pmol/L. Therefore...

madman · Sep 12, 2026

Context

Scope and terms of reference

Clinical Practice Guideline 2025

madman · Sep 12, 2026

Androgen metabolism in women

madman · Sep 12, 2026

* About 90% or more cases of androgen excess in women will be related to underlying PMOS

Androgen excess in women can result in:

Causes of androgen excess in women

Clinical history and examination

Clinical red flags

madman · Sep 12, 2026

Severe insulin resistance syndromes

madman · Sep 12, 2026

Ovarian hyperthecosis (OHT)

Viriising ovarian tumours (VOTs)

Differentiating OHT from VOT

madman · Sep 12, 2026

Biochemical work up

Testosterone immunoassay performance v LC-MS/MS

Thread 'Initiative Calls for Updated Standards in Testing for Suspected Low Testosterone'

Apr 4, 2025

* Dr. Dunaif was a featured speaker at this CDC meeting. “We hope that the CDC initiative will finally lead to accurate testosterone measurements by clinical laboratories almost 20 years after the Endocrine Society position statement. It is exceptionally disappointing that major clinical laboratories have ignored the Endocrine Society and CDC recommendations. Health care provider education on the correct testosterone assay methodology will be critical for ensuring that clinical laboratories clearly indicate the correct assay methodology in their test ordering options,”...

Thread 'Serum Free Testosterone: Precision LC-MS/MS for PCOS Diagnosis'

Mar 9, 2025

* A standardized ED method is recommended to effectively separate FT from the serum matrix.

* With the rapid development of liquid chromatography-tandem mass spectrometry (LC-MS/MS), the ED separation combined with LC-MS/MS has become the “gold standard” for quantifying FT [4].

* Serum FT concentration can be as low as 1% of serum TT [15]. The lower limit of female serum TT reference interval could be as lowas 0.29 nmol/L [14]. Thus, to accommodate measuring female serum FT, the LLMI for an LCMS/MS method would ideally be lower than 3 pmol/L. Therefore...