Chronic high-dosage androgen administration to ovulatory women does not alter adrenocortical steroidogenesis

OBJECTIVE: To evaluate the role of chronic long-term exogenous androgen administration to normal ovulatory women on adrenal steroidogenesis. DESIGN: Prospective study of four consecutive female-to-male transsexuals before and during chronic testosterone (T) therapy. SETTING: Clinical Research Center of the Mount Sinai Medical Center. PATIENTS: Four female-to-male transsexuals were studied before and during 6 to 12 months of chronic T enanthate therapy for desired virilization. All four subjects were ovulatory before treatment. Adrenocorticotropic hormone (ACTH) testing was performed before, and 6 and 12 months of androgen therapy and various adrenal androgens as well as precursor:product pairs were evaluated as an index of specific adrenocortical biosynthetic defects. RESULTS: Baseline and 1 hour after 0.25 mg ACTH intravenously, adrenal androgen levels as well as adrenal precursor/product pairs demonstrated no difference before and during chronic T treatment. Studies included determinations of plasma 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone, androstenedione, 11-deoxycortisol, and cortisol. CONCLUSION: It is concluded that chronic hypertestosteronemia does not alter adrenal steroidogenesis.