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Androstenedione Blood Test

Last updated Sept. 4, 2018

Approved by: Krish Tangella MD, MBA, FCAP

The Androstenedione Blood Test helps determine the level of androstenedione in blood. It is used to identify problems with the production of testosterone and the estrogens.

What are other Names for this Test? (Equivalent Terms)

  • ∆4-dione Blood Test
  • 17-Ketotestosterone Blood Test
  • Androst-4-ene-3, 17-dione Blood Test

What is the Androstenedione Blood Test? (Background Information)

  • Androstenedione is a compound formed in the production of testosterone and estrogen. It is made in the adrenal glands and gonads (testes in males and ovaries in females). It is an active hormone with effects similar to those of testosterone
  • Testosterone is the major male sex hormone, or androgen. It causes development of the male sex organs and the maturation of sperm. It also causes development of secondary sex characteristics such as hair and voice deepening
  • Men produce testosterone in large amounts during puberty. Leydig cells, or interstitial cells, in the testes are responsible for the majority of testosterone production. Some testosterone is also produced by the adrenal glands, situated atop the kidneys, in both men and women
  • Women produce testosterone in small quantities. Aside from the adrenal glands, the ovaries produce minor amounts of testosterone in women. Testosterone is mainly used to make estradiol, the main female sex hormone
  • Secretion of testosterone is tightly controlled. Luteinizing hormone (LH) released by the pituitary gland stimulates testosterone production by Leydig cells, and increased testosterone inhibits LH release. This negative feedback mechanism ensures balanced testosterone levels
  • Most testosterone molecules circulate in a bound form. Sex-hormone-binding globulin (SHBG) and albumin bind testosterone. A small amount (1-4%) circulates unbound
  • Meanwhile, androstenedione is also formed in the production of 2 of the 3 estrogens - estrol (E1), estradiol (E2), and estriol (E3) being the 3rd. E1 is produced in the adrenal gland and E2 is made in the ovaries
  • Estrogens are the female sex hormones. They cause the development of female sex organs and secondary sex characteristics
  • The Androstenedione Blood Test helps determine the level of androstenedione in blood. It is used to identify problems with the production of testosterone and the estrogens

What are the Clinical Indications for performing the Androstenedione Blood Test?

Following are the clinical indications for performing the Androstenedione Blood Test:

  • Following up to a sex hormone test such as a testosterone blood test
  • Early or late onset of puberty
  • Masculinization in females, such as excessive hair growth and voice deepening
  • Infertility
  • Decreased sex drive
  • Erectile dysfunction
  • Diminished menstrual cycle
  • Abnormal uterine bleeding

How is the Specimen Collected for the Androstenedione Blood Test?

Following is the specimen collection process for Androstenedione Blood Test:

Sample required: Blood

Process of obtaining blood sample in adults:

  • A band is wrapped around the arm, 3-4 inches above the collection site (superficial vein that lies within the elbow pit)
  • The site is cleaned with 70% alcohol in an outward spiral, away from the zone of needle insertion
  • The needle cap is removed and is held in line with the vein, pulling the skin tight
  • With a small and quick thrust, the vein is penetrated using the needle
  • The required amount of blood sample is collected by pulling the plunger of the syringe out slowly
  • The wrap band is removed, gauze is placed on the collection site, and the needle is removed
  • The blood is immediately transferred into the blood container, which has the appropriate preservative/clot activator/anti-coagulant
  • The syringe and the needle are disposed into the appropriate “sharp container” for safe and hygienic disposal

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the Androstenedione Blood Test Result?

The significance of the Androstenedione Blood Test result is explained:

  • A high test value may indicate:
    • Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency
    • Adrenal tumor
    • Polycystic ovarian disease
    • Cushing disease 
  • A low test value may indicate Addison disease

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Certain factors interfere with the results of the Androstenedione Blood Test. These include strenuous exercise, age, nutrition status, and alcohol consumption

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 31, 2015
Last updated: Sept. 4, 2018