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What does a high level of DHEAS with normal level of testosterone and prolactin indicate for women?
Feb 26, 2015

Dr. Zakia Dimassi Pediatrics

DHEAS, testosterone and Prolactin, usually in addition to LH
(lutenizing hormone
and Follicle Stimulating Hormone (FSH) (LH and FSH are the hormones that
encourage ovulation. Both LH and FSH are secreted by the pituitary gland in the
brain) are ordered to investigate women presenting with menstrual
irregularities +/- hirsutism (growth of hair in unexpected areas of the body in
a female). The 1st and most common disorder that is associated with
these symptoms is polycystic ovary syndrome (PCOS), a condition that causes irregular
menstrual periods because monthly ovulation is not occurring and levels of
androgens (male hormones) in women are elevated. The condition occurs in about
5 to 10% of women. The elevated androgen levels can may induce excessive facial
hair growth, acne, and/or male-pattern hair thinning. A good percentage of
women with PCOS are also overweight or obese, and they are at higher than
average risk of developing diabetes and obstructive sleep apnea.

LH and FSH:

While many women with PCOS
still have LH and FSH within the normal range, their LH level is often
twice to three times greater than their level of FSH. This situation is called
an elevated LH to FSH ratio. This change in the LH to FSH ratio can very well
perturb the ovulation process. While this test used to be heavily relied upon
to make the diagnosis of PCOS, it is now considered less useful for this
purpose, but is still helpful when looking at the overall picture.


All women have testosterone in their bodies. There are two methods to measure
testosterone levels:


Free Testosterone

Total testosterone refers to the
total amount of all testosterone in the body, including the free testosterone. 
Free testosterone refers to the amount of testosterone that is unbound to a
protein, and is actually active in your body.  Women with PCOS often, but
not always, have an increased level of both total testosterone and free
testosterone.  Furthermore, even a slight increase in testosterone in a
woman’s body can suppress normal menstruation and ovulation.


DHEA-S (dehydroepiandrosterone) is another androgen
(male hormone) that is also found in all women. DHEA-S is an androgen that is
secreted by the adrenal gland (the tiny gland that sits on the upper pole of
the kidney, and also secretes cortisol and adrenaline). The majority of women
with PCOS tend to have DHEA-S levels greater than 200 ug/dl.


Prolactin is a pituitary hormone (the pituitary gland, or الغدة النخامية,
is a small gland in the brain that produces hormones that stimulate the
function of other glands, like the thyroid gland and the ovaries). Prolactin that
stimulates and sustains milk production in nursing mothers. Prolactin levels are
usually normal in women with PCOS, but it is important to check the prolactin
levels and make sure they are not elevated in order to rule out other problems,
such as a pituitary tumor, that might be causing PCOS-related symptoms. 
Some women with PCOS do have elevated prolactin levels, typically between 25-40