Concentration range of serum sex steroids in normal postmenopausal women and those with diagnosis of vulvovaginal atrophy. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Ke, Yuyong; Bélanger, Alain; Simard, Jean-Nicolas; Gonthier, Renaud; Martel, Céline; Vaillancourt, Mario; Labrie, Fernand
• Is Part Of: Menopause. Volume 25:Issue 3(2018)
• Publication Date: 2018-03
• Subjects: Estradiol -- Intracrinology -- Mass spectrometry -- Postmenopause -- Testosterone -- Vulvovaginal atrophy; Menopause -- Periodicals; 618.175005
• DOI: 10.1097/GME.0000000000000993
• Languages: English
• ISSNs: 1072-3714

Abstract

Abstract: Objective: The aim of the study was to determine the range of serum sex-related steroids in normal postmenopausal women and in women of the same age with a diagnosis of vulvovaginal atrophy (VVA). Methods: Validated mass spectrometry-based assays coupled to gas or liquid chromatography were used over a 10-year period for steroid measurements. Serum samples were obtained in up to 1, 512 women aged 55 to 65 years. Results: Serum estrone sulfate (E1 S) and androsterone glucuronide (ADT-G), the main metabolites of estrogens and androgens, respectively, were 16.9% ( P = 0.005) and 16.1% ( P = 0.001) higher in women not diagnosed with moderate/severe VVA than those diagnosed with VVA. Serum estrone (E1 ) was 14.5% ( P < 0.0001) higher in women with no diagnosis of VVA, whereas the other steroids did not show meaningful differences. The limited biological significance of serum estradiol (E2 ) and testosterone is supported by the lack of statistical significance in the serum concentrations of these two steroids between the two groups. Most importantly, for the women without a diagnosis of VVA, the normal upper limit (95 th centile) of serum E2 was 9.15 pg/mL ( n = 364) and 10.7 pg/mL ( n = 67) for a weighted average of 9.99 pg E2 /mL. A limit of 10 pg E2 /mL has recently been found by two other laboratories. When comparing 50- to 59-year-old and 70- to 79-year-old women, serum E2, E1 S, ADT-G, and DHEA were, respectively, 24.4%, 22.6%, 27.0%, and 85.9% higher in the younger group. Conclusions: Somewhat higher values, namely, 16.9% and 16.1%, are observed in the serum concentrations of the estrogen (E1 S) and androgen (ADT-G) metabolites in normal compared with women with a diagnosis of VVA. Such data indicating a lower estrogenic and androgenic global exposure in women diagnosed with VVA offers an opportunity for the local intravaginal administration of DHEA to replace the deficiency in endogenous DHEA.