Serum prostate-specific antigen concentrations are not useful for monitoring the treatment of hirsutism with oral contraceptive pills.

Prostate-specific antigen (PSA) is produced in several female tissues, under the regulation of steroid hormones. Serum PSA levels are increased in women with hirsutism, and they correlate with serum androgen levels. Therefore, as a marker of androgen excess, measurement of serum PSA may play a role in monitoring the treatment of hirsutism with contraceptive pills. Sixteen hirsute patients were included in the study. Clinical and biochemical variables, including serum PSA (using an ultrasensitive chemiluminescent immunoassay), total testosterone, sex hormone-binding globulin, androstenedione, dehydroepiandrosterone-sulfate, estradiol, and gonadotropin concentrations were recorded at baseline and after 3 and 6 cycles of treatment with a monophasic contraceptive pill containing ethynylestradiol and desogestrel. Twenty-seven healthy women served as controls for serum PSA level and for the serum androgen profile. Serum PSA levels were higher in hirsute patients, as compared with healthy women (mean +/- SEM: 0.014 +/- 0.003 vs. 0.006 +/- 0.001 microg/L, P < 0.02). Despite a marked decrease in serum androgens (total testosterone and androstenedione, calculated free testosterone and free androgen index; and dehydroepiandrosterone-sulfate) and in the hirsutism score, and a marked increase in sex hormone-binding globulin levels, serum PSA levels did not change and remained detectable in all the hirsute patients after 3 and 6 cycles of treatment with contraceptive pills. In conclusion, the increased serum PSA levels present in hirsute patients do not change during treatment with contraceptive pills and do not parallel the amelioration in hirsutism and the decrease in serum androgen concentrations that occur during this treatment. Thus, serum PSA measurements have no apparent role in the management of hirsute patients on oral contraceptive treatment, at least with the ultrasensitive assays currently available.

[1]  M. Muggeo,et al.  Antiandrogen drugs lower serum prostate-specific antigen (PSA) levels in hirsute subjects: evidence that serum PSA is a marker of androgen action in women. , 2000, The Journal of clinical endocrinology and metabolism.

[2]  A. Vermeulen,et al.  A critical evaluation of simple methods for the estimation of free testosterone in serum. , 1999, The Journal of clinical endocrinology and metabolism.

[3]  S. Weitsman,et al.  5α-Reductase Activity in Women with Polycystic Ovary Syndrome1 , 1999 .

[4]  H. Escobar-Morreale,et al.  The increased circulating prostate-specific antigen concentrations in women with hirsutism do not respond to acute changes in adrenal or ovarian function. , 1998, The Journal of clinical endocrinology and metabolism.

[5]  H. Escobar-Morreale,et al.  Circulating leptin concentrations in women with hirsutism. , 1997, Fertility and sterility.

[6]  E. Diamandis,et al.  Nonprostatic sources of prostate-specific antigen. , 1997, The Urologic clinics of North America.

[7]  L. Witherspoon,et al.  Sensitive prostate specific antigen measurements identify men with long disease-free intervals and differentiate aggressive from indolent cancer recurrences within 2 years after radical prostatectomy. , 1997, The Journal of urology.

[8]  H. Escobar-Morreale,et al.  Lack of an ovarian function influence on the increased adrenal androgen secretion present in women with functional ovarian hyperandrogenism. , 1997, Fertility and sterility.

[9]  E. Diamandis,et al.  Prostate-specific antigen in female serum, a potential new marker of androgen excess. , 1997, The Journal of clinical endocrinology and metabolism.

[10]  E. Diamandis.  Prostate specific antigen--new applications in breast and other cancers. , 1996, Anticancer research.

[11]  E. Diamandis,et al.  Ultrasensitive detection of prostate-specific antigen by a time-resolved immunofluorometric assay and the Immulite immunochemiluminescent third-generation assay: potential applications in prostate and breast cancers. , 1996, Clinical chemistry.

[12]  E. Diamandis,et al.  Oral Contraceptive-induced Expression of Prostate-specific Antigen in the Female Breast (*) , 1995, The Journal of Biological Chemistry.

[13]  E. Diamandis,et al.  Original Articles: Prostate Cancer: Measurement of Serum Prostate Specific Antigen Levels in Women and in Prostatectomized Men With an Ultrasensitive Immunoassay Technique , 1995 .

[14]  P. Darney.  The androgenicity of progestins. , 1995, The American journal of medicine.

[15]  R. Azziz,et al.  Clinical review 56: Nonclassic adrenal hyperplasia: current concepts. , 1994, The Journal of clinical endocrinology and metabolism.

[16]  G. Okoev,et al.  [Diagnostic criteria for polycystic ovary syndrome]. , 1989, Akusherstvo i ginekologiia.

[17]  P. Mauvais-Jarvis,et al.  7 Regulation of androgen receptor and 5α-reductase in the skin of normal and hirsute women , 1986 .

[18]  P. Mauvais-Jarvis,et al.  Regulation of androgen receptor and 5 alpha-reductase in the skin of normal and hirsute women. , 1986, Clinics in endocrinology and metabolism.

[19]  M. Kim,et al.  Hirsutism: implications, etiology, and management. , 1981, American journal of obstetrics and gynecology.