Menstrual cycle-related changes in circulating androgens in healthy women with self-reported normal sexual function

Andrea Salonia, Marina Pontillo, Rossella E. Nappi, Giuseppe Zanni, Fabio Fabbri, Marina Scavini, Rita Daverio, Andrea Gallina, Patrizio Rigatti, Emanuele Bosi, Pier Angelo Bonini, Francesco Montorsi

Research output: Contribution to journalArticlepeer-review


Introduction. There is currently neither a clinically useful, reliable and inexpensive assay to measure circulating levels of free testosterone (T) in the range observed in women, nor is there agreement on the serum free T threshold defining hypoandrogenism that is associated with female-impaired sexual function. Aim. Following the Clinical and Laboratory Standards Institute guidelines, we generated clinically applicable ranges for circulating androgens during specific phases of the menstrual cycle in a convenience sample of 120 reproductive-aged, regularly cycling healthy European Caucasian women with self-reported normal sexual function. Methods. All participants were asked to complete a semistructured interview and fill out a set of validated questionnaires, including the Female Sexual Function Index, the Female Sexual Distress Scale, and the 21-item Beck's Inventory for Depression. Between 8 am and 10 am, a venous blood sample was drawn from each participant during the midfollicular (day 5 to 8), the ovulatory (day 13 to 15), and the midluteal phase (day 19 to 22) of the same menstrual cycle. Main Outcome Measures. Serum levels of total and free testosterone, Δ 4 -androstenedione, dehydroepiandrosterone sulphate and sex hormone-binding globulin during the midfollicular, ovulatory and midluteal phase of the same menstrual cycle. Results. Total and free T levels showed significant fluctuations, peaking during the ovulatory phase. No significant variation during the menstrual cycle were observed for Δ4-androstenedione and dehydroepiandrosterone sulphate. Despite the careful selection of participants that yielded an homogeneous group of women without sexual disorders, we observed a wide range of distribution for each of the circulating androgens measured in this study. Conclusions. This report provides clinically applicable ranges for androgens throughout the menstrual cycle in reproductive-aged, regularly cycling, young healthy Caucasian European women with self-reported normal sexual function.

Original languageEnglish
Pages (from-to)854-863
Number of pages10
JournalJournal of Sexual Medicine
Issue number4
Publication statusPublished - Apr 2008


  • Androgens
  • Female Women
  • Sexual Dysfunction
  • Sexual Function
  • Testosterone

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology


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