Androgen deficiency in women has been recognized as a distinct clinical syndrome that affects thousands of women particularly women in the postmenopausal period of their life. This syndrome has been described by several names including female
androgen deficiency syndrome as well as
hypoactive, sexual desire disorder. A recent large survey concerning sexual problems in women also adds personal distress as a potential contributor to the low sexual desire found in some women with sexual dysfunction. Recognition of an
androgen deficiency syndrome however, has been controversial and limited to a clinical diagnosis due to the lack of accurate and sensitive methods for measuring
androgens in women. Up until now, available methods for measuring the sex
steroids have been dependent on antibody based assays that employ a range of different detection systems including the use of
isotopes such as
tritium and I-125 or chemical signalling molecules that produce chemiluminescence. These assays have become increasingly more sensitive for the measurement of
testosterone but are still incapable of providing the proper low-end sensitivity for analyzing
testosterone in female blood specimens. Assays for
testosterone performed either manually or with highly automated immunoassay instruments have been used to measure
testosterone in women but with varying degrees of success. Existing immunoassay-based methods are quite adequate for measuring
testosterone levels in males but lack sufficient sensitivity to accurately and reproducibly measure
testosterone in females and pre-pubertal children. Recent advances with the use of ultrasensitive methods such as mass spectrometry coupled to either gas or liquid chromatography have improved the technology for measuring
testosterone and other low concentration sex
steroids like
estradiol to the degree that mass spectrometry based methods are now capable of measuring the
testosterone levels found in normal women and in women with extremely low levels of
testosterone as observed in a true
androgen deficiency disorder. This application of mass spectrometry for measuring
testosterone should allow clinicians to better define female
androgen deficiency and facilitate further investigation in the diagnosis and optimal management of
androgen deficiency in women.