Hormone Profile – Saliva
Testosterone is the primary androgen produced in the Leydig cells of the testes in males by the action of Luteinising hormone from the anterior pituitary gland(4) and in the ovaries and adrenal glands of females(1). The major pathway leading to the production of testosterone is through Pregnenolone → 17-α-hydroxypregnenolone → DHEA → Androstenedione → Testosterone. (4.)
Investigating the levels of testosterone in concurrence with follicle stimulating hormone (FSH) and Luteinising hormone (LH) can assist in the evaluation of reproductive dysfunction in both males and females(1). In females, peak levels are noticed mid cycle and the test can be used to evaluate ovarian tumors, hirsutism and infertility(1,3,4). In males, testosterone is responsible for the development and growth of axillary, facial and pubic hair and promotes the production of sperm(1,3,4) and can be used to evaluate impotency and infertility(1). Concurrent low levels of testosterone, Luteinising hormone and follicle stimulating hormone are diagnostic for secondary hypogonadism and require further follow up(3). Approximately 60% of circulating testosterone binds to the Sex Hormone Binding Globulin (SHBG) and the remaining testosterone is loosely bound to albumin(3).
Increased Levels (Male) – Idiopathic sexual precocity, Pinealoma, Encephalitis, Congenital adrenal hyperplasia, Adrenocortical tumour, Testicular or extragonadal tumor, Hyperthyroidism, Testosterone resistance syndromes(1,3).
Decreased Levels (Male) – Klinefelter’s syndrome, Cryptorchidism, Primary and secondary hypogonadism, Trisomy 21, Orchiectomy, Hepatic cirrhosis (1,3).
Increased Levels (Female) – Ovarian tumour, Adrenal tumour, Congenital adrenocortical hyperplasia, Trophoblastic tumour, Polycystic ovarian syndrome (1,3).
Medications that increase levels (Female) – Anticonvulsants, Bromocriptine, Clomipramine, Danazol, Minoxidil, Oestrogen, Pravastatin, Rifampin, Tamoxifen (1,3).
Medications that increase levels (Male) – Bicalutamide, Cimetidine, Finasteride, Lupron, Nilutamide, Phenytoin, Pravastatin, Rifampin, Tamoxifen, Valproic acid (1,3).
Medications that decrease levels – Alcohol, Androgens, Carbamazepine, Cimetidine, Corticosteroids, Cyclophosphamide, Dexamethasone, Diethylstilbestrol, Digoxin, Finasteride, Gemfibrozil, Goserelin, Ketoconazole, Leuprolide, Narcotics, Oestrogen, Phenothiazine, Pravastatin, Spironolactone, Steroids, Tetracycline, Verapamil(1,3).
Oestrogens are primarily produced in the ovary, with smaller amounts in the testes and adrenal cortex and during pregnancy the placenta takes over Oestrogen synthesis(8).
Estradiol is the most active form of oestrogen (3) and is responsible for endometrial growth and the regulation of FSH and LH levels (3). Estradiol is used in the evaluation of ovarian function.
The determination of estradiol is used clinically to evaluate fertility and hormone disorders, it also plays a major role in In vitro Fertilisation (IVF) (8).
Increased values – Feminisation syndromes, Precocious puberty, Ovarian Tumours, Testicular tumours, Adrenal tumours, Pregnancy, Hepatic Cirrhosis, Liver necrosis, Hyperthyroidism, Renal failure (1,3).
Decreased values – Failing pregnancy, Turner Syndrome, Hypopituitarism, Primary and secondary hypogonadism, Stein-Leventhal syndrome, Menopause, Anorexia, Amenorrhea, Ovarian failure, Extreme exercise (1,3).
Medications that increase values – Ampicillin, Cascara, Diethylstilbestrol, Oestrogens, Hydrochlorothiazide, Meprobamate, Oral contraceptives, Phenazopyridine, Prochlorperazine, Tetracycline (1).
Medications that decrease values – Clomiphene, Dexamethasone, Oestrogen blockers (1).
Progesterone is a steroid sex hormone that is secreted by the corpus luteum (female), the placenta (female) and the adrenal cortex (male) (1,9).
The progesterone concentration is linked with the development and deterioration of the corpus luteum (9). A rise in progesterone levels are notable the day prior to ovulation and around the luteal phase (9).
Increased levels – Adrenal hyperplasia, Adrenal neoplasms, Chorionepithelioma of ovary, Corpus luteum cyst, Molar pregnancy, Ovarian neoplasms, Precocious puberty, Pregnancy, Retained placental tissue (1).
Decreased levels – Adrenogenital syndrome, Amenorrhea, Anovular menstruation, Fetal death, Menopause, Menstrual disorders, Ovarian failure, Placental insufficiency, Preeclampsia, Stein-Leventhal syndrome, Threatened abortion, Toxemia of pregnancy, Turner’s Syndrome (1).
Medications that increase levels – Adrenocorticol hormones, Clomiphene, Ketoconazole, Oestrogens, Progesterones, Tamoxifen (1).
Medications that decrease levels – Ampicillin, Anticonvulsants, Danazol, Goserelin, Leuprolide, Oral contraceptives(1).