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

J Sex Med. 2008 Apr;5(4):854-863. doi: 10.1111/j.1743-6109.2008.00791.x.


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, Delta(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 Delta(4)-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.

MeSH terms

  • Adult
  • Androgens / blood*
  • Androstenedione / blood
  • Dehydroepiandrosterone / blood
  • Female
  • Humans
  • Italy
  • Libido / physiology*
  • Menstrual Cycle / metabolism*
  • Reference Values
  • Sex Hormone-Binding Globulin / analysis
  • Surveys and Questionnaires
  • Testosterone / blood
  • Testosterone Congeners / blood*
  • Women's Health


  • Androgens
  • Sex Hormone-Binding Globulin
  • Testosterone Congeners
  • Testosterone
  • Androstenedione
  • Dehydroepiandrosterone