Elevated free testosterone in an obese, hirsute premenarchial girl: effects of norethynodrel and mestranol

Pediatrics. 1979 Nov;64(5):609-12.


An 11-year-old premenarchial girl who demonstrated the clinical and biochemical abnormalities of the Stein-Leventhal syndrome is reported. Although the concentration of total circulating testosterone was within normal limits, levels of free testosterone and testosterone-estradiol-binding globulin (12.9 to 22.7 pg/ml and 7.9 to 11 X 10(-9) moles/liter, respectively) were markedly different from those of prepubertal girls (1.1 +/- 0.9 pg/ml and 102 +/- 27 X 10%-9) moles/liter, mean +/- 1 SD) and normal women (4.3 +/- 1.2 pg/ml and 82 +/- 30 X 10(-9) moles/liter). Luteinizing hormone but not follicle-stimulating hormone concentrations were increased. In the absence of abnormal adrenal steroid excretion or response to dexamethasone suppression and with a clear biochemical response to oral contraceptives (decreased levels of luteinizing hormone and free testosterone and increased concentrations of testosterone-estradiol-binding globulin), this patient closely resembles older individuals with the Stein-Leventhal syndrome. Therefore, the measurement of testosterone-estradiol-binding globulin and free testosterone may be useful in the laboratory evaluation of any adolescent girl in whom no other cause for hirsutism can be identified.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Dexamethasone
  • Female
  • Follicle Stimulating Hormone / blood
  • Hirsutism / blood*
  • Hirsutism / etiology
  • Humans
  • Luteinizing Hormone / blood
  • Mestranol / therapeutic use
  • Norethynodrel / therapeutic use
  • Obesity / blood*
  • Polycystic Ovary Syndrome / blood
  • Sex Hormone-Binding Globulin / analysis
  • Testosterone / blood*


  • Sex Hormone-Binding Globulin
  • Testosterone
  • Dexamethasone
  • Norethynodrel
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Mestranol