Test Name

Androstenedione (A4)

Sample Type

Blood (Serum or Plasma)

Fasting Required?

✅ Usually recommended (8–10 hours fasting)

Normal Range

Varies by age, sex, and lab, e.g.:

• Women: 0.7 – 3.1 ng/mL (or 2.4 – 10.8 nmol/L)

• Men: 0.8 – 3.6 ng/mL (or 2.8 – 12.5 nmol/L)

• Children: Age-specific reference ranges

Adrenal glands

Major source of A4, especially in children and women

Ovaries

Produce A4 as part of estrogen synthesis

Testes

Minor source of A4 in males

Pituitary gland

Regulates A4 via ACTH, LH, FSH

Hirsutism / Excess hair in women

Evaluate causes of excess androgens

Polycystic Ovary Syndrome (PCOS)

Diagnose or monitor androgen excess

Amenorrhea (absent menstruation)

Hormonal imbalance assessment

Early puberty in children

Assess adrenal and gonadal hormone production

Adrenal tumors or hyperplasia

Differentiate source of excess steroids

Congenital Adrenal Hyperplasia (CAH)

Screening or monitoring (especially 21-hydroxylase deficiency)

High A4

- PCOS
- CAH
- Adrenal or ovarian tumors
- Cushing’s syndrome

Low A4

- Adrenal insufficiency
- Hypopituitarism
- Gonadal failure

Total & Free Testosterone

Assess androgen excess

DHEAS

Determine adrenal contribution

17-Hydroxyprogesterone

Essential in CAH evaluation

LH, FSH

Evaluate pituitary-gonadal axis

Estradiol / Estrone

Balance with estrogenic pathway

Cortisol / ACTH

Assess adrenal function

Pelvic/Abdominal Ultrasound

Check for ovarian or adrenal masses

Main Uses

Evaluate excess androgens in females/children

Organs Involved

Adrenal glands, ovaries, testes

Conditions Diagnosed

PCOS, CAH, adrenal tumors, early puberty

Common Conjunction Tests

Testosterone, DHEAS, 17-OHP, LH/FSH, Estradiol

Interpretation

High = Androgen excess; Low = Adrenal or gonadal insufficiency