Salivary and plasma bound and “free” testosterone in men and women

Salivary Testosterone Levels and Pain Perception Exhibit Sex-Specific Association in Healthy Adults But Not in Patients With Migraine

This study investigated the sex-specific associations between pain perception and testosterone levels in healthy controls (HCs) and patients with migraine. Male and female HCs and migraine patients were recruited. A series of questionnaires were completed by the participants to evaluate their psychosocial profiles, which included data on mood, stress, and sleep quality. Heat pain thresholds and suprathreshold pain ratings at 45 °C (referred to as the pain perception score [PPS]) were assessed using the Thermode system. Salivary testosterone levels were analyzed using a commercial enzyme-linked immunosorbent assay kit. A total of 88 HCs (men/women: 41/47, age: 29.9 ± 7.7 years) and 75 migraine patients (men/women: 30/45, age: 31.1 ± 7.7 years) completed all assessments. No significant differences were observed in either the psychosocial profiles or heat pain thresholds and PPSs between the sexes in the control and migraine groups. A positive correlation between testosterone levels and PPSs was identified in the male controls (r = .341, P = .029), whereas a negative correlation was identified in the female controls (r = -.407, P = .005). No such correlations were identified in the migraine group. This study confirms that a negative association is present between PPSs and testosterone levels in female controls, which is in line with the findings that testosterone is associated with reduced pain perception. Our study is the first to demonstrate a sex-specific association between PPSs and testosterone levels in HCs. Moreover, this study also revealed that the presence of migraine appears to disrupt this association. PERSPECTIVE: This study revealed that testosterone levels demonstrate opposite associations with pain perception in healthy men and women. However, the presence of migraine appears to disrupt this sex-specific association.

Physiological biomarker monitoring during arduous military training: Maintaining readiness and performance

OBJECTIVES

Physiological and psychological stressors can degrade soldiers' readiness and performance during military training and operational environments. Integrative and holistic assessments of biomarkers across diverse human performance optimization domains during multistressor training can be leveraged to provide actionable insight to military leadership regarding service member health and readiness.

DESIGN/METHOD

A broad categorization of biomarkers, to include biochemical measures, bone and body composition, psychometric assessments, movement screening, and physiological load can be incorporated into robust analytical pipelines for understanding the complex factors that impact military human performance.

RESULTS

In this perspective commentary we overview the rationale, selection, and methodologies for monitoring biomarker domains that are relevant to military research and specifically highlight methods that have been incorporated in a research program funded by the Office of Naval Research, Code 34 Biological and Physiological Monitoring and Modeling of Warfighter Performance.

CONCLUSIONS

The integration of screening and continuous monitoring methodologies via robust analytical approaches will provide novel insight for military leaders regarding health, performance, and readiness outcomes during multistressor military training.

Mutual Shaping of Circadian Body-Wide Synchronization by the Suprachiasmatic Nucleus and Circulating Steroids

Background

Steroids are lipid hormones that reach bodily tissues through the systemic circulation, and play a major role in reproduction, metabolism, and homeostasis. All of these functions and steroids themselves are under the regulation of the circadian timing system (CTS) and its cellular/molecular underpinnings. In health, cells throughout the body coordinate their daily activities to optimize responses to signals from the CTS and steroids. Misalignment of responses to these signals produces dysfunction and underlies many pathologies.

Questions Addressed

To explore relationships between the CTS and circulating steroids, we examine the brain clock located in the suprachiasmatic nucleus (SCN), the daily fluctuations in plasma steroids, the mechanisms producing regularly recurring fluctuations, and the actions of steroids on their receptors within the SCN. The goal is to understand the relationship between temporal control of steroid secretion and how rhythmic changes in steroids impact the SCN, which in turn modulate behavior and physiology.

Evidence Surveyed

The CTS is a multi-level organization producing recurrent feedback loops that operate on several time scales. We review the evidence showing that the CTS modulates the timing of secretions from the level of the hypothalamus to the steroidogenic gonadal and adrenal glands, and at specific sites within steroidogenic pathways. The SCN determines the timing of steroid hormones that then act on their cognate receptors within the brain clock. In addition, some compartments of the body-wide CTS are impacted by signals derived from food, stress, exercise etc. These in turn act on steroidogenesis to either align or misalign CTS oscillators. Finally this review provides a comprehensive exploration of the broad contribution of steroid receptors in the SCN and how these receptors in turn impact peripheral responses.

Conclusion

The hypothesis emerging from the recognition of steroid receptors in the SCN is that mutual shaping of responses occurs between the brain clock and fluctuating plasma steroid levels.

Developmental variation in testosterone:cortisol ratio alters cortical- and amygdala-based cognitive processes

Testosterone (T) and cortisol (C) are the end products of neuroendocrine axes that interact with the process of shaping brain structure and function. Relative levels of T:C (TC ratio) may alter prefrontal-amygdala functional connectivity in adulthood. What remains unclear is whether TC-related effects are rooted to childhood and adolescence. We used a healthy cohort of 4-22-year-olds to test for associations between TC ratios, brain structure (amygdala volume, cortical thickness (CTh), and their coordinated growth), as well as cognitive and behavioral development. We found greater TC ratios to be associated with the growth of specific brain structures: 1) parietal CTh; 2) covariance of the amygdala with CTh in visual and somatosensory areas. These brain parameters were in turn associated with lower verbal/executive function and higher spatial working memory. In sum, individual TC profiles may confer a particular brain phenotype and set of cognitive strengths and vulnerabilities, prior to adulthood.

Role of testosterone: cortisol ratio in age- and sex-specific cortico-hippocampal development and cognitive performance

Testosterone (T) and cortisol (C) are steroid hormones that have been argued to play opposing roles in shaping physical and behavioral development in humans. While there is evidence linking T and C to different memory processes during adulthood, it remains unclear how the relative levels of T and C (TC ratio) may influence brain and behavioral development, whether they are influenced by sex of the child, and whether or not they occur as a result of stable changes in brain structure (organizational changes), as opposed to transient changes in brain function (activational changes). As such, we tested for associations among TC ratio, cortico-hippocampal structure, and standardized tests of executive, verbal, and visuo-spatial function in a longitudinal sample of typically developing 4-22-year-old children and adolescents. We found greater TC ratios to be associated with greater coordinated growth (i.e. covariance) between the hippocampus and cortical thickness in several areas primarily devoted to visual function. In addition, there was an age-related association between TC ratio and parieto-hippocampal covariance, as well as a sex-specific association between TC ratio and prefrontal-hippocampal covariance. Differences in brain structure related to TC ratio were in turn associated with lower verbal/executive function, as well as greater attention in tests of visuo-spatial abilities. These results support the notion that TC ratio may shift the balance between top-down (cortex to hippocampus) and bottom-up (hippocampus to cortex) processes, impairing more complex, cortical-based tasks and optimizing visuospatial tasks relying primarily on the hippocampus.

Exercise-Induced Salivary Hormone Responses to High-Intensity, Self-Paced Running

PURPOSE

Physical overexertion can lead to detrimental overreaching states without sufficient recovery, which may be identifiable by blunted exercise-induced cortisol and testosterone responses. A running test (RPETP) elicits reproducible plasma cortisol and testosterone elevations (in a healthy state) and may detect blunted hormonal responses in overreached athletes. This current study determined the salivary cortisol and testosterone responses reproducibility to the RPETP, to provide greater practical validity using saliva compared with the previously utilized blood sampling. Second, the relationship between the salivary and plasma responses was assessed.

METHODS

A total of 23 active, healthy males completed the RPETP on 3 occasions. Saliva (N = 23) and plasma (N = 13) were collected preexercise, postexercise, and 30 minutes postexercise.

RESULTS

Salivary cortisol did not elevate in any RPETP trial, and reduced concentrations occurred 30 minutes postexercise (P = .029, η2 = .287); trial differences were observed (P < .001, η2 = .463). The RPETP elevated (P < .001, η2 = .593) salivary testosterone with no effect of trial (P = .789, η2 = .022). Intraindividual variability was 25% in cortisol and 17% in testosterone. "Fair" intraclass coefficients of .46 (cortisol) and .40 (testosterone) were found. Salivary and plasma cortisol positively correlated (R = .581, P = .037) yet did not for testosterone (R = .345, P = .248).

CONCLUSIONS

The reproducibility of salivary testosterone response to the RPETP is evident and supports its use as a potential tool, subject to further confirmatory work, to detect hormonal dysfunction during overreaching. Salivary cortisol responds inconsistently in a somewhat individualized manner to the RPETP.

Adult attachment and testosterone reactivity: Fathers' avoidance predicts changes in testosterone during the strange situation procedure

We assessed parents' testosterone reactivity to the Strange Situation Procedure (SSP), a moderately stressful parent-infant interaction task that pulls for parental nurturance and caregiving behavior. Parents (146 mothers, 154 fathers) interacted with their 1-year-old infants, and saliva samples were obtained pre- and post-task to assess changes in testosterone. We examined whether testosterone reactivity differed between mothers and fathers, the extent to which parents' characteristic approaches to closeness (i.e., adult attachment orientation) contributed to testosterone changes, and whether any influences of adult attachment orientation were independent of more general personality characteristics (i.e., the Big Five personality dimensions). Results revealed that mothers and fathers showed comparable declines in testosterone during the SSP, and that these declines were attenuated among fathers with a more avoidant attachment orientation (i.e., those less comfortable with closeness). Associations between fathers' avoidance and testosterone reactivity were statistically independent of broader personality traits. Our findings provide some of the first evidence for short-term changes in both mothers' and fathers' testosterone in contexts that pull for nurturance. Moreover, these findings demonstrate that individual differences in adult attachment may play an important role in understanding such changes. We discuss possible explanations for gender differences in associations between adult attachment and parents' testosterone reactivity, and the extent to which testosterone reactivity might be sensitive to changes in context for mothers versus fathers.

Rapid liquid chromatography tandem mass spectrometry method for targeted quantitation of human performance metabolites in saliva

Saliva is increasingly being targeted for metabolic studies due to its non-invasive collection methods. Tracing levels of certain metabolites within biofluids can provide indications for a myriad of physiological conditions. This study was performed on a panel of eight analytes found in saliva that have shown associations with physiological conditions of human performance, such as stress, inflammation, and circadian rhythm. This dual polarity liquid chromatography tandem mass spectrometric (LCMS/MS) method was developed to accommodate a diverse group of analytes including steroids, alkaloids, and neurotransmitters. Samples collected during field exercises from soldiers were compared to those of civilians and baseline levels of each of these compounds was determined in saliva. Although most analytes showed no significant differences between the two populations, relative cortisol levels were higher for soldiers than for civilians. This developed dual polarity LCMS/MS method can be applied to very diverse groups of salivary analytes simultaneously.

Putting the flight in "fight-or-flight": Testosterone reactivity to skydiving is modulated by autonomic activation

Sensation-seeking (SS) involves the tendency to pursue exciting activities, potentially including risky behaviors (e.g., substance use, risky sexual behavior). Testosterone is associated with cortisol, SS, and autonomic nervous system (ANS) functioning. Testosterone reactivity/recovery during sky-diving and its relationship to cortisol response, ANS response and SS were examined. Forty-four participants provided reactive saliva samples and autonomic activity data before, during and after sky-diving and as well as basal day saliva samples. Testosterone reactivity/recovery to skydiving was significantly greater than basal day measurements. Testosterone responsivity to skydiving was predicted by increased cortisol, increased sympathetic activity (heart rate) and reduced parasympathetic activity (RMSSD). Independent of physiological effects, increased SS predicted testosterone responsivity to skydiving. These data suggest that testosterone reactivity, and its relationship to ANS responsivity, may be associated with pleasurable responses to risky/intense situations. These data may be useful in developing novel intervention strategies for risky behaviors.

Testosterone-cortisol dissociation in children exposed to prenatal maternal stress, and relationship with aggression: Project Ice Storm

Prenatal maternal stress (PNMS) has been associated with postnatal behavioral alterations that may be partly explained by interactions between the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. Yet it remains unclear whether PNMS leads to enduring HPA-HPG alterations in the offspring, and whether HPA-HPG interactions can impact behavior during development, in particular levels of aggression in childhood. Here we investigated the relationship between a marker for HPG axis function (baseline testosterone) and a marker for HPA axis response (cortisol area under the curve) in 11½-year-olds whose mothers were exposed to the 1998 Quebec ice storm during pregnancy (n = 59 children; 31 boys, 28 girls). We examined (a) whether the degree of objective or subjective PNMS regulates the testosterone-cortisol relationship at age 11½, and (b) whether this testosterone-cortisol relationship is associated with differences in aggressive behavior. We found that, at lower levels of subjective PNMS, baseline testosterone and cortisol reactivity were positively correlated; in contrast, there was no relationship between these hormones at higher levels of subjective PNMS. Cortisol response moderated the relationship between testosterone and aggression. These results support the notion PNMS may explain variance in fetal HPA-HPG interactions, and that these interactions may be associated with aggressive behavior in late childhood.

Do Sex Offenders Have Higher Levels of Testosterone? Results From a Meta-Analysis

The purpose of the current study is to review the available scientific evidence on the relationship between testosterone and sexual aggression. A systematic search for all primary studies comparing basal testosterone levels in sex offenders and non-sex offenders was undertaken across 20 electronic databases using an explicit search strategy and inclusion/exclusion criteria. A total of seven studies were identified and 11 effect sizes were computed; effects were pooled using both fixed and random effects meta-analysis models. Although individual study findings present a mix of results wherein sex offenders have higher or lower baseline levels of testosterone than non-sex offenders, pooled results indicate no overall difference between groups. Moderators of the analyses suggest possibly lower rates of testosterone in child molesters than controls; however, results are dependent on study weighting. Limitations, policy implications with respect to chemical castration laws, and future directions for research are discussed.

Chemical analysis in saliva and the search for salivary biomarkers – a tutorial review

A review of the uses of saliva biomarkers, detection methods and requirements for new biomarkers.

Imaging immunoassay in negative: surface-catalysed chemiluminescence for the detection of pregnancy hormones in artificial saliva

Before and after exposure to progesterone or œstriol – visualising the extent of antibody/antigen complexation.

Dehydroepiandrosterone impacts working memory by shaping cortico-hippocampal structural covariance during development

Existing studies suggest that dehydroepiandrosterone (DHEA) may be important for human brain development and cognition. For example, molecular studies have hinted at the critical role of DHEA in enhancing brain plasticity. Studies of human brain development also support the notion that DHEA is involved in preserving cortical plasticity. Further, some, though not all, studies show that DHEA administration may lead to improvements in working memory in adults. Yet these findings remain limited by an incomplete understanding of the specific neuroanatomical mechanisms through which DHEA may impact the CNS during development. Here we examined associations between DHEA, cortico-hippocampal structural covariance, and working memory (216 participants [female=123], age range 6-22 years old, mean age: 13.6 +/-3.6 years, each followed for a maximum of 3 visits over the course of 4 years). In addition to administering performance-based, spatial working memory tests to these children, we also collected ecological, parent ratings of working memory in everyday situations. We found that increasingly higher DHEA levels were associated with a shift toward positive insular-hippocampal and occipito-hippocampal structural covariance. In turn, DHEA-related insular-hippocampal covariance was associated with lower spatial working memory but higher overall working memory as measured by the ecological parent ratings. Taken together with previous research, these results support the hypothesis that DHEA may optimize cortical functions related to general attentional and working memory processes, but impair the development of bottom-up, hippocampal-to-cortical connections, resulting in impaired encoding of spatial cues.

Sex-specific associations of testosterone with prefrontal-hippocampal development and executive function

Testosterone is thought to play a crucial role in mediating sexual differentiation of brain structures. Examinations of the cognitive effects of testosterone have also shown beneficial and potentially sex-specific effects on executive function and mnemonic processes. Yet these findings remain limited by an incomplete understanding of the critical timing and brain regions most affected by testosterone, the lack of documented links between testosterone-related structural brain changes and cognition, and the difficulty in distinguishing the effects of testosterone from those of related sex steroids such as of estradiol and dehydroepiandrosterone (DHEA). Here we examined associations between testosterone, cortico-hippocampal structural covariance, executive function (Behavior Rating Inventory of Executive Function) and verbal memory (California Verbal Learning Test-Children's Version), in a longitudinal sample of typically developing children and adolescents 6-22 yo, controlling for the effects of estradiol, DHEA, pubertal stage, collection time, age, handedness, and total brain volume. We found prefrontal-hippocampal covariance to vary as a function of testosterone levels, but only in boys. Boys also showed a specific association between positive prefrontal-hippocampal covariance (as seen at higher testosterone levels) and lower performance on specific components of executive function (monitoring the action process and flexibly shifting between actions). We also found the association between testosterone and a specific aspect of executive function (monitoring) to be significantly mediated by prefrontal-hippocampal structural covariance. There were no significant associations between testosterone-related cortico-hippocampal covariance and verbal memory. Taken together, these findings highlight the developmental importance of testosterone in supporting sexual differentiation of the brain and sex-specific executive function.

The developmental relationship between DHEA and visual attention is mediated by structural plasticity of cortico-amygdalar networks

Humans and the great apes are the only species demonstrated to exhibit adrenarche, a key developmental event leading to increased production of dehydroepiandrosterone (DHEA), suggesting that this hormone may play an important evolutionary role. Similarly, visual attention networks have been shown to evolve in a human-specific manner, with some anatomical connections and elements of cortical organization exclusive to our species. Existing studies of human brain development support the notion that DHEA shows significant uptake in cortical structures and the amygdala, and as such, could be involved in the bottom-up regulation of visual attention. Here we examined associations between DHEA, structural covariance of the amygdala with whole-brain cortical thickness, and tests of visual attention, in a longitudinal sample of typically developing children and adolescents 6-22 years of age. We found that DHEA predicted covariance between amygdalar volume and the left occipital pole, right somatosensory parietal cortex and right anterior cingulate cortex. Amygdala-occipital covariance predicted visual awareness; amygdala-parietal covariance predicted visuo-motor dexterity and processing speed; amygdala-prefrontal covariance predicted global attentional impairment. Further, effects of DHEA were above and beyond those of age and sex, as well as distinct from those of pubertal stage, estradiol and testosterone. These findings support the notion that DHEA may play a unique role in shaping amygdala-dependent cortical plasticity and in regulating 'bottom-up' visual attention processes from childhood to young adulthood.

A testosterone-related structural brain phenotype predicts aggressive behavior from childhood to adulthood

Structural covariance, the examination of anatomic correlations between brain regions, has emerged recently as a valid and useful measure of developmental brain changes. Yet the exact biological processes leading to changes in covariance, and the relation between such covariance and behavior, remain largely unexplored. The steroid hormone testosterone represents a compelling mechanism through which this structural covariance may be developmentally regulated in humans. Although steroid hormone receptors can be found throughout the central nervous system, the amygdala represents a key target for testosterone-specific effects, given its high density of androgen receptors. In addition, testosterone has been found to impact cortical thickness (CTh) across the whole brain, suggesting that it may also regulate the structural relationship, or covariance, between the amygdala and CTh. Here, we examined testosterone-related covariance between amygdala volumes and whole-brain CTh, as well as its relationship to aggression levels, in a longitudinal sample of children, adolescents, and young adults 6-22 years old. We found: (1) testosterone-specific modulation of the covariance between the amygdala and medial prefrontal cortex (mPFC); (2) a significant relationship between amygdala-mPFC covariance and levels of aggression; and (3) mediation effects of amygdala-mPFC covariance on the relationship between testosterone and aggression. These effects were independent of sex, age, pubertal stage, estradiol levels and anxious-depressed symptoms. These findings are consistent with prior evidence that testosterone targets the neural circuits regulating affect and impulse regulation, and show, for the first time in humans, how androgen-dependent organizational effects may regulate a very specific, aggression-related structural brain phenotype from childhood to young adulthood.

Dyadic associations between testosterone and relationship quality in couples

Testosterone is thought to be positively associated with "mating effort", or the initiation and establishment of sexual relationships (Wingfield et al., 1990). Yet, because testosterone is negatively associated with nurturance (van Anders et al., 2011), high levels of testosterone may be incompatible with relationship maintenance. For instance, partnered men with high testosterone report lower relationship quality compared to partnered men with low testosterone (e.g., Booth and Dabbs, 1993). Findings for women are inconsistent, however, and even less is known about potential dyadic associations between testosterone and relationship quality in couples. In the current report, we assessed relationship satisfaction, commitment, and investment in heterosexual couples and tested the hypothesis that these aspects of relationship quality would be negatively associated with an individual's own and his/her partner's testosterone levels. We found that testosterone was in fact negatively associated with relationship satisfaction and commitment in both men and women. There was also evidence for dyadic associations: Participants' satisfaction and commitment were negatively related to their partners' levels of testosterone, and these associations were larger for women's than men's testosterone. Our findings are consistent with the idea that high testosterone may be incompatible with the maintenance of nurturant relationships. The current findings also provide some of the first evidence for dyadic associations between testosterone and relationship quality in couples, highlighting the interdependent nature of close relationship processes and the importance of considering this interdependence in social neuroendocrine research.

Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men?

Past findings suggest links between orgasms and testosterone (T), as well as sexuality and estradiol (E), and we examined hormone-orgasm links in this study via two hypotheses (below). Participants were 86 women and 91 men who provided a saliva sample and completed a demographics questionnaire, the Orgasm Checklist (Mah and Binik, 2002), the Hurlbert (1991) Index of Sexual Assertiveness, and the Sexual Desire Inventory (Spector and Fremeth, 1996). Results supported the first hypothesis of correlations between T and positive orgasm experience in women, specifically with the relaxation, soothing, and peaceful items in both partnered and solitary orgasm contexts. Results also indicated correlations between E and flooding and spreading items in a solitary orgasm context. There were no associations between hormones and men's perceptions of their orgasm experiences. There was no support for the second hypothesis of associations between higher T and more sexual assertiveness. Post hoc analyses showed associations between E and women's sexual desire, and T and men's sexual desire. We discuss implications of these findings including that solitary vs. partnered orgasm experiences may differ, and suggest that T might be associated with perceptions of psychological experiences of orgasms, and E might be associated with perceptions of physical experiences of orgasms.

Waist-to-hip ratio is positively associated with bioavailable testosterone but negatively associated with sexual desire in healthy premenopausal women

OBJECTIVE

We examined whether high waist-to-hip ratio (WHR) in women is a biomarker for increased testosterone (T) and higher levels of sexual desire.

METHODS

Participants were 99 healthy nonobese premenopausal women. Trait levels of mean bioavailable T were estimated from three saliva samples collected at 8:00 am, 9:30 am, and 6:00 pm to 9:00 pm, controlling for phase of the menstrual cycle. Sexual desire was measured with the Sexual Desire Inventory.

RESULTS

WHR was positively, although moderately, correlated with bioavailable T. WHR, but not T, was negatively correlated with level of sexual desire.

CONCLUSIONS

These results confirm that the positive association between WHR and androgens seen in clinical populations also exists in the general population of healthy adult women. However, the relationship may not be strong enough in healthy women for WHR to serve as a useful biomarker of androgen levels in sexuality studies, especially given its association with other, perhaps negatively valued, morphologic attributes.

Testosterone, sexuality and antisocial personality in rapists and child molesters: a pilot study

Morning and afternoon levels of saliva testosterone levels in Finnish imprisoned rapists (n = 10) and child molesters (n = 10) were compared to those in randomly selected control subjects (n = 31). The associations of saliva testosterone with sexual behavior and antisocial personality traits were explored in all groups. The sexual offenders and control subjects did not differ in the between-subjects main effect estimated for the averaged morning and afternoon testosterone levels. Seven rapists and three child molesters met the criteria for antisocial personality disorder (ASP). In the sexual offenders, a summed ASP index was positively correlated with mean saliva testosterone. Sexual activity as estimated from self-reports of sexual intercourse and masturbation was significantly related to testosterone in both rapists and child molesters but not in the control males. The implications of these results are discussed.

Metabolism of progesterone and testosterone in human parotid and submandibular salivary glands in vitro

Twenty-three parotid and twelve submandibular human salivary glands were used for analyzing in vitro metabolism of progesterone (P) and/or testosterone (T), in order to find out their possible contribution to the concentrations of salivary P or T. Glands were excised from 21 women and 14 men because of a stone, tumor or sialoadenitis, and the healthy tissue was used for incubation. The tissues were homogenized and incubated with 5 to 7 nmol/l of [14C]P or [14C]T for 2 h, extracted with methylacetate and subjected to two dimensional thin-layer chromatography. The thin-layer plates were autoradiographed, and the radioactivity of the different metabolites were counted to assess the amounts of metabolites formed. No lipoidal or conjugated steroids were formed. All of the radioactivity was associated with the free fraction of steroids. Both P and T were metabolized significantly more actively in male submandibular gland compared to male parotid gland (P < 0.05-0.01). No significant differences were found between female and male parotid glands, nor between the parotid glands of hormonally medicated (oral contraceptives or postmenopausal estrogen treatment) and non-medicated women. The submandibular glands more actively metabolized the steroids studied than the parotids (P < 0.01). The main metabolites were 20 alpha-hydroxy-4-pregnen-3-one for P, and androstenedione for T. In conclusion, the present results bring further evidence that the P or T levels in saliva may not be identical with the unbound steroid fraction in circulation, but a part of the steroids are metabolized in salivary glands. However, due to the rapid passage of steroids from blood to saliva, the metabolism demonstrated probably does not form an important source of error in salivary P and T measurements.

Salivary free testosterone in hirsutism

A sensitive, specific and accurate direct radioimmunoassay of testosterone in human saliva is described. A single salivary testosterone result is shown to be of greater diagnostic use in hirsutism than any of the currently used serum androgen assays. Thus, of 50 hirsute patients, salivary testosterone (Sa-T) was elevated in 34 patients, sex hormone-binding globulin (SHBG) was decreased in 30 women, serum testosterone (S-T) elevated in 13, dehydroepiandrosterone sulphate (DHEA-S) was elevated in 14, and androstenedione in three of the investigated group.

Salivary testosterone in cryptorchid pubertal boys: a parameter to assess the gonadal function

The authors studied salivary and serum testosterone (T) levels in basal conditions and at 6 and 12 months after orchidopexy in 36 pubertal boys with unilateral or bilateral cryptorchidism. Boys were divided into two groups according to Tanner classification. Salivary and serum T levels were significantly lower in the group with scanty or absent sexual development than those obtained in the group with normal development. Both groups exhibited similar saliva and serum testosterone values at 12 months of the follow-up study. The data shown indicate that salivary T seems a good index for evaluating the androgenic status of these patients.

Salivary testosterone in prostatic carcinoma

Testosterone concentrations in saliva were measured in 13 patients with prostatic carcinoma after surgical or medical (diethylstilboestrol or Estracyt) orchiectomy. The salivary testosterone values in these patients were significantly lower than in normal males but not significantly different from those in normal females. The salivary testosterone concentrations were measured for 6 consecutive months and did not vary significantly from month to month. The results suggest that the measurement of salivary testosterone concentrations could be useful in evaluating the androgenic function of patients with prostatic carcinoma after medical or surgical orchiectomy.

Measurement of testosterone in seminal plasma, saliva and serum by solid-phase enzymeimmunoassay

When testosterone concentrations in serum, saliva and seminal plasma were measured with a solid-phase enzymeimmunoassay in which antitestosterone antibody was bound to CNBr-Sepharose-4B, we found the ratios of testosterone in saliva and seminal plasma to that in serum were 2.5 +/- 0.2% and 5.19 +/- 0.42%. Testosterone level in saliva could be an index of free serum testosterone. In addition, we found a correlation between sperm motility and testosterone level in seminal plasma when sperm motility was measured with a transmembrane migration method. This enzymeimmunoassay could be applied to clinical studies of testosterone.

Direct assay for testosterone in saliva: relationship with a direct serum free testosterone assay

A direct non-extraction radioimmunoassay for salivary testosterone is described using a modified commercial kit procedure that is in use for total serum testosterone (T). Serum free testosterone was also measured by direct radioimmunoassay. A significant correlation (r = 0.83, p less than 0.01, n = 194) was obtained between salivary and serum free testosterone in matched serum and saliva samples over a wide range of concentrations. Within- and between-batch precision for the salivary testosterone method was 11% and 18%, respectively at a concentration of 170 pmol/l. Recovery of added T was 89% +/- 15% (mean +/- 2 SD) dilution of high samples showed parallelism. Salivary testosterone measured by direct radioimmunoassay offers a simple cheaper alternative to serum free testosterone measurement with the additional advantages of a stress-free non-invasive sampling procedure.

Saliva testosterone time-course response to hCG in adult normal men. Comparison with plasma levels

Testosterone time-course response to 5000 IU hCG was studied simultaneously in the saliva and the plasma of 13 adult normal men. Baseline levels in saliva and plasma were: 93 +/- 9 pg/ml (mean +/- SEM) and 4.9 +/- 0.3 ng/ml respectively. After hCG the same biphasic pattern was observed in both fluids with a similar early response but the delayed peak at 72 h was relatively higher in saliva than in plasma. Thus it was suggested to collect saliva instead of plasma for the evaluation of testicular secretion of testosterone after hCG administration.

Testosterone assays: guidelines for the provision of a clinical biochemistry service

Approximately one year after the devolution of testosterone assays from the SAS, the Analytical Methods Working Party of the Association of Clinical Biochemists set up a working party to investigate the performance of the assays, to survey the available methodology and to give guidance on the factors that influence the assay. This document represents a summary of the deliberations of the group and forms one of a series of similar reports.

Role of serum androgens and sex hormone binding globulin capacity in the evaluation of hirsutism in women

Serum samples from 23 hirsute women and 23 non-hirsute women matched for age and deviation from ideal weight were analyzed for total testosterone (T), percent free testosterone (% FT) and sex hormone binding globulin capacity (SHBG). The % FT was assayed by 2 methods, using diluted serum in equilibrium dialysis (EQD) and using undiluted serum in centrifugal ultra-filtration (UF). SHBG was measured by a DEAE cellulose filter assay and T by radioimmunoassay. The two methods for determining % FT correlated well. There was considerable overlap between the hirsute and control groups for all of the measured parameters. The discrimination between the 2 groups provided by the indirect estimate of free testosterone obtained from the ratio of T to SHBG was at least as good as that provided by the free testosterone derived from ultrafiltration or dialysis.