Estrogen-Androgen Balance in Anovulation

The balance of estradiol (E 2 ) and testosterone (T) in 15 anovulatory patients was evaluated by measuring the daily plasma concentration of E 2 and T, and their free and protein-bound fractions for a 3- to 4-week period. Similar daily plasma E 2 and T data were obtained from five normal ovulatory cycles as a control group. The daily concentration of the free, non-testosterone-estradiol-binding globulin (TeBG)-bound (index), and total E 2 fluctuated in a wider range than that of the T in the ovulatory as well as in the anovulatory cycles. The percentage of free (%F) and TeBG-bound (%TeBG) fractions of both E 2 and T were relatively constant. The concentration of the free, index, and total E 2 and T showed a parallel pattern even in anovulatory cycles. An increased %F fraction associated with a decreased %TeBG fraction of E 2 and T was observed in anovulatory patients who were hypo- or normoestrogenic; however, an opposite shifting of these two fractions was observed in anovulatory patients who were severely hypoestrogenic. In a hyperestrogen-normoandrogenic state, there was a significant increase in the binding of E 2 and T. The daily binding capacity of plasma TeBG revealed a greater fluctuation than the binding fractions, and it decreased in anovulatory patients, especially in the hyperandrogenic state. E 2 :T ratio of concentration showed a curve-linear relationship to %F, %TeBG, and binding capacity of sex steroids.