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Androstenedione

A hormone made by the adrenal glands and by the ovaries or testes. The body turns it into testosterone and estrogen.

AI-verified against cited sources. Awaiting expert reviewAlso called A4LOINC 1854-9

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What it is

Androstenedione is a steroid hormone made mainly by the adrenal glands, and by the ovaries in women and the testes in men. It is a building block: the body converts some of it into testosterone and some into estrone, a form of estrogen. By itself it is a weak androgen (a male-pattern hormone). Everyone has some. Levels rise at puberty, differ by sex and tend to fall with age.

Why it matters

Clinicians measure androstenedione to help look into signs of extra androgens, such as acne, extra facial or body hair, or irregular periods. It is one of several tests used in polycystic ovary syndrome (PCOS) work-ups, and it helps clinicians look into and follow congenital adrenal hyperplasia (CAH), an inherited condition of the adrenal glands. The 2023 international PCOS guideline says androstenedione and DHEA-S could be measured if testosterone is not elevated, but they are less specific than testosterone. One result is hard to read alone, so it is usually looked at with testosterone, 17-hydroxyprogesterone and DHEA-S.

If it’s low

A low level is expected after menopause and is common with older age. Less often it points to reduced adrenal or gonad function. Steroid medicines and some other hormones can also lower it. A clinician will read a low result with your symptoms and other hormones.

Common causes

  • Menopause and older age
  • Steroid (glucocorticoid) medicines, which quiet the adrenal glands
  • Reduced adrenal function, including problems with the pituitary signals that drive the adrenal glands
  • Reduced ovarian or testicular function
  • Some other medicines and hormones, including those that speed up liver enzymes

What can help

  • Ask whether cortisol and other adrenal hormones should be checked
  • Review your medicines and hormones with your clinician, because some can lower androstenedione
  • Ask whether the result fits your age and menopause status

If it’s high

A high level means the adrenal glands or ovaries may be making extra androgens. PCOS and conditions of the adrenal glands, such as CAH, are common explanations, and supplements can also raise it. A result above your lab's range does not tell you the cause. A clinician will read it with testosterone and other hormones.

Common causes

  • Polycystic ovary syndrome (PCOS)
  • Congenital adrenal hyperplasia (CAH), including milder forms that show up in adulthood
  • Treatment for CAH that is not yet controlling the condition well
  • Androstenedione or DHEA supplements
  • Puberty, when levels rise normally
  • Rarely, a tumor of the adrenal gland or ovary that makes androgens

What can help

  • Tell your clinician about any supplements, especially DHEA or androstenedione, and about all medicines
  • Ask whether testosterone, DHEA-S and 17-hydroxyprogesterone should be checked too
  • Ask whether the test should be repeated at a set time of day or cycle day

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

The usual range depends on sex and age. Choose women or men to see the one that applies.

See Androstenedione by age and sex, with the U.S. survey numbers where they exist.

What can affect your result

  • Age and sex: levels rise at puberty, are higher in younger adults, fall with age and are lower after menopause
  • Puberty stage in children, since labs publish different ranges for each Tanner stage
  • Time of day and, for people on steroid medicine for CAH, the timing of the dose
  • Menstrual cycle phase: clinicians often prefer the follicular phase for women who have periods
  • Supplements (androstenedione, DHEA) and medicines
  • Test method and lab: LC-MS/MS is the preferred method, and ranges differ between labs
  • Androstenedione supplements, and to a lesser degree DHEA-S supplements, can raise the level. With very large doses, levels can almost double (Mayo).
  • Many medicines and hormones may change androstenedione, most often lowering it. Steroid hormones and medicines that speed up liver enzymes are examples (Mayo). Tell whoever reads your result what you take.
  • Failure of the adrenal glands or gonads can lower levels, which limits what the test can show in those settings (Mayo).
  • Mass spectrometry (LC-MS/MS) is the preferred method (Endocrine Society 2018). Other methods can be less specific, so avoid comparing results from different methods.

Adrenal hormones follow a daily rhythm, so a consistent time of day matters for repeat tests. If you take steroid medicine for congenital adrenal hyperplasia (CAH), keep the draw at the same time relative to your doses (Endocrine Society 2018). If you still have periods, clinicians often ask for a sample in the first half of the cycle (the follicular phase). It reflects what your adrenal glands and ovaries or testes are making now, so it can shift soon after a treatment change.

When to talk to a clinician

Contact a clinician if you notice fast-growing facial or body hair, scalp hair loss, a deepening voice, or periods that have become very irregular or stopped. For a child, talk with a pediatric clinician about signs of puberty that start unusually early. If you have CAH or adrenal insufficiency and develop severe vomiting, dizziness or fainting, get urgent medical care.

Questions you could ask

  • Which other hormones should be checked along with this one?
  • Should I use the same lab for repeat tests?
  • Could my result fit with PCOS or another hormone condition, and what else should we check?
  • Should we repeat this at a specific time of day or point in my cycle?
  • Could a supplement or medicine I take explain it?
  • Does my result make sense for my age and menopause status?

Questions people ask

Why do labs give different ranges for androstenedione?

Ranges depend on the test method and on the age, sex and puberty stage of the people used to set them. For adults, one lab's mass spectrometry test lists 28-230 ng/dL for women and 44-186 for men aged 18-40, while another lab lists 30-200 and 40-150. Use the range printed on your own report.

Do androstenedione or DHEA supplements show up on this test?

Yes. Mayo Clinic Laboratories notes that androstenedione supplements, and to a lesser degree DHEA-S supplements, can raise the level, and very large doses can nearly double it. Tell your clinician about any supplement you take.

How is androstenedione different from testosterone?

Androstenedione is a weaker hormone that the body converts into testosterone and estrone. Testosterone is the main androgen, so clinicians usually check testosterone first and use androstenedione as an extra clue.

Show the science and sources

Units

  • 1 ng/dL = 1 ng/dL
  • 1 ng/dL = 0.03492 nmol/L
  • 1 ng/dL = 0.01 ng/mL

Open the Androstenedione unit converter

Is a change real?

Androstenedione naturally varies about 20% from test to test in the same healthy person. Between two results from the same lab, a rise of 85% or more, or a fall of 46% or more, is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: Sex Hormones and Adrenal Steroids: Biological Variation Estimated Using Direct and Indirect Methods (Roys EA et al.).

For clinicians and researchers

Androstenedione (androst-4-ene-3,17-dione, MW 286.4) is made in the adrenal cortex and the gonads from DHEA. It is a precursor of testosterone (via 17-beta-hydroxysteroid dehydrogenase) and of estrone (via aromatase). Circadian rhythm and the timing of glucocorticoid doses influence steroid measurements, so the 2018 Endocrine Society CAH guideline recommends consistently timed measurements, referencing results to age- and sex-specific norms, and using LC-MS/MS. In CAH, androstenedione is read with 17-hydroxyprogesterone to judge glucocorticoid treatment. For men, the same guideline gives an androstenedione-to-testosterone ratio under 0.5 in eugonadal men, with values above 2 suggesting poor CAH control. The 2023 international PCOS guideline says androstenedione and DHEAS could be considered when testosterone or free testosterone is not elevated, noting their poorer specificity. Intervals depend heavily on lab, method, sex, age and Tanner stage. Labcorp's HPLC-MS/MS adult intervals are 44-186 ng/dL (men 18-40), 28-230 (women 18-40) and less than 10-93 (postmenopausal). Mayo lists 40-150 (men) and 30-200 (women) for 19 and older. Prepubertal limits also differ, at 17 ng/dL (Labcorp, ages 1-10) and 51 ng/dL (Mayo, Tanner stage 1). Conversion: ng/dL x 0.0349 = nmol/L (Labcorp).

LOINC 1854-9 (primary), 14603-5, 107493-9, 35190-8. Specimen: serum.

Sources

  1. Endocrinology Expected Values and S.I. Unit Conversion Tables, Labcorp (Endocrine Sciences specialty testing) (2021)
  2. Androstenedione (Mayo Clinic Laboratories test ANST), UW Medicine Laboratory Test Guide, UW Medicine Laboratory Medicine and Pathology (reproducing Mayo Clinic Laboratories information)
  3. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline, Journal of Clinical Endocrinology & Metabolism (2018)
  4. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, Journal of Clinical Endocrinology & Metabolism (2023)
  5. Androstenedione (PubChem compound 6128), PubChem (National Library of Medicine)

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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