Testosterone and Estrone Increase From the Age of 70 Years: Findings From the Sex Hormones in Older Women Study

Context

There is a lack of understanding of what is normal in terms of sex steroid levels in older women.

Objective

To determine whether sex steroid levels vary with age in and establish reference ranges for women >70 years of age.

Design and setting

Cross-sectional, community-based study. Participants included 6392 women ≥70 years of age.

Main outcome measures

Sex steroids measured by liquid chromatography–tandem mass spectrometry. A reference group, to establish sex steroid age-specific reference ranges, excluded women using systemic or topical sex steroid, antiandrogen or glucocorticoid therapy, or an antiglycemic agent.

Results

The reference group of 5,326 women had a mean age of 75.1 (±4.2) years, range of 70 to 94.7 years. Median values (range) were 181.2 pmol/L (3.7 to 5768.9) for estrone (E₁), 0.38 nmol/L (0.035 to 8.56) for testosterone (T), 2.60 nmol/L (0.07 to 46.85) for dehydroepiandrosterone (DHEA), and 41.6 nmol/L (2.4 to 176.6) for SHBG. Estradiol and DHT were below method sensitivity in 66.1% and 72.7% of the samples, respectively. Compared with women aged 70 to 74 years, women aged ≥85 years had higher median levels of E₁ (11.7%, P = 0.01), T (11.3%, P = 0.02), and SHBG (22.7%, P < 0.001) and lower DHEA (30% less, P < 0.001). Women with overweight and obesity had higher E₁ (P < 0.001) and T (P < 0.03) and lower SHBG (P < 0.001) than did women with normal body mass index. Smokers had 17.2% higher median T levels (P = 0.005).

Conclusion

From the age of 70 years, T and E₁ increase with age, despite a steady decline in DHEA. Whether E₁ and T are biomarkers for longevity or contribute to healthy aging merits investigation.