ABSTRACT
Much of our knowledge about the physiologic role of androgens in women is based on
measurements, primarily in serum, using radioimmunoassay (RIA) methodology that involves
purification of the analyte by organic solvent extraction and column chromatography.
Although the extraction/chromatographic RIA is highly reliable when properly validated,
it is time consuming and costly. For this reason, direct RIA methods were developed.
Subsequently, the radioactive marker was replaced by other labels that have been used
in direct chemiluminescent, fluorescent, and enzyme immunoassays on autoanalyzers.
Although direct immunoassays are simple and rapid, they are seldom thoroughly validated,
and generally lack the sensitivity and specificity for reliable measurements of testosterone
levels found in postmenopausal serum. In recent years there has been increased use
of mass spectrometry assay methods to quantify steroid hormones. These methods are
touted to become the gold standard for all steroid hormone measurements. Because urine
contains predominantly glucuronidated androgens, multistep procedures are required
for the measurement, which is not practical for diagnostic testing. Androgens also
can be measured in saliva, but major methodologic problems are associated with the
measurements. In addition, there is a misconception that salivary testosterone levels
reflect free testosterone levels in serum.
KEYWORDS
Androgens - immunoassays - mass spectrometry - serum - urine - saliva
REFERENCES
Solid-phase radioimmunoassay of serum estradiol-17β: a semi-automated approach . In: Peron FG, Caldwell BV Immunologic Methods in Steroid Determination. New York;
Appleton-Century-Crofts 1970: 87-112 DHEA: biology and use in therapeutic intervention . In: Lobo RA, Kelsey J, Marcus R Menopause: Biology and Pathobiology. New York; Academic
Press 2000: 625-638
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