Prostate-specific antigen as a diagnostic marker in female hyperandrogenism

Background Prostate-specific antigen (PSA) (a known marker for prostate carcinoma) is found in a wide variety of female tissues and fluids. It is upregulated by androgens. Hirsutism, androgenetic alopecia, acne vulgaris, and seborrhea are the most common clinical manifestations of hyperandrogenism in women. Free testosterone (FT) level represents the most sensitive biochemical marker supporting the diagnosis of hyperandrogenism and polycystic ovary syndrome in women. Objective To determine the PSA level in women with clinical manifestations of hyperandrogenism and study the possibility of using it as a diagnostic marker compared with FT. Patients and methods FT and PSA serum levels were evaluated in 30 premenopausal women with different clinical manifestations of hyperandrogenism. Thirty age-matched healthy women were included as controls. Results Both serum FT and serum PSA showed a statistically significant increase in women with clinical hyperandrogenism (P =0.000 and 0.002, respectively). There was a statistically significant correlation between serum FT and PSA (r = 0.342, P= 0.007) and no significant difference was found between FT and PSA in specificity, sensitivity, and positive and negative predictive values (P= 1, 0.152, 0.933, and 0.438, respectively). The levels of each of FT and PSA showed no significant difference between the grades of either androgenetic alopecia, acne, or the degrees of hirsutism. Conclusion The increased level of PSA could be used as a diagnostic marker of hyperandrogenism in women.