Urinary steroids in women with androgenic alopecia

Objectives: To determine the nature of the hormonal overproduction in androgenic alopecia. Design and methods: Urinary steroid metabolites were measured after enzyme hydrolysis and methoxym-silyl derivatization by capillary gas chromatography in 56 women with androgenic alopecia and in 17 control healthy laboratory women workers. Results: Elevated C19 metabolites of testosterone and androstendione, hyperandrogenemia (p < 0.01), and increased cortisol (p< 0.01) and corticosterone metabolite, aTHB (p< 0.01) were found in patients with androgenic alopecia compared to normal control. Normal 11β-hydoxylase activity and increased 5α-reductase activity were experienced. Conclusion: We propose that in addition to the increased excretion of almost all steroid metabolites, the enhanced activity of 5α-reductase is the primary defect in the majority of androgenic alopecia.