After the 1 st intramuscular injection of 1000 mg testosterone undecanoate to hypogonadal men, mean Cmax values of 38 nmol/L (11 ng/mL) were obtained after 7 days. The second dose was administered 6 weeks after the 1 st injection and maximum testosterone concentrations of about 50 nmol/L (15 ng/mL) were reached. A constant dosing interval of 10 weeks was maintained during the following 3 administrations and steady-state conditions were achieved between the 3 rd and the 5 th administration. Mean Cmax and Cmin values of testosterone at steady-state were about 37 (11 ng/mL) and 16 nmol/L (5 ng/mL), respectively. The median intra- and inter-individual variability (coefficient of variation, %) of Cmin values was 22 % (range: 9-28%) and 34% (range: 25-48%), respectively.
My case is a little special (I wrote you a quite long email to explain every analysis I did during the last 4 years, I also saw many specialists who couldn’t tell me what I suffer from and what to do..)
But to summarise :
– hyperandrogenism, alopecia, acne, hirsutism and hypoestrogenism since 4 years, amenorrhea since last february ;
– LH, FSH, progesteron (I did’nt know in which part of my cycle I was but in every part it was ok), TSH/T4/FT3/FT4, ACTH stimulation test, 24 hours cortisolurie, 17-OH-progesteron, DHEA, SHBG, fasting insulin/glucose tolerance test, abdominal ultrasound normal ;
– Delat-4-Androstenedione high level (14,4 in 2013, 15,3nmol/l for 2 months – normal: 1,4-12)
– Hypoestrogenism (17 pg/ml)
– New ultrasound last month that may shows PCOS.
A far more common cause of excess production of androgens in women is polycystic ovary syndrome (PCOS; also called Stein-Leventhal syndrome ). This syndrome is characterized by excess androgens and the presence of a menstrual disorder. Androgen excess often manifests as hirsutism, with or without increased serum concentrations of one or more androgens. Some women have increased serum androgen concentrations and no hirsutism. A variety of menstrual disorders have been associated with PCOS, including oligomenorrhea, amenorrhea, anovulation, and infertility . An ultrasound may reveal multiple ovarian cysts. Many women with this syndrome are obese . Another characteristic feature of PCOS is tissue resistance to the action of insulin . This is expected in obese women, but it is also present in nonobese women with the syndrome. Insulin resistance leads to an increase in insulin secretion (hyperinsulinemia), which is thought to stimulate ovarian androgen production. Hyperinsulinemia also decreases the production of sex hormone-binding globulin so that more of the testosterone in the serum is free and accessible to the tissues. In addition, the conversion of androgens to estrogens in adipose tissue is increased (particularly in obese women), which leads to a small sustained increase in the secretion of luteinizing hormone and to the suppression of ovulation .