Testosterone and estrone increase from the age of 70 years; findings from the Sex Hormones in Older Women Study

Importance: 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 beyond 70 years.Design and Setting: Cross-sectional, community based, study.Participants: 6392 women, aged 70 years and older.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, anti-androgen or glucocorticoid therapy or an anti-glycaemic agent.Results: The reference group of 5326 women had a mean age of 75·1 (± 4·2) years, range 70-94·7 years. Median values (range) were estrone (E1)181·2 pmol/L (3·7-5768·9), T 0·38 nmol/L (0·035-8·56), dehydroepiandrosterone (DHEA) 2·60 nmol/L (0·07-46·85) and SHBG 41·6 nmol/L (2·4-176·6). Estradiol and dihydrotestosterone were below method sensitivity in 66·1% and 72·7% of the samples, respectively. Compared with women aged 70-74 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%, pConclusion: 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