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5-Reductase Activity in the Genital Skin of Hirsute Women^*

Department of Obstetrics and Gynecology, University of Southern California School of Medicine, and Women's Hospital, Los Angeles County/USC Medical Center Los Angeles, California 90033

Address requests for reprints to: Rogerio A. Lobo, M.D., Women's Hospital, Room L913,1240 North Mission Road, Los Angeles, Califor-nia 90033.

A simplified, rapid, and highly reproducible technique is described for measuring 5-reductase activity (5RA) in small skin biopsies. Human genital skin was obtained from 23 nonhirsute and 20 hirsute premenopausal women (HW) and 5 normal men. Skin samples were minced at 4 C and incubated (with RPMI-1640 in the presence of 95% O₂-5% CO₂ and 4.15 nmol [¹⁴C]testosterone ([¹⁴)C]T) for 2 h at 37 C. Steroids were extracted with diethyl ether and separated by Celite and paper chromatography. Radioactivity in specific eluates was quantified, and the mass of each steroid was measured by RIA. The separate formation of 5-androstane-17β-ol-3-one (DHT), 5-androstane-3, 17B diol (3diol), androstene-dione, and androsterone from [¹⁴C]T was measured. In separate experiments it was demonstrated that an incubation time of 2 h was optimum and that the addition of cofactors was unnecessary. Radiochemical purity was confirmed after chromatography. The mean ± SE conversion ratio (CR) of T to DHT (in 2 h) in HW was higher than that in normal women (16.80 ± 1.62% us. 4.48 ± 0.36%; P < 0.01). In men, the CR of T to DHT averaged 31.60 ± 3.96%. Individual values for the CR of T to DHT in HW and normal women did not overlap. The CR of T to 3adiol was significantly higher in HW (9.66 ±0.86%) and men (15.98 ± 2.0%) compared to that in normal women (2.96 ± 0.32%; P < 0.05). The CR of T to androstenedione was significantly greater n i HW and men (6.18 ± 0.42 and 7.28 ± 1.92%) compared to that in normal women (2.64 ±0.64%; P < 0.05). The CR of T to androsterone was very low and was similar in the three groups. The production of DHT in HW (4.50 ± 1.0 pmol/mg-2 h) was significantly greater than that in normal women (0.48 ± 0.08; P < 0.01) and was similar to the production in men (6.18 ± 1.94 pmol/mg-2 h). There was a significant correlation between the CR of T to DHT and DHT production, and the CR of T to 3diol and 3diol production as well as between the CRs of T o t DHT and T to 3adiol. These data suggest that measurements of DHT formation are best suited for the assessment of 5aRA and that the measurement of 5RA in vitro from small skin biopsies is suitable for the clinical evaluation of hirsutism.

^* This work was supported in part by Grant HD-17519-01A1 from the NIH.

Received August 22, 1984.

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