Context: The effect of race and obesity on the age-associated decline of androgens in reproductive-aged and menopausal women has not been well characterized.

Objective: To determine the impact of racial differences and body mass index (BMI) on the change in androgen levels during a woman's reproductive and early menopausal years.

Design: Frequency matched cross-sectional study

Setting: Tertiary academic medical center

Patients or other participants: 260 healthy, non-hirsute and eumenorrheic, self-identified Black and White women, ages 15 to 60 years.

Interventions: A medical and reproductive history, physical exam, and blood sampling were determined in the fasting state during the early follicular phase.

Main outcome measures: Serum levels of androgens or androgen metabolites (dehydroepiandrosterone sulfate [DHEAS], androstenedione [A4], total [TT] and free testosterone [FT]), and sex hormone-binding globulin (SHBG) were measured, and the BMI, the waist/hip ratio (WHR), and the basal insulin resistance estimated by the homeostasis model assessment (HOMA-IR) determined.

Results: After controlling for differences in BMI, insulin resistance, and WHR, Black women had lower androgen levels than age-matched White women. All androgens, or androgen metabolites, declined similarly across the reproductive lifespan and menopausal transition in both Black and White women. Race was a significant predictor of DHEAS, A4, FT and TT, but not SHBG.

Conclusions: Eumenorrheic, non-hirsute Black women have a lower range of normal androgen levels than White women of the same age, BMI, WHR and HOMA-IR index. Race and age-adjusted data should be considered when evaluating androgen levels in women between the ages of 15 and 60.