Unmasking Androstenedione Shadowy Dance in Sarah’s Metabolic Tango

December 21, 2023by Dr. S. F. Czar0

Patient: Sarah, a 42-year-old woman with a growing waistline and a persistent energy drain – Androstenedione 

Presenting Symptoms:

Over the past year, Sarah has noticed gradual weight gain, particularly around her abdomen. She experiences fatigue and difficulty concentrating, often needing afternoon naps to function. Blood work reveals pre-diabetic blood sugar levels and elevated cholesterol.

Medical History:

Sarah has a history of irregular periods and mild hirsutism (excess hair growth). She was diagnosed with Polycystic Ovary Syndrome (PCOS) six years ago.

Initial Investigation:

Based on Sarah’s symptoms and PCOS diagnosis, her doctor suspects androstenedione could be playing a role in her metabolic struggles. Further blood tests confirm elevated androstenedione levels.

Diagnosis: Insulin resistance and potential early-stage metabolic syndrome, potentially exacerbated by elevated androstenedione associated with PCOS.

Treatment Plan:

  • Lifestyle Modifications: A dietician helps Sarah adopt a low-glycemic diet rich in fiber and healthy fats, along with regular physical activity, focusing on high-intensity interval training. Stress management techniques like yoga and meditation are also incorporated.
  • Medication: Metformin, an insulin sensitizer, is prescribed to help her body utilize glucose more effectively, along with a low-dose anti-androgen medication to manage androstenedione levels.
  • Continued Monitoring: Regular blood tests and consultations with her doctor and dietician are scheduled to monitor progress and adjust the treatment plan as needed.


  • After three months, Sarah notices a significant improvement in her energy levels and a reduction in fatigue. Her blood sugar levels stabilize within the normal range, and her cholesterol levels show improvement.
  • Her abdominal fat starts to decrease, leading to a healthier body composition. She reports feeling more confident and motivated to continue her healthy lifestyle.


Sarah’s case highlights the potential role of androstenedione in metabolic dysfunction, particularly in women with PCOS. Early identification and a multi-pronged approach targeting lifestyle modifications, medication, and careful monitoring can lead to significant improvements in metabolic health and overall well-being.

Further Considerations:

  • While effective for Sarah, the treatment plan is individualized and may vary based on specific needs and potential complications.
  • Ongoing research is crucial to fully understand the complex interplay between androstenedione, PCOS, and metabolic health.
  • Personalized healthcare remains key in managing metabolic conditions and empowering individuals like Sarah to take control of their health.

This case study demonstrates how understanding the intricate dance of hormones like androstenedione can lead to personalized interventions and positive outcomes in managing metabolic health, paving the way for a healthier future for individuals like Sarah.

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