Facebook Pixel

Salivary Testing Opens Pandora’s Box of Issues Surrounding Measuring Testosterone in Women: Editorial

Rate This

Measurement of hormone levels by salivary testing is currently in vogue, yet for now, the enthusiasm to embrace this approach far exceeds its capacity to reliably achieve precise and accurate estimates of testosterone at low levels. In this issue of Menopause, Flyckt et al,(1) directly compare measurement of testosterone levels in postmenopausal women using salivary versus serum testing. In doing so, they open a virtual Pandora’s box of issues surrounding measurement of testosterone in general and particularly at low levels, such as those seen in women and children.

Salivary testing of hormones is a valid approach, effectively representing an ultrafiltrate of blood, and has the benefits of being less invasive and potentially less expensive than the serum approach. Salivary cortisol, for example, has been described as having high diagnostic accuracy for the screening of Cushing syndrome and has been recommended in clinical practice guidelines for screening for this condition.(2)

However, as Flyckt et al report, the current technology is such that the accuracy of
testosterone levels achieved by the salivary method is questionable in individuals whose actual testosterone levels are low.

The authors directly compare salivary versus serum testosterone levels in 56 postmenopausal women who provided multiple samples for hormone analysis both before and during treatment with a 300-Kg transdermal testosterone patch versus placebo.

Direct correlation between the methods was poor, although improved somewhat after log transformation of non-normally distributed data. The authors concede that the very low levels of testosterone in their study sample of postmenopausal women were likely to provide a challenge for the salivary approach to measurement. The other issue is that different immunoassays were used to compare testosterone levels as collected by salivary versus the serum approach; others have reported the variation between results from testosterone immunoassays to be broad.(3) The most concerning aspect of the findings from this

Add a CommentComments

There are no comments yet. Be the first one and get the conversation started!

Enter the characters shown in the image.
By submitting this form, you agree to EmpowHER's terms of service and privacy policy

We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


Get Email Updates

Menopause Guide

HERWriter Guide

Have a question? We're here to help. Ask the Community.


Health Newsletter

Receive the latest and greatest in women's health and wellness from EmpowHER - for free!