Androstenedione (A4) - Serum

Clinical definition of the Androstenedione (A4) test
Androstenedione is a steroid sex hormone produced in the adrenal glands and the gonads. This test is used when women are suspected of virilizing syndromes i.e. a condition where females develop male sexual characteristics due to of high testosterone levels in them. This test is also used when steroid abuse is suspected. It is not as useful as 17-OH progesterone in diagnosis of congenital adrenal hyperplasia (CAH) but is helpful in management of such patients. In CAH, the male (46 XY) babies have female or ambiguous genitalia and at puberty, marked virilization occurs.

Why is the Androstenedione (A4) test done?
This test measures the amount of androstenedione in the blood. It may be used to check for:-

  • Elevated male sex hormone (testosterone) in women
  • Routine health screenings
  • To screen a suspected disease or toxicity
  • To see the progress of a medication or treatment plan.
  • Suspected cases of virilizing syndromes in women
  • Suspected anabolic steroid abuse
  • May be used along with 17-OH progesterone to diagnose CAH 
  • Management of CAH

What are the common signs/symptoms when the Androstenedione (A4) test is done?
These symptoms may be diagnosed by, screened for, or associated with Androstenedione test:

  • Early puberty
  • Return of periods in postmenopausal women
  • Virilizing syndromes in women

Who should do the Androstenedione (A4) test (Target population)?

  • Done in women who develop male sexual characteristics
  • To check for steroid abuse

What should I do before the Androstenedione (A4) test?

Specimen type

Specimen collection procedure

Preparatory instructions during specimen collection*

Serum (Blood Sample)

Venipuncture - Collection of blood from a vein, usually from the arm.

No Fasting Required.

No other special preparations required.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

How do I interpret my Androstenedione (A4) test results?



Female 1 to 10 years

8-50 ng/dL

Female 10 to 17 years

8-240 ng/dL

Adult female

85-275 ng/dL

Adult male

75-205 ng/dL

‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Diseases/condition related to the Androstenedione (A4) test

  • Androgen access
  • CAH
  • Cushing's syndrome
  • Ovarian cancer
  • Testicular cancer
  • Adrenocortical tumors
  • Hypogonadism

Other tests related to the Androstenedione (A4) test

  • 17 Hydroxyprogesterone measurement
  • Free testosterone
  • Testosterone
  • Cortisol
  • Serum dehydroepiandrosterone measurement