Dihydrotestosterone in the blood

In most androgen-sensitive tissues, testosterone is converted by 5α-reductase to dihydrotestosterone, a more active form of androgen. Testosterone and dihydrotestosterone bind to the same receptor in the cell, but testosterone has a significantly lower affinity for the receptor than dihydrotestosterone. Only dihydrotestosterone has an effect on the prostate gland, skull bones, and hair growth. DHT is metabolized to 3α-androstenediol glucuronide.

Reference values (norm) of dihydrotestosterone concentration in blood serum

Age	Floor	DGT
		Ng/dl	Nmol/l
Newborns	Male	5-60	0.17-2.06
	Female	<2-15	<0.07-0.52
Prepubertal age (1-10 years)		<3	<0.1
Puberty (Tanner stages)
1	Male	<3	<0.1
	Female	<3	<0.1
2	Male	3-17	0.1-0.58
	Female	5-12	0.17-0.41
3	Male	8-33	0.27-1.14
	Female	7-19	0.24-0.65
4	Male	22-52	0.76-1.79
	Female	4-13	0.14-0.45
5	Male	24-65	0.83-2.24
	Female	3-18	0.10-0.62
Adults	Male	30-85	1.03-2.92
	Female	4-22	0.14-0.76

Androgens play a central role in the development of the prostate gland and an auxiliary role in the formation of its benign hyperplasia (in individuals castrated before the full development of the prostate gland during puberty, benign hyperplasia never develops). It has been established that when testosterone enters the cells of the prostate gland, it undergoes metabolic transformations. More than 95% of testosterone in the prostate gland is metabolized by the enzyme 5α-reductase into dihydrotestosterone, which, interacting with androgen receptors, stimulates the synthesis of specific proteins (growth factors). These growth factors cause proliferation of prostate cells and simultaneously slow down the death of older cells. Normally, the level of testosterone and the formation of dihydrotestosterone maintain a constant balance between the death of old cells and the formation of new ones. If excess DHT is formed, this leads to an increase in the level of growth factors and uncontrolled growth of the prostate gland - benign hyperplasia. The important role of male sex hormones in the development of benign prostatic hyperplasia is supported by data indicating that the consumption of significant amounts of alcohol leads to a decrease in the concentration of testosterone in the blood, an increase in its clearance, and is combined with a decrease in the frequency of prostatectomies for this disease. Currently, the important role of dihydrotestosterone in the development and progression of benign prostatic hyperplasia has been proven, therefore, a targeted decrease in its concentration in the blood has therapeutic significance.

Serum dihydrotestosterone concentrations are closely related to testosterone concentrations. The dihydrotestosterone/testosterone ratio is reduced during pregnancy.

The concentration of dihydrotestosterone in the blood is reduced in 5a-reductase deficiency and hypogonadism. An increase in the concentration of dihydrotestosterone is characteristic of hirsutism (this indicator is not used to assess the course of hirsutism, since the concentration of dihydrotestosterone in the blood serum does not reflect its intracellular content).

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