Reently, it has been discussed the menstrual disorder caused by deranged metabolism of androgens in ovaries. While the derangement may not be demonstrable by urinary total 17-KS estimation, it is necessary to study urinary 17-KS in detail such as 1) fractionation study of 17-KS, 2) adrenal suppression and gonadal stimulation, dynamic test, after Netter, 3) ratio analysis of specific 17-KS fraction, as androsterone or DHA (dehydoepiandrosterone), to total 17-KS.
The ratio analysis of urinary 17-KS after Yoshida were performed in 32 cases of menstrual disorder and 19 carses of normal female in proliferative phase and dynamic test was combined in 15 cases of menstrual disorder. 1) Specific change in urinary total 17-KS level has not been observed in the cases of menstrual disorder. 2) Urinary 17-KS fractions also did not show specific excretion pattern in these patients. 3) The ratio analysis of androsterone/total 17-KS and DHA/total 17-KS clearly revealed deranged metabolism of androgens in Primary amenorrhea patients. 4) The ratio analysis combined dynamic test demonstrated more clearly the deranged metabolism.
As the conclusion, it should be emphasized that the ratio analysis and the dynamic test were required in evaluating deranged steroid metabolism.