Urinary steroid fractionation studies were carried out on 15 normally ovulating women, 5 women with secondary amenorrhea without hirsutism and 48 women with hirsutism. Six hirsute women had elevated levels of 11-oxygenated and 11-deoxy-17-ketosteroids, while 7 others had an elevation only in the 11-oxygenated-17-ketosteroid fraction, particularly 11-hydroxyandrosterone. The presence of elevated levels of 11-oxygenated-17-ketosteroids and their ready suppression by dexamethasone suggests adrenal origin. Twenty-one hirsute women had elevations in 11-deoxy-17-ketosteroids. Five of these suppressed well with dexamethasone, again implicating the adrenals, while, in ten, the suppression was poor and an ovarian origin was suspected. Evidence for an ovarian origin of these steroids was furnished by their further suppression with stilbestrol. A significant fall in these steroids was also noted after wedgeresection. Statistical analysis using Student's t test and Duncan's multirange analysis showed significant differences in the abovementioned groups. Considerable difficulty was experienced in classifying 6 of the 21 patients with elevated 11-deoxy-17-keotsteroids. Eleven hirsute women had a normal steroid excretion pattern and the response to dexamethasone administration was also judged normal. Urinary steroid excretion patterns and their response to adrenal suppression tests are also presented in 3 cases of virilizing adrenal tumor.

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