Table 5.

Adjusted geometric means (GM) of serum androgens/androgen metabolites (nmol/L) and serum estrogens/estrogen metabolites levels (pmol/L) stratified by time since hysterectomy and time between hysterectomy and menopause in the Women’s Health Initiative – Observational Study

	Time since hysterectomy
	≤ 25 years	> 25 years
	n=70	n=29
	GM (95% CI)a	GM (95% CI)a	p-valueb
Androgens and androgen metabolites
Dehydroepiandrosterone (DHEA)	4.49 (3.44, 5.86)	4.53 (2.86, 7.16)	0.97
DHEA sulfate (DHEAS)	1139 (873, 1487)	851.32 (529.86, 1367.81)	0.29
Androstenedione	1.24 (1.03, 1.49)	1.27 (0.84, 1.92)	0.90
Testosterone	0.47 (0.37, 0.61)	0.42 (0.27, 0.67)	0.64
5α-Androstanedione	1.18 (0.94, 1.50)	1.36 (0.97, 1.91)	0.46
Dihydroestosterone (DHT)	0.20 (0.17, 0.25)	0.24 (0.19, 0.32)	0.19
DHT sulfate (DHTS)	1.09 (0.83, 1.43)	0.76 (0.59, 0.98)	0.01
Androsterone (ADT)	0.50 (0.43, 0.59)	0.50 (0.41, 0.60)	0.95
ADT glucuronide (ADT-G)	23.0 (17.0, 31.1)	16.82 (9.70, 29.15)	0.34
5α-androstane-3α, 17β diol-3-glucuronide (3α-diol-3G)	1.53 (1.19, 1.98)	1.11 (0.72, 1.71)	0.19
5α-androstane-3α, 3α-diol-17-glucuronide (3α-diol-17G)	1.49 (1.16, 1.90)	1.52 (1.04, 2.22)	0.91
Σ(ADTG+3α-diol-3G+3α-diol-17G)	26.2 (19.7, 34.9)	19.89 (11.97, 33.04)	0.37
Etiocholanolone-glucuronide	37.6 (28.4, 49.9)	25.11 (16.59, 38.02)	0.12
Estrogens and estrogen metabolites
Parent estrogens
Estrone	496 (332, 740)	440 (295, 656)	0.59
Unconjugated	67.3 (50.2, 90.1)	65.5 (45.8, 93.6)	0.90
Conjugated	414 (271, 634)	363 (235, 560)	0.58
Estradiol	71.7 (48.8, 105)	60.0 (42.2, 85.4)	0.35
Unconjugated	19.3 (13.4, 27.9)	17.4 (10.3, 29.4)	0.74
Conjugated	46.0 (30.6, 69.2)	33.9 (21.2, 54.2)	0.21
2-Hydroxylation pathway
2-hydroxyestrone	91.6 (68.0, 123)	102 (71.5, 145)	0.63
2-hydroxyestradiol	22.3 (16.1, 31.1)	26.2 (18.8, 36.6)	0.46
2-methoxyestrone	59.8 (44.6, 80.1)	54.8 (38.7, 77.6)	0.69
Unconjugated	12.9 (8.46, 19.5)	11.8 (8.49, 16.3)	0.69
Conjugated	44.3 (32.9, 59.7)	42.0 (28.5, 61.8)	0.82
2-methoxyestradiol	18.6 (13.8, 25.0)	15.9 (12.0, 21.2)	0.35
Unconjugated	2.72 (1.91, 3.88)	2.74 (1.99, 3.76)	0.98
Conjugated	15.4 (11.3, 21.0)	13.0 (9.57, 17.7)	0.33
2-hydroxyestrone-3-methyl ether	10.9 (8.41, 14.2)	11.6 (8.19, 16.5)	0.77
4-Hydroxylation pathway
4-hydroxyestrone	11.8 (8.73, 15.9)	13.3 (9.16, 19.4)	0.59
4-methoxyestrone	6.82 (5.10, 9.10)	5.85 (4.02, 8.54)	0.49
4-methoxyestradiol	2.99 (2.24, 4.01)	2.43 (1.67, 3.53)	0.27
16α-Hydroxylation pathway
16α-hydroxyestrone	45.4 (33.3, 61.9)	49.1 (34.1, 70.6)	0.73
Estriol	225 (164, 309)	209 (145, 302)	0.75
Unconjugated	37.0 (28.1, 48.9)	33.2 (23.7, 46.5)	0.58
Conjugated	185 (131, 261)	169 (110, 261)	0.73
17-epiestriol	15.9 (12.0, 21.1)	15.4 (11.8, 20.2)	0.87
16-ketoestradiol	53.5 (38.5, 74.4)	56.1 (37.9, 83.2)	0.84
16-epiestriol	19.3 (14.6, 25.7)	19.2 (14.5, 25.4)	0.96
Ratios
Unconjugated Estrone: Androstenedione	54.3 (40.5, 72.8)	51.4 (38.6, 68.6)	0.75
Unconjugated Estradiol: Testosterone	40.7 (27.9, 59.4)	41.3 (25.1, 67.9)	0.96
DHT: Testosterone	0.43 (0.34, 0.55)	0.58 (0.38, 0.89)	0.22
5α-Androstanedione: Androstenedione	0.96 (0.70, 1.30)	1.07 (0.64, 1.79)	0.67

^aAdjusted for: age at blood draw (<55, 55–59, 60–64, 65–69, 70–74, and 75–79 years old), blood draw year (1993–1996 and 1997–1998), race and ethnicity (non-Hispanic White and other), parity (never pregnant, 1, and 2+ pregnancies), oral contraceptive use (never, ever), BMI (<25, 25–29.9, and 30+ kg/m²), time since menopause (<10, 10–20 and ≥ 20 years).

^bp-value was estimated using the Wald test for the relevant beta estimate from the variable comparing mean hormone level among women reporting surgery >25 years relative to those reporting surgery ≤25 years.

All FDR q-values≥0.10.

^*Bold p-values represent nominal statistical significance at p<0.05