It is increasingly recognized that testosterone at some level is important to women's health, and must be available to cells to fulfill its functions. Bioavailable testosterone (BT) reflects the form that is readily available, meaning it is circulating freely or loosely bound to albumin, a blood protein. Bioavailable testosterone is not bound to sex hormone binding globulin (SHBG).
Insufficiency of BT in women, along with lower SHBG and lower total and free testosterone, has been associated with increased risk of atherosclerosis and, therefore, cardiovascular disease and cardiovascular events. Lower BT may also increase risk of hip fractures in women.
However, at extremely high levels, BT has also been associated with increased risk of cardiovascular disease in women, suggesting a U-shaped relationship. Increasing levels of BT in women have also been associated with an increased risk of non-alcoholic fatty liver disease.
Evaluating bioavailable testosterone in many of these conditions can provide additional clinical information regarding women's health.
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