Hormone dynamics are similar in all disorders of the androgen receptor. Plasma testosterone levels, and rates of testosterone production by the testes, are normal or high. The elevated testosterone production is caused by the high plasma level of LH, which in turn is due to defective feedback regulation caused by resistance to androgen action at the hypothalamic-pituitary level. Elevated LH levels cause increased oestrogen production by the testes (see Fig. 11.9b), and increased oestrogen production combined with variable androgen resistance leads to feminisation.
