Androgens Tend to Be Higher, but What about Altered Progesterone Metabolites in Boys and Girls with Autism?

Benedikt Gasser*, Johann Kurz, Escher Genevieve, Hiten D. Mistry, Markus G. Mohaupt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Evidence exists that steroid hormones are altered in individuals with autism, especially androgens. Despite lower prevalence in girls than boys, evidence of potential alterations in progesterone metabolites is sparse, so the aim of this study was to elucidate different progesterone metabolites in affected children with autism versus healthy controls. Material and Methods: Circadian urine samples from 48 boys and 16 girls with autism spectrum disorders and a matched case–control group were analysed for progesterone metabolites by gas chromatography–mass spectrometry and normalised for creatinine excretion. Results: In boys with autism, the majority of progesterone metabolites were reduced, such as progesterone, 6a-OH-3a5b-TH-progesterone, or 20a-DH-progesterone (p < 0.01 for all). In girls with autism, a similar pattern of reduction in progesterone metabolites was detected; however, potentially due to the relatively small sample, this pattern was only detectable on the level of a trend. Discussion: As stated, androgen levels are higher in boys and girls with autism, but evidence for progesterone metabolites is much sparser. The pattern of a decrease in progesterone metabolites suggests the existence of an altered routing of steroid metabolites, probably in combination with a dysregulation of the HPAG axis. As, recently, increased CYP17A1 activity has been suggested, the stronger routing towards androgens is further implied in line with our findings of lower progesterone concentrations in boys and girls with autism than healthy controls.

Original languageEnglish
Article number1004
Issue number7
Publication statusPublished - Jul 2022


  • androgen theory of autism
  • gender ratio of autism
  • progesterone metabolites


Dive into the research topics of 'Androgens Tend to Be Higher, but What about Altered Progesterone Metabolites in Boys and Girls with Autism?'. Together they form a unique fingerprint.

Cite this