We examined the correlation between hyperandrogenemia and lipid profiles in 25 hirsute patients with polycystic ovary syndrome in our reproductive endocrinology outpatient clinic. Concentrations of triglycerides, low density lipoprotein cholesterol and total cholesterol were increased and concentrations of high density lipoprotein (HDL) cholesterol were decreased in women with severe hirsutism. Total and free testosterone levels were correlated with triglycerides (r = 0.72, p < 0.05; r = 0.55, p < 0.01, respectively) and HDL cholesterol (r = -0.55; p < 0.05; r = -0.68, p < 0.05, respectively). There was no correlation between levels of androstenedione, dehydroepiandrosterone sulfate or 17-OH progesterone and any parameters of the lipid profiles. In those with a luteinizing hormone/follicle stimulating hormone ratio > or = 1.5, total testosterone levels were higher than in those with a lower ratio (129.5 +/- 6.4 vs. 95.2 +/- 9.2 ng/dl, p < 0.05), HDL cholesterol levels were lower (45.2 +/- 4.2 vs. 60.4 +/- 4.8 mg/dl, p < 0.05) and triglyceride levels were higher (138.1 +/- 4.5 vs. 92.6 +/- 6.1 mg/dl, p < 0.001). We conclude that altered lipid profiles in women with hirsutism are a result of high testosterone levels.