Regional Variations and Socioeconomic Factors Influencing Sex Hormone Profiles in Adolescent Girls in Ghana

Eric Kyei-Baafour^1*Sawadatu Zakariah-Akoto^2*Michael Fokuo Ofori¹Lutherodt Bentum-Ennin¹Oscar Nii Otoo Darko¹Godfred Egbi²Benjamin Abuaku³Collins Stephen Ahorlu³Dorothy Yeboah-Manu⁴

• ¹Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
• ²Department of Nutrition, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
• ³Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
• ⁴Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana

Introduction: Adolescence is a critical period of hormonal changes that affect growth, development, and behaviour. Estrogen, progesterone, and androgen are sex hormones that play important roles in reproductive development and functions. Factors including diet, Health care, and genetic variation affect hormone production/levels. However, the effect of different environments has not been explored in detail. This study aimed to evaluate hormonal levels in adolescents from two regions in Ghana and also assess the associated socioeconomic status. Method: One hundred and sixteen (116) blood samples were drawn from in-school adolescent girls aged 10-19 years who were involved in a qualitative study to explore adolescent girls’ knowledge, perceptions, and experiences of hormonal imbalance in Northern and Southern Ghana between June and October 2022. Their hormonal levels were assessed with respect to androgen, estrogen, and progesterone to determine the influence of environmental and parents’ socio-economic factors. Using the Enzyme-Linked Immunosorbent Assay (ELISA), serum levels were determined. Results: Generally, average serum levels of estrogen, androgen, and progesterone were 195.5 (29.2-899.2.0) pg/ml, 60.7 (8.2-687.3) pg/ml, 46.0 (5.2-130.6) ng/ml respectively. When categorized by location, serum estrogen level was 195.8(35.7-899.2)pg/ml in the north compared to 195.3(29.2-899.2)pg/ml, in the south, p=0.63. Androgen was 52.8(8.2-687.3)pg/ml vrs 61.2(16.0-683.33)pg/ml, p= 0.81, and progesterone level was 53.3(9.2-130.6)ng/ml vrs 43.0(5.2-111.3)ng/ml, p=0.0019. Northern participants whose mothers did not have any formal education had higher androgen (p=0.009) and estrogen (p=0.0012) levels compared to those from the south. Also, girls with educated fathers had higher progesterone levels (p=0.03). The proportion of parental unemployment was low across locations. Other covariates did not influence hormonal levels (p>0.05). Conclusion: This study provides useful information on the hormonal profiles of adolescent girls in Ghana, which can inform the School Health Education Programme’s (SHEP) intervention activities related to reproductive health issues. The study shows that there were some variations in the levels of serum progesterone between the two locations, with participants from Northern having higher levels. It also highlights the need for practices that address the differences in hormonal levels among adolescent girls based on the educational levels of mothers, recognizing its potential implications for their fertility, and well-being.