Sex hormones, such as testosterone and estrogens, play an essential role in regulating physiological and reproductive development throughout the lifetime of the individual. Although variation in levels of these hormones are observed throughout the distinct stages in life, significant deviations from reference ranges can result in detrimental effects to the individual. Alterations, by either an increase or decrease, in hormone levels are associated with physiological changes, decreased reproductive capabilities, and increased risk for diseases. Hormone therapies (HTs) and assisted reproductive technologies (ARTs) are commonly used to address these factors. In addition to these treatments, gender-affirming therapies, an iteration of HTs, are also a prominent treatment for transgender individuals. Considering that the effectiveness of these treatments relies on achieving therapeutic hormone levels, monitoring of hormones has served as a way of assessing therapeutic efficay. The need for reliable methods to achieve this task has led to great advancements in methods for evaluating hormone concentrations in biological matrices. Although immunoassays are the more widely used method, mass spectrometry (MS)-based methods have proven to be more sensitive, specific, and reliable. Advances in MS technology and its applications for therapeutic hormone monitoring have been significant, hence integration of these methods in the clinical setting is desired. Here, we provide a general overview of HT and ART, and the immunoassay and MS-based methods currently utilized for monitoring sex hormones. Additionally, we highlight recent advances in MS-based methods and discuss future applications and considerations for MS-based hormone assays.

中文翻译：

---

金标准的进步：通过质谱法测量类固醇性激素

性激素，例如睾酮和雌激素，在个体一生中调节生理和生殖发育方面发挥着重要作用。尽管在生命的不同阶段观察到这些激素水平的变化，但与参考范围的显着偏差可能会对个体产生有害影响。激素水平的变化（无论是增加还是减少）都与生理变化、生殖能力下降和疾病风险增加有关。激素疗法（HT）和辅助生殖技术（ART）通常用于解决这些因素。除了这些治疗之外，性别肯定疗法（HT 的迭代）也是跨性别者的一种重要治疗方法。考虑到这些治疗的有效性依赖于达到治疗激素水平，激素监测已成为评估治疗效果的一种方法。需要可靠的方法来完成这项任务，这导致了评估生物基质中激素浓度的方法取得了巨大进步。尽管免疫测定是使用更广泛的方法，但基于质谱 (MS) 的方法已被证明更灵敏、特异且可靠。MS 技术及其在治疗性激素监测方面的应用取得了重大进展，因此需要将这些方法整合到临床环境中。在这里，我们概述了 HT 和 ART，以及目前用于监测性激素的免疫测定和基于 MS 的方法。此外，我们重点介绍了基于 MS 的方法的最新进展，并讨论了基于 MS 的激素测定的未来应用和注意事项。