madman
Super Moderator
INTRODUCTION
The word androgen is derived from the Greek words andros and genao, which translate to “a man” and “produce or create,” respectively. Hyperandrogenism is therefore any state with excess production of “male” hormones, although these hormones are normally found in women at lower levels. The most clinically relevant hormone in hyperandrogenism is testosterone, which is converted peripherally to dihydrotestosterone (DHT), its biologically active form. The most common symptom of hyperandrogenism in women is hirsutism, and the most prevalent cause is polycystic ovarian syndrome (PCOS).1 The approach to hyperandrogenism in women differs depending on the stage of the woman’s life. This article will serve as a concise review of hyperandrogenism in women at various stages of adult life.
*Physiology of Androgens in Women
*Genetics
*History/Physical
-Age
-Ethnicity
-Duration of symptoms
*The most common symptoms of hyperandrogenism in women are as follows:
-Hirsutism
-Alopecia
-Acne
-Oligomenorrhea/amenorrhea
*Diagnostic Evaluation
-Laboratory investigation
-Imaging
*Differential Diagnoses
Premenopausal hyperandrogenism
-Polycystic ovarian syndrome
-Idiopathic hirsutism
-Non-classic congenital adrenal hyperplasia
Postmenopausal hyperandrogenism
-Ovarian hyperthecosis
-Ovarian and adrenal neoplasms
-Iatrogenic hyperandrogenism
-Gestational hyperandrogenism
*Treatment
Medical management
-Lifestyle
-Oral contraceptives
-Antiandrogens
-Spironolactone
-Finasteride
-Cyproterone acetate
-Local/topical treatment
-Glucocorticoids
-GnRH agonists
-Medications that reduce insulin levels or improve insulin action
SUMMARY
The approach to hyperandrogenism in women varies depending on the woman’s age and severity of symptoms. Once tumorous hyperandrogenism is excluded, the most common cause is PCOS. Hirsutism is the most common presenting symptom. The woman’s concern about her symptoms plays an important role in the management of the disease. Although measurement of testosterone is useful in identifying an underlying cause, care must be taken when interpreting the less accurate assays that are available commercially. Surgical resection is curative in tumorous etiologies, whereas medical management is the mainstay for nontumorous causes.
The word androgen is derived from the Greek words andros and genao, which translate to “a man” and “produce or create,” respectively. Hyperandrogenism is therefore any state with excess production of “male” hormones, although these hormones are normally found in women at lower levels. The most clinically relevant hormone in hyperandrogenism is testosterone, which is converted peripherally to dihydrotestosterone (DHT), its biologically active form. The most common symptom of hyperandrogenism in women is hirsutism, and the most prevalent cause is polycystic ovarian syndrome (PCOS).1 The approach to hyperandrogenism in women differs depending on the stage of the woman’s life. This article will serve as a concise review of hyperandrogenism in women at various stages of adult life.
*Physiology of Androgens in Women
*Genetics
*History/Physical
-Age
-Ethnicity
-Duration of symptoms
*The most common symptoms of hyperandrogenism in women are as follows:
-Hirsutism
-Alopecia
-Acne
-Oligomenorrhea/amenorrhea
*Diagnostic Evaluation
-Laboratory investigation
-Imaging
*Differential Diagnoses
Premenopausal hyperandrogenism
-Polycystic ovarian syndrome
-Idiopathic hirsutism
-Non-classic congenital adrenal hyperplasia
Postmenopausal hyperandrogenism
-Ovarian hyperthecosis
-Ovarian and adrenal neoplasms
-Iatrogenic hyperandrogenism
-Gestational hyperandrogenism
*Treatment
Medical management
-Lifestyle
-Oral contraceptives
-Antiandrogens
-Spironolactone
-Finasteride
-Cyproterone acetate
-Local/topical treatment
-Glucocorticoids
-GnRH agonists
-Medications that reduce insulin levels or improve insulin action
SUMMARY
The approach to hyperandrogenism in women varies depending on the woman’s age and severity of symptoms. Once tumorous hyperandrogenism is excluded, the most common cause is PCOS. Hirsutism is the most common presenting symptom. The woman’s concern about her symptoms plays an important role in the management of the disease. Although measurement of testosterone is useful in identifying an underlying cause, care must be taken when interpreting the less accurate assays that are available commercially. Surgical resection is curative in tumorous etiologies, whereas medical management is the mainstay for nontumorous causes.
