Approach to Androgen Excess in Women: Clinical and Biochemical Insights

March 2022 in “ Clinical Endocrinology ”

Leanne Cussen, Tara McDonnell, Gillian Bennett, Chris Thompson, Mark Sherlock, Michael O'Reilly

TLDR The document concludes that a systematic approach is crucial to identify causes of androgen excess in women beyond the most common cause, Polycystic ovary syndrome (PCOS).

The document "Approach to androgen excess in women: Clinical and biochemical insights" discusses the causes, symptoms, and diagnosis of androgen excess in women. The most common cause is Polycystic ovary syndrome (PCOS), affecting at least 10% of women. Other causes include congenital adrenal hyperplasia (CAH), adrenocortical carcinoma (ACC), ovarian hyperthecosis (OHT), syndromes of severe insulin resistance (SIR), Cushing's disease, and virilizing ovarian tumours (VOTs). Symptoms include hirsutism, acne, and alopecia. The document emphasizes the importance of careful clinical and biochemical phenotyping to identify patients at risk of non-PCOS pathology. Diagnostic approaches include the GnRH analogue test, short synacthen test, and ovarian and adrenal venous sampling. The document concludes that a systematic approach is needed to identify non-PCOS pathology.

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research Approach to Androgen Excess in Women: Clinical and Biochemical Insights

14 citations , March 2022 in “Clinical Endocrinology”

The document concludes that a systematic approach is crucial to identify causes of androgen excess in women beyond the most common cause, Polycystic ovary syndrome (PCOS).

research Polycystic Ovary Syndrome, Androgen Excess, and the Risk of Nonalcoholic Fatty Liver Disease in Women: A Longitudinal Study Based on a United Kingdom Primary Care Database

114 citations , March 2018 in “PLOS Medicine”

Women with PCOS are more than twice as likely to develop nonalcoholic fatty liver disease.

research Discriminating Between Virilizing Ovary Tumors and Ovary Hyperthecosis in Postmenopausal Women: Clinical Data, Hormonal Profiles, and Imaging Studies

27 citations , July 2017 in “European journal of endocrinology”

The research found that MRI and certain hormone levels can help tell apart ovarian tumors from hyperthecosis in postmenopausal women, but tissue analysis is still needed for a definite diagnosis.

research Polycystic Ovary Syndrome: A Review for Dermatologists

60 citations , November 2014 in “Journal of the American Academy of Dermatology”

Dermatologists play a key role in treating skin symptoms of PCOS like dark patches, excess hair, acne, and hair loss.

research The Androgen Excess and PCOS Society Criteria for the Polycystic Ovary Syndrome: The Complete Task Force Report

1540 citations , February 2009 in “Fertility and Sterility”

The report concludes that PCOS is mainly a condition of excess male hormones and its definition may change as new information is discovered.

research Androgen Dependence of Hirsutism, Acne, and Alopecia in Women

105 citations , January 2009 in “Medicine”

Hirsutism is more linked to high androgen levels than acne or hair loss, and a mix of hormonal tests is best for diagnosis; certain treatments can reduce symptoms.

research A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia Among Women Presenting with Hyperandrogenic Symptoms and Signs

150 citations , February 2008 in “The Journal of Clinical Endocrinology and Metabolism”

About 2.2% of women with symptoms of high male hormones have a mild form of congenital adrenal hyperplasia, and measuring a specific hormone level can accurately diagnose it.

research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline

1744 citations , November 2006 in “The Journal of Clinical Endocrinology and Metabolism”

Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.

research Relative Prevalence of Different Androgen Excess Disorders in 950 Women Referred Because of Clinical Hyperandrogenism

352 citations , January 2006 in “The Journal of Clinical Endocrinology and Metabolism”

Most women referred for excess male hormone symptoms had polycystic ovary syndrome (PCOS), with other conditions being less common.

research A Detailed Investigation of Hirsutism in a Turkish Population: Idiopathic Hyperandrogenemia as a Perplexing Issue

42 citations , October 2004 in “Experimental and Clinical Endocrinology & Diabetes”

The main cause of excessive hair growth in Turkish women is Polycystic ovary syndrome, but in about one fifth of cases, the reason for high male hormone levels is unknown.

research Androgen Excess in Women: Experience with Over 1000 Consecutive Patients

947 citations , February 2004 in “The Journal of Clinical Endocrinology and Metabolism”

Most women with excess male hormones have Polycystic Ovary Syndrome, and hormonal therapy can improve symptoms but may cause side effects.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome

4809 citations , January 2004 in “Fertility and Sterility”

The 2003 consensus updated PCOS diagnosis criteria and highlighted increased risks of diabetes and heart disease for those affected.

research Screening for 21-Hydroxylase-Deficient Nonclassic Adrenal Hyperplasia Among Hyperandrogenic Women: A Prospective Study

216 citations , November 1999 in “Fertility and Sterility”

Testing basal 17-HP levels is a good way to screen for nonclassic adrenal hyperplasia in women with high androgen levels.

research Prevalence of Polycystic Ovary Syndrome in Unselected Black and White Women of the Southeastern United States: A Prospective Study

633 citations , September 1998 in “The Journal of Clinical Endocrinology and Metabolism”

PCOS affects a similar percentage of Black and White women in the Southeastern United States.

research A Prospective Study of the Prevalence of Clear-Cut Endocrine Disorders and Polycystic Ovaries in 350 Patients Presenting with Hirsutism or Androgenic Alopecia

135 citations , August 1994 in “Clinical Endocrinology”

Most women with hirsutism or androgenic alopecia had polycystic ovaries, especially if they had irregular periods.

5 / 5 results

research Approach to Investigation of Hyperandrogenism in a Postmenopausal Woman

November 2022 in “The Journal of Clinical Endocrinology and Metabolism”

Postmenopausal hyperandrogenism, a condition with symptoms like increased hair growth and acne, is usually caused by PCOS but can also be due to other factors. It's diagnosed by checking testosterone levels and treated either by removing the adrenal tumor or through antiandrogen therapy.

research Approach to Androgen Excess in Women: Clinical and Biochemical Insights

14 citations , March 2022 in “Clinical Endocrinology”

The document concludes that a systematic approach is crucial to identify causes of androgen excess in women beyond the most common cause, Polycystic ovary syndrome (PCOS).

research Differential Diagnosis of Hyperandrogenism in Women with Polycystic Ovary Syndrome

35 citations , March 2012 in “Experimental and Clinical Endocrinology & Diabetes”

The conclusion is that accurately identifying the cause of high androgen levels in women with PCOS is crucial and requires specific tests.

research Hirsutism

July 2011 in “Oxford University Press eBooks”

The document's conclusion cannot be determined without content to analyze.

research The Evaluation and Treatment of Hirsute Women

3 citations , November 2005 in “Women's health”

Excessive body hair in women can be caused by various conditions and treated with medication like Diane® 35 or androgen blockers.