Androgenization in Women: Symptoms, Diagnosis, and Treatment

The document from 2012 addresses the issue of androgenization in women, focusing on symptoms such as hirsutism, androgenetic alopecia (AGA), and acne. It reports that hirsutism affects 5-10% of women of reproductive age and AGA affects 30-40%, with an increase during perimenopause. The paper stresses the importance of a detailed diagnostic process and individualized treatment plans, requiring collaboration between gynecology and dermatology. It provides definitions and etiologies for these conditions, and outlines diagnostic procedures like the Ferriman-Gallwey Score for hirsutism and Ludwig Stages for AGA. Laboratory diagnostics are recommended for moderate to severe hirsutism or when other symptoms are present. The document also discusses hormone levels indicative of significant androgenization and recommends further tests for abnormal results, including the dexamethasone suppression test and ACTH test. Imaging techniques are suggested for tumor exclusion. Treatment options for hirsutism include monotherapy with oral contraceptives or antiandrogens for at least 6 months, and a table of pharmacological treatments is provided. The paper concludes that it is essential to efficiently identify serious causes of androgenization for proper management and to manage patient expectations regarding treatment outcomes.