Case 33-2015

    October 2015 in “ The New England Journal of Medicine ”
    Graham T. McMahon, Jennifer A. Bennett
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    TLDR The woman's surgery lowered her testosterone and improved scalp hair loss but did not change her excessive body hair.
    The document detailed the case of a 57-year-old woman with symptoms of hyperandrogenism, including hirsutism, scalp hair loss, and a deepening voice, leading to a diagnosis of ovarian hyperthecosis. Elevated testosterone levels were noted, but imaging showed no tumors. Transvaginal ultrasonography and an endometrial biopsy supported the diagnosis, which was confirmed after a robot-assisted laparoscopic total hysterectomy and bilateral salpingo-oophorectomy. Post-surgery, the patient's testosterone levels decreased, and her alopecia mildly improved, but her hirsutism did not change. She was referred to a dermatologist for further symptom management. The document highlights that hirsutism typically does not revert after treatment for postmenopausal hyperandrogenism, but scalp hair growth usually recovers, and a more feminine body habitus is restored.
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