Hyperandrogenism in Polycystic Ovary Syndrome and Adrenal Hyperplasia: Finding Differences to Make a Specific Diagnosis

January 2025 in “ Archives of Gynecology and Obstetrics ”

Vittorio Unfer, Elisa Lepore, Gianpiero Forte, Imelda Hernández Marín, Artur Wdowiak, Lali Pkhaladze

hyperandrogenism polycystic ovary syndrome adrenal hyperplasia non-classic adrenal hyperplasia PCOS NCAH

TLDR Differentiating PCOS from NCAH helps improve diagnosis and treatment.

This review focuses on differentiating between hyperandrogenic polycystic ovary syndrome (PCOS) and non-classic adrenal hyperplasia (NCAH) to improve diagnosis and treatment strategies for patients with hyperandrogenism. By clarifying the distinctions between these conditions, the review aims to facilitate more personalized therapeutic approaches, enhancing patient outcomes.

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Research cited in this study

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research Challenges in Treatment of Patients With Non-Classic Congenital Adrenal Hyperplasia

4 citations , December 2022 in “Frontiers in Endocrinology”

Treating non-classic congenital adrenal hyperplasia is complex because the benefits of hormone treatment must be weighed against potential health risks.

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 and NC-CAH: Distinct Characteristics and Common Findings. A Systematic Review

32 citations , June 2019 in “Frontiers in Endocrinology”

Polycystic Ovary Syndrome (PCOS) is common in women with conditions like anovulation, hirsutism, hair loss, and type 2 diabetes, and it can lead to health risks like heart disease, obesity, insulin resistance, and depression. Non-Classic Congenital Adrenal Hyperplasia (NC-CAH) is also discussed.

Non-Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency Revisited: An Update with a Special Focus on Adolescent and Adult Women

research Non-Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency Revisited: An Update with a Special Focus on Adolescent and Adult Women

117 citations , May 2017 in “Human Reproduction Update”

The update highlights that non-classic congenital adrenal hyperplasia is common in women with excess male hormones, requires specific hormone tests for diagnosis, and has various treatment options depending on age and symptoms.

research Clinician vs Self-Ratings of Hirsutism in Patients With Polycystic Ovarian Syndrome

52 citations , March 2016 in “JAMA dermatology”

Patients with PCOS rate their hirsutism higher than clinicians, and these self-ratings are more closely related to their quality of life and risk of depression.

research Sexual Function and Depressive Symptoms in Young Women With Nonclassic Congenital Adrenal Hyperplasia

11 citations , January 2016 in “The Journal of Sexual Medicine”

Young women with nonclassic congenital adrenal hyperplasia may experience worse sexual function and mild depression compared to healthy women.

research Nonclassic Congenital Adrenal Hyperplasia

59 citations , January 2010 in “International Journal of Pediatric Endocrinology”

NonClassic Congenital Adrenal Hyperplasia is a less severe form of a genetic disorder affecting adrenal gland function.

research Nonclassic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency: Pathophysiology, Diagnosis, and Treatment

49 citations , January 2010 in “International Journal of Pediatric Endocrinology”

The document concludes that Nonclassic Congenital Adrenal Hyperplasia requires personalized treatment plans to manage symptoms and fertility, with glucocorticoids being a common therapy.

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

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

150 citations , November 2007 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 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 Prevalence of Polycystic Ovaries in Women with Androgenic Alopecia

84 citations , November 2003 in “European journal of endocrinology”

Women with androgenic alopecia are more likely to have polycystic ovaries and higher androgen levels, which may indicate PCOS.

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.