Insights into Ovarian Hyperandrogenism: Lessons from Two Unusual Cases

The 2019 study "Insights into Ovarian Hyperandrogenism: Lessons from Two Unusual Cases" examined two cases of postmenopausal hyperandrogenism associated with ovarian hyperthecosis. The first case involved a 73-year-old obese woman with severe hirsutism and virilization, whose testosterone levels were between 200-350 ng/dL. Despite negative imaging findings, a tumorous ovarian source of androgen excess was suspected, and salpingo-oophorectomy revealed small bilateral steroid cell tumors. The second case was a 53-year-old obese woman with progressive male pattern hair loss, acne, and acanthosis nigricans, with testosterone levels between 100-150 ng/dL. Imaging was negative for an adrenal or ovarian mass, but treatment with a GnRH analogue resulted in complete testosterone suppression and scalp hair regrowth. The study concluded that imaging often fails to detect small ovarian tumors, and suggested that testosterone levels >150 ng/dL and absent testosterone suppression during LDDST might indicate androgen-producing tumors. It also proposed GnRH therapy as an alternative to surgery in cases of ovarian hyperandrogenism.