Ovarian Stromal Hyperthecosis and Hyperandrogenemia Refractory to Hormonal Suppression

    Gregory M. Gressel
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    TLDR Removing both ovaries may better treat increased male hormone levels and related symptoms in postmenopausal women when hormone therapy doesn't work.
    In 2015, a unique case of a 67-year-old postmenopausal woman with ovarian stromal hyperthecosis (OSH) was reported. The woman experienced increased libido, hirsutism, and male pattern hair loss due to elevated testosterone levels. Despite treatment with a GnRH antagonist, her androgen levels remained high. After undergoing a bilateral oophorectomy, her symptoms resolved and testosterone levels normalized. This case suggested that oophorectomy might be a more effective treatment for OSH and hyperandrogenemia in postmenopausal women or those who have completed childbearing, especially when there's a risk of hidden ovarian cancer.
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