Ovarian Stromal Hyperthecosis and Hyperandrogenemia Refractory to Hormonal Suppression

October 2015 in “ Obstetrics and gynaecology cases - reviews ”

Gregory M. Gressel

ovarian stromal hyperthecosis hyperandrogenemia hirsutism male pattern hair loss testosterone GnRH antagonist bilateral oophorectomy male pattern baldness GnRH blocker ovary removal

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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