Postmenopausal Hyperandrogenism in a Patient With an Adrenal Adenoma: How Should We Approach It?

In the 2016 case report, a 57-year-old postmenopausal woman presented with severe hyperandrogenism, including symptoms of alopecia and hirsutism. Elevated testosterone levels were found, and while imaging revealed an adrenal nodule, ovarian and adrenal vein sampling identified the right ovary as the source of the excess androgen. Treatment with a gonadotropin-releasing hormone (GnRH) agonist led to normalization of testosterone levels. Ultimately, a bilateral oophorectomy was performed, which normalized her testosterone levels and alleviated her hyperandrogenism symptoms. The case demonstrated the effectiveness of GnRH suppression and venous sampling in determining the source of androgen excess when imaging is not definitive, and confirmed the ovarian origin of the patient's condition.