Postmenopausal Ovarian Hyperthecosis Associated with Rapid Testosterone Excess

The document described two cases of postmenopausal women who developed rapid onset hirsutism and androgenic alopecia due to hyperandrogenism caused by ovarian hyperthecosis (OH). Imaging techniques confirmed that the excess testosterone was produced by the ovaries. Treatment with bilateral oophorectomy, and in one case an additional unilateral adrenalectomy, normalized serum testosterone levels and resolved the hirsutism. The study highlighted the necessity of excluding neoplastic causes in postmenopausal hyperandrogenism and suggested OH as a potential diagnosis. It concluded that the primary treatments for OH in postmenopausal women are bilateral oophorectomy or gonadotropin-releasing hormone (GnRH) agonists.