The Investigation and Management of Severe Hyperandrogenism Pre- and Postmenopause: Non-Tumor Disease Is Strongly Associated with Metabolic Syndrome and Typically Responds to Insulin-Sensitization with Metformin

The study conducted over a seven-year period investigated severe hyperandrogenism in 18 pre- and postmenopausal women, focusing on those without tumors. After excluding 4 cases with adrenal carcinoma, the remaining 14 women, who had a mean BMI of 39.9 ± 8.1 kg/m² and high serum testosterone levels (6.14 ± 1.6 nmol/l), were found to have metabolic syndrome. Treatment interventions, particularly with metformin, significantly reduced serum testosterone levels to 2.2 ± 1.04 nmol/l in these patients. Metformin was effective in normalizing or reducing serum testosterone by more than 40% in 11 out of 12 treated patients. The study concluded that non-tumor hyperandrogenism is closely associated with metabolic syndrome and that metformin therapy is effective in reducing serum testosterone levels, suggesting the absence of an androgen-secreting tumor.