The Hyperandrogenic-Insulin-Resistant Acanthosis Nigricans Syndrome: Therapeutic Response

    March 1994 in “ Fertility and sterility
    Ricardo Azziz
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    Studysummary This study found that oral contraceptives effectively suppressed hyperandrogenemia in most patients with hyperandrogenic-insulin-resistant acanthosis nigricans syndrome, though GnRH-a therapy was beneficial for those not responding initially.
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    The study investigated the therapeutic response of five women with hyperandrogenic-insulin-resistant acanthosis nigricans syndrome to oral contraceptives (OC) and spironolactone (SPA). After 6 months, four patients showed adequate suppression of free testosterone (T), increased sex hormone-binding globulin (SHBG) levels, and improved hair growth rate, with two also noting better hair texture. The fifth patient did not respond to OC therapy but showed significant improvement with GnRH-a suppression combined with hormonal replacement and SPA. The study concluded that while most patients respond well to OC treatment, GnRH-a suppression can be effective for those who do not. Hyperinsulinemia was found to enhance LH-stimulated androgen biosynthesis but could not sustain androgen production without sufficient gonadotropin stimulation.
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