Hyperandrogenism in Polycystic Ovary Syndrome and Adrenal Hyperplasia: Finding Differences to Make a Specific Diagnosis

January 2025 in “ Archives of Gynecology and Obstetrics ”

Vittorio Unfer, Elisa Lepore, Gianpiero Forte, Imelda Hernández Marín, Artur Wdowiak, Lali Pkhaladze

hyperandrogenism polycystic ovary syndrome adrenal hyperplasia non-classic adrenal hyperplasia PCOS NCAH

Studysummary In this review, the authors aim to improve the differential diagnosis between hyperandrogenic PCOS and NCAH, which could lead to more personalized treatment strategies for patients experiencing hyperandrogenism.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This review focuses on differentiating between hyperandrogenic polycystic ovary syndrome (PCOS) and non-classic adrenal hyperplasia (NCAH) to improve diagnosis and treatment strategies for patients with hyperandrogenism. By clarifying the distinctions between these conditions, the review aims to facilitate more personalized therapeutic approaches, enhancing patient outcomes.

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Research cited in this study

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research Challenges in Treatment of Patients With Non-Classic Congenital Adrenal Hyperplasia

4 citations , December 2022 in “Frontiers in Endocrinology”

This review discusses various treatment options for non-classic congenital adrenal hyperplasia due to 21α-hydroxylase and 11β-hydroxylase deficiencies without providing new clinical results.

research Approach to Androgen Excess in Women: Clinical and Biochemical Insights

14 citations , March 2022 in “Clinical Endocrinology”

This review outlines a diagnostic approach for identifying non-PCOS pathology in women with androgen excess, emphasizing the importance of clinical history and biochemical phenotyping but reports no new clinical results.

research Polycystic Ovary Syndrome and NC-CAH: Distinct Characteristics and Common Findings. A Systematic Review

32 citations , June 2019 in “Frontiers in Endocrinology”

This review discusses the overlapping clinical features and diagnostic challenges of non-classic adrenal hyperplasia and polycystic ovary syndrome without presenting original research findings.

Non-Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency Revisited: An Update with a Special Focus on Adolescent and Adult Women

research Non-Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency Revisited: An Update with a Special Focus on Adolescent and Adult Women

117 citations , May 2017 in “Human Reproduction Update”

This review examines the epidemiology, pathophysiology, diagnosis, and management strategies for non-classic congenital hyperplasia due to 21-hydroxylase deficiency, and provides evidence-based recommendations for its treatment and genetic counseling.

research Clinician vs Self-Ratings of Hirsutism in Patients With Polycystic Ovarian Syndrome

52 citations , March 2016 in “JAMA dermatology”

This study found that hirsutism significantly negatively impacts quality of life, with self-assessed severity more strongly linked to quality-of-life impact and depressive symptoms than clinician assessments.

research Sexual Function and Depressive Symptoms in Young Women With Nonclassic Congenital Adrenal Hyperplasia

11 citations , January 2016 in “The Journal of Sexual Medicine”

This study found that young women with nonclassic congenital adrenal hyperplasia had impaired sexual function and mild depressive symptoms compared to healthy women.

research Nonclassic Congenital Adrenal Hyperplasia

59 citations , January 2010 in “International Journal of Pediatric Endocrinology”

This review discusses the pathophysiology, diagnosis, and treatment of nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency and provides no new clinical results.

research Nonclassic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency: Pathophysiology, Diagnosis, and Treatment

49 citations , January 2010 in “International Journal of Pediatric Endocrinology”

This review covers the pathophysiology, diagnosis, and treatment of nonclassic congenital adrenal hyperplasia due to P450c21, but it reports no new clinical results.

A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia Among Women Presenting with Hyperandrogenic Symptoms and Signs

research A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia Among Women Presenting with Hyperandrogenic Symptoms and Signs

150 citations , November 2007 in “The Journal of Clinical Endocrinology and Metabolism”

This study determined that nonclassical congenital adrenal hyperplasia has a 2.2% prevalence among hyperandrogenic women in Spain, with basal serum 17-hydroxyprogesterone showing excellent diagnostic performance.

research Androgen Excess in Women: Experience with Over 1000 Consecutive Patients

947 citations , February 2004 in “The Journal of Clinical Endocrinology and Metabolism”

In this study, polycystic ovary syndrome was the most prevalent cause of androgen excess, and suppressive hormonal therapy improved hirsutism, menstrual dysfunction, and acne in most patients, though side effects were common.

research Prevalence of Polycystic Ovaries in Women with Androgenic Alopecia

84 citations , November 2003 in “European journal of endocrinology”

This study found that women with androgenic alopecia had a higher prevalence of polycystic ovarian morphology and higher androgen levels compared to controls, suggesting a strong association with PCO.

research Screening for 21-Hydroxylase-Deficient Nonclassic Adrenal Hyperplasia Among Hyperandrogenic Women: A Prospective Study

216 citations , November 1999 in “Fertility and Sterility”

This study found that a basal 17-hydroxyprogesterone level is effective for screening nonclassic adrenal hyperplasia in women, with a 4 ng/mL cutoff providing high specificity and positive predictive value.