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Mild androgen phenotypes.

Enrico Carmina1

  • 1Department of Clinical Medicine, University of Palermo, Via delle Croci 47, 90139 Palermo, Italy. enricocarmina@libero.it

Best Practice & Research. Clinical Endocrinology & Metabolism
|June 15, 2006
PubMed
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Mild androgen disorders, including ovulatory PCOS, affect women with normal cycles. These conditions require careful evaluation for metabolic and cardiovascular risks, especially when polycystic ovaries are present.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Women's Health

Background:

  • Mild androgen excess affects 30-40% of women with suspected hyperandrogenic syndrome.
  • These disorders present with hyperandrogenism signs in women with regular menstrual cycles.
  • Key conditions include ovulatory polycystic ovarian syndrome (PCOS), idiopathic hyperandrogenism, and idiopathic hirsutism.

Purpose of the Study:

  • To distinguish and characterize mild androgen disorders.
  • To highlight the clinical implications and management of ovulatory PCOS.
  • To differentiate idiopathic hyperandrogenism and hirsutism.

Main Methods:

  • Clinical and biological assessment of hyperandrogenism.
  • Diagnosis of ovulatory PCOS using ESHRE/ASRM criteria.

Related Experiment Videos

  • Ovarian sonography for polycystic ovary evaluation.
  • Assessment of glucose tolerance, dyslipidemia, and cardiovascular risk factors.

    • Main Results:

    • Ovulatory PCOS, characterized by hyperandrogenism and polycystic ovaries in ovulatory women, is part of the PCOS spectrum.
    • While fertility is not an issue, ovulatory PCOS is linked to insulin resistance and potential cardiovascular/metabolic risks.
    • Idiopathic hyperandrogenism and hirsutism involve normal ovaries; the former has elevated androgens, the latter has hirsutism with normal androgens. Differentiation can be challenging due to assay limitations.
    • Idiopathic hyperandrogenism may involve insulin resistance, but neither idiopathic disorder significantly increases cardiovascular risk.

    Conclusions:

    • Ovulatory hyperandrogenic patients require ovarian sonography to identify polycystic ovaries and assess cardiovascular/metabolic risks.
    • Insulin-sensitizing agents may benefit ovulatory PCOS patients with metabolic derangements.
    • Hirsutism in idiopathic hyperandrogenism and hirsutism can be managed with aesthetic or pharmacological approaches.