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Benign symptomatic hyperandrogenism in a postmenopausal woman
B D Cowan1, J L Moore, N S Whitworth
1Division of Reproductive Endocrinology, University of Mississippi Medical Center, Jackson.
Geriatrics
|December 11, 1991
Summary
Unexplained high androgen levels in postmenopausal women may stem from ovarian stromal overproduction, potentially treatable with gonadotropin suppression. This finding offers a new therapeutic avenue when tumors are ruled out.
Area of Science:
- Endocrinology
- Reproductive Medicine
Background:
- Postmenopausal hyperandrogenemia necessitates excluding pathological ovarian or adrenal conditions.
- Standard evaluations include biochemical testing and pelvic sonography.
Observation:
- A patient presented with hyperandrogenemia without signs of hypercortisolism, congenital adrenal hyperplasia, or neoplasia.
- Initial diagnostic workup did not reveal any identifiable pathologic cause.
Findings:
- The unexplained androgen excess was hypothesized to originate from gonadotropin-dependent ovarian stromal androgen production.
- This condition may mirror gestational hyperreactio luteinalis, characterized by elevated gonadotropins stimulating ovarian stromal cells.
Implications:
- Excluding neoplasia is crucial for diagnosis.
- Long-acting gonadotropin-releasing hormone agonists (GnRH-a) may benefit women with this syndrome by suppressing gonadotropins.