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Androgen excess: Investigations and management
Daria Lizneva1, Larisa Gavrilova-Jordan2, Walidah Walker2
1Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta State University, 1120 15th Street, 30912 Augusta, GA, USA; Medical Company IDK, ul. Entuziastov 29, 443067 Samara, Russian Federation; Department of Reproductive Health Protection, Scientific Center of Family Health and Human Reproduction, ul. Timiryazeva 16, 664003 Irkutsk, Russian Federation.
Summary
Androgen excess (AE) in polycystic ovary syndrome (PCOS) causes symptoms like hirsutism and acne. Management involves medical and cosmetic treatments, with varying response times for different symptoms.
Area of Science:
- Endocrinology
- Dermatology
- Gynecology
Background:
- Androgen excess (AE) is a defining characteristic of polycystic ovary syndrome (PCOS).
- AE contributes to ovulatory dysfunction, menstrual irregularities, hirsutism, acne, and female pattern hair loss (FPHL).
Purpose of the Study:
- To outline the evaluation and management of clinical hyperandrogenism in PCOS patients.
- To detail diagnostic methods and therapeutic strategies for AE-related symptoms.
Main Methods:
- Clinical assessment including the modified Ferriman-Gallwey method for hirsutism.
- Biochemical evaluation of hyperandrogenism using testosterone (T), dehydroepiandrosterone sulfate (DHEAS), and androstenedione assays.
- Management strategies encompassing androgen suppression, blockade, and combined medical and cosmetic treatments.
Main Results:
- Acne typically responds rapidly to treatment.
- Hirsutism improvement is observed between 3-8 months of therapy.
- Female pattern hair loss (FPHL) shows the slowest response, often requiring 12-18 months for noticeable results.
Conclusions:
- Effective management of AE in PCOS requires a multi-faceted approach.
- Treatment outcomes vary significantly based on the specific symptom, necessitating patient counseling on realistic timelines.
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