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Non-PCOS Hyperandrogenic Disorders in Adolescents
M Rebeca Esquivel-Zuniga1, Cassandra K Kirschner2, Christopher R McCartney3,4
1Division of Endocrinology and Metabolism, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia.
Seminars in Reproductive Medicine
|January 20, 2022
Summary
This study focuses on hyperandrogenism in adolescent girls, excluding PCOS. It details clinical signs and proposes an evaluation algorithm for androgen excess, aiding diagnosis and management.
Area of Science:
- Pediatric Endocrinology
- Reproductive Endocrinology
- Adolescent Medicine
Background:
- Hyperandrogenism, characterized by excess androgen production or action, affects 3-20% of adolescent girls.
- Common causes in prepubertal girls include premature adrenarche (60%) and congenital adrenal hyperplasia (CAH; 4%).
- In pubertal girls, polycystic ovary syndrome (PCOS; 20-40%) and CAH (14%) are prevalent, while tumors are rare (0.2%).
Purpose of the Study:
- To outline clinical manifestations of non-PCOS-related hyperandrogenism in adolescent girls.
- To provide management considerations for these conditions.
- To propose a diagnostic algorithm for evaluating androgen excess in this population.
Main Methods:
- Review of clinical features associated with hyperandrogenism.
- Analysis of etiologies of androgen excess in prepubertal and pubertal girls.
- Development of a diagnostic algorithm for non-PCOS hyperandrogenism.
Main Results:
- Common signs include early pubic hair, acne, and hirsutism.
- Overt virilization signs necessitate detailed evaluation.
- The proposed algorithm aids in differentiating causes of androgen excess.
Conclusions:
- Early identification and evaluation of hyperandrogenism are crucial in adolescent girls.
- The diagnostic algorithm assists in managing non-PCOS related androgen excess.
- Understanding diverse etiologies is key for appropriate patient care.
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