androgen excess (hyperandrogenism)
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Etiology
- postmenopausal hyperandrogenism
- functional hyperandrogenism
- tumor-associated hyperandrogenism
- adrenal adenoma, adrenal carcinoma (androgen secreting)*
- ovarian neoplasm (androgen secreting)*
- metastatic neuroendocrine tumor
* androgen-secreting ovarian tumors are uncommon among ovarian tumors but much more common than androgen-secreting adrenal tumors[1]
* markedly elevated serum DHEA-sulfate makes adrenal neoplasm more likely than ovarian neoplasm[2]
Clinical manifestations
- disorders of the pilosebaceous unit
- ovulatory dysfunction
- emotional lability
- excessive muscle bulk
- small testes, testicular atrophy
- gynecomastia
- diminished spermatogenesis & male infertility
- hypogonadotropic hypogonadism
Laboratory
- serum testosterone elevated
- serum free testosterone elevated
- serum DHEA may be normal if testosterone is elevated
Radiology
- pelvic ultrasound to evaluate ovarian neoplasm
- abdominal CT to evaluate adrenal neoplasm
More general terms
Additional terms
References
- ↑ 1.0 1.1 McMahon GT, Bennett JA. CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL. Case 33-2015. A 57-Year-Old Woman with Hair Loss and Deepening Voice. N Engl J Med. 2015 Oct 22;373(17):1660-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26488697
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2022.
- ↑ Barbieri RL, Makris A, Randall RW et al Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. J Clin Endocrinol Metab. 1986 May;62(5):904-10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/3514651
- ↑ Markopoulos MC, Kassi E, Alexandraki KI, Mastorakos G, Kaltsas G. Hyperandrogenism after menopause. Eur J Endocrinol. 2015 Feb;172(2):R79-91. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25225480