An interesting cause of hyperandrogenemic hirsutism.

Murat Atmaca,Murat Alay,İsmet Seven,Veysi Barut,Yasin Sezgin,Yaren Dirik,Rıfkı Üçler

doi:10.1155/2014/987272

Murat Atmaca, Murat Alay + Show 5 more

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https://doi.org/10.1155/2014/987272

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Abstract

Mild clinical signs of hyperandrogenism such as hirsutism may appear during the menopausal transition as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess. We report a case of a 68-year-old woman with signs of virilization that had started 6 months before. Clinical analyses revealed high levels of serum testosterone for a postmenopausal woman. Pelvic MRI and abdomen CT showed no evidence of ovarian and adrenal tumor. Postmenopausal hyperandrogenism can be the result of numerous etiologies ranging from normal physiologic changes to ovarian or rarely adrenal tumors. Our patient was found to have iatrogenic hyperandrogenism. This condition is rarely reported cause of virilization.

Highlights

The postmenopausal ovary remains hormonally active and secreting significant amounts of androgens and relatively less estrogens many years after menopause [1]
The development of true hirsutism, alopecia, or acne should not be considered normal in postmenopausal women
The case was hospitalized for differential diagnoses of hyperandrogenism including polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), Cushing’s syndrome, and benign and malignant androgen-secreting ovarian and adrenal tumors

Summary

Introduction

The postmenopausal ovary remains hormonally active and secreting significant amounts of androgens and relatively less estrogens many years after menopause [1]. The very high gonadotropin levels of menopause could maintain ovarian androgen production [2, 3]. This imbalance between estrogens and androgens after menopause is amplified further by the evolving decrease in sex hormone binding globulin (SHBG) concentrations and the subsequent increase of free androgen index [4]. The development of true hirsutism (defined as the presence of excessive terminal hair in androgen-dependent areas), alopecia, or acne should not be considered normal in postmenopausal women. A 68-year-old postmenopausal case with virilization is presented with a discussion referenced to the medical literature

Case Report

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