SAT-235 Severe Hyperandrogenemia in Postmenopausal Women as a Presentation of Ovarian Hypertheocosis

Abstract

Severe Hyperandrogenemia in Postmenopausal Woman as a Presentation of Ovarian Hyperthecosis Dr Sandeep Ganta, Dr Praveen Ganji, Dr Suresh V, Dr Alok Sachan Dr sai Krishna chaitnya,Dr sree divya Department of Endocrinology, SVIMS, Tirupathi,Andra Pradesh,India ABSTRACT BACK GROUND 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 CASE REPORT We report a case of 50 years old lady who came for evaluation of hirsutism and excessive weight gain. She had attained menopause 2 years back. On examination her weight was 77 kg ,height was 155 cms and BMI was 32.04 kg/m2. Modified FG score was 20, clitoromegaly and acanthosis nigricans were present. Her FSH was 8.4 IU/L(3.78-8.78IU/L), testosterone was 6.4 ng/ml(lt 0.6 ng/ml). Thyroid profile, overnight dexamathasone suppression, prolactin, DHEAS,17 hydroxy progesterone were with in normal range. On imaging, ultrasound of pelvis and Contrast enhanced CT for adrenal were normal. Patient was given a therapeutic trial of GnRH analogue(Leuprolide) for 3 months but no response was observed. Patient under went laproscopic oophorectomy. Biopsy showed stromal proliferation accompanied by luteinized stromal cells suggestive of ovarian hyperthecosis Two months After surgery serum testosterone had fallen to 0.04 ng/mL Conculsion Although ovarian hyperthecosis is a recognized cause of premenopausal virilization, it should also be included as an unusual cause of postmenopausal virilization. The demonstration that this syndrome can develop in the postmenopausal period, as in our patient, strongly suggest that it is a distinct entity and is unlikely to be a late stage of polycystic ovary syndrome.