Hyperandrogenic Disorders Flashcards
What is hyperandrogenism commonly associated with?
Polycystic ovary syndrome (PCOS); an endocrinopathy.
What percentage of women are affected by hyperandrogenism?
6% to 20% of all women.
What are common symptoms of hyperandrogenism?
Hirsutism, acne, androgenic alopecia, menstrual irregularity, infertility.
What are some adverse health outcomes associated with hyperandrogenism?
Endometrial cancer, type 2 diabetes, cardiovascular disease, metabolic syndrome.
What is the most common source of increased testosterone and androstenedione in hyperandrogenism?
The ovaries
How does elevated androgens and insulin affect sex hormone binding globulin (SHBG) synthesis?
Suppresses SHBG synthesis, leading to increased free testosterone and exacerbating insulin resistance.
What is hirsutism?
Excessive terminal hair growth in androgen-sensitive areas in women.
What can prolonged exposure to circulating androgens cause?
Alopecia (hair loss).
What is virilization?
Severe signs of androgen excess, including clitoral hypertrophy, deepening voice, increased muscle mass, breast atrophy, and male pattern baldness.
What percentage of women with PCOS are insulin resistant?
50%–70%.
What mental health conditions are more prevalent in women with PCOS?
Depressive disorders, anxiety disorders, and binge eating.
What key historical information should be obtained during assessment?
Age at thelarche (onset of breast development) and adrenarche (onset of adrenal gland maturation, leading to the production of androgens), age at menarche; menstrual pattern; pregnancy and medication history; onset of obesity, hirsutism, seborrhea, acne, alopecia.
What physical examination measures are essential for assessing hyperandrogenism?
Waist circumference, BMI, skin examination, thyroid and breast examination.
What diagnostic tests are used for hyperandrogenic disorders?
Serum prolactin, TSH, fasting lipid profile, 2-hour oral glucose tolerance test, serum progesterone, 17-hydroxyprogesterone, Cushing syndrome tests, pelvic ultrasonography, endometrial biopsy.
What are the key diagnostic criteria for PCOS?
Oligo- or anovulation, clinical and/or biochemical signs of hyperandrogenism, polycystic ovaries (string of pearls on US), exclusion of other androgen excess disorders.
