Sexual characteristics

Question 1

Define Hirsutism

Answer 1

Excessive hair growth in females where terminal hair does not normally grow
Growth in androgenic pattern

Question 2

What are the causes of Hirsutism?

Answer 2

Famialial
Idiopathic
Endocrine - Polycystic ovary syndrome, Cushing’s, Adrenal Ca, Steroids (Increased androgens)
Identify cause and treat accordingly

Question 3

What are the features of PCOS?

Answer 3

Secondary oligo-/amenorrhoea → infertility
Obesity
Acne
Hirsutism

Question 4

What investigations can be done in a patient with suspected PCOS?

Answer 4

US - Bilateral polycystic ovaries

Bloods - ↑ testosterone, ↑LH:FSH ratio

Question 5

What is the management of PCOS?

Answer 5

Metformin
COCP
Clomifene (specific oestrogen receptor modulator) for infertility

Question 6

Define Gynaecomastia

Answer 6

Abnormal amount of breast tissue in men usually due to hormone imbalances

Question 7

What are the causes of Gynaecomastia?

Answer 7

Can occur in normal puberty
Cirrhosis
Hypogonadism
Hyperthyroidism
Oestrogen- or HCG-producing tumours: e.g. testicular
Drugs: spironolactone, digoxin, oestrogen

Question 8

What are the causes of Erectile dysfunction?

Answer 8

Smoking
Alcohol excess
DM
Endocrine - Hyperthyroidism, Hypogonadism
Neurological - MS, cord lesion
Pelvic surgery - bladder, prostate
Penile abnormalities: Peyronie’s disease - fibrotic tissue causes deformity of shaft