Hiperandrogenismo y síndrome de ovario poliquístico

Resumo

Female hyperandrogenism may arise from congenital monogenic disorders, from functional polygenic disorders, or from dysregulated androgen secretion in tumours and hyperplasia. The clinical manifestations of hyperandrogenism consist of signs and symptoms of masculinisation (hirsutism, acne, alopecia, seborrhoeal, virilisation (enlargement of clitoris or labia minora, increase in muscle rnass, deepening of the voice] or defeminisation (loss of female secondary sexual characters such as mammary atrophy or loss of hip tat). The diagnosis relies on clinical history and physical examination and the diagnosis also requires assessment of androgen concentrations, ovulatory function and ovarian morphology in order to rule out the polycystic ovary syndrome, which is the most common cause. When clinical presentation suggests dysregulated androgen secretion by tumours or hyperplasia the diagnosis relies mostly on adrenal and ovarian imaging techniques. Treatment of functional hyperandrogenism is chronic and must focus on amelioration of hyperandrogenism symptoms, restoration of fertility and cardiometabolic prevention. In addition to life-style modification, drug treatment, especially with antiandrogenic oral contraceptives, may be needed. Non-functional causes usually require a surgical approach.