A prospective study of the prevalence of clear‐cut endocrine disorders and polycystic ovaries in 350 patients presenting with hirsutism or androgenic alopecia

O'Driscoll, J. B.; Mamtora, H.; Higginson, Jason; Pollock, Alexander C; Kane, John; Anderson, D. C.

doi:10.1111/j.1365-2265.1994.tb02535.x

Cited by 145 publications

(76 citation statements)

References 24 publications

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“…Specifically, ovarian ultrasound was not routinely used in the diagnosis of PCOS. O'Driscoll and co-workers (8) studied 350 women with 'hirsutism or androgenetic alopecia' (the study does not specify how many women had alopecia and how many had hirsutism) and found a 60% prevalence of PCO upon ultrasound scan (8). They did not report on androgen levels apart from describing eight patients with clearcut endocrine disorders.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of polycystic ovaries in women with androgenic alopecia

Cela¹,

Robertson²,

Rush³

et al. 2003

Eur J Endocrinol

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Objective: Although androgenic alopecia is recognised to be a symptom of polycystic ovary syndrome (PCOS), it is not known whether polycystic ovaries (PCO) and associated endocrine abnormalities are present in patients who present with alopecia as a primary complaint. We therefore set out to determine the strength of the association between androgenic alopecia and PCO. We examined the prevalence of ultrasound-based polycystic ovarian morphology and associated clinical and biochemical features in a large multiethnic group of women whose presenting complaint was of alopecia, and in a control group. Subjects and methods: We studied 89 women of mixed ethnic origin with androgenic alopecia and compared them to 73 control women. A detailed history was taken, anthropometry was performed and assessment of body-hair distribution was made. The presence of PCO was established by pelvic ultrasound scan. Serum gonadotrophins, testosterone, androstenedione, dihydrotestosterone and sex hormone binding globulin concentrations were measured. Results: Women with alopecia had a higher prevalence of PCO and hirsutism than the control population (PCO: 67% vs 27%, P , 0.00001; hirsutism: 21% vs 4%, P ¼ 0.003). Women with alopecia (with or without PCO) had higher testosterone, androstenedione and free androgen index than controls, even though few had frankly abnormal androgens. Conclusions: These findings confirm an association between androgenic alopecia and PCO, and other symptoms of hyperandrogenaemia. Thus most women who present with androgenic alopecia as their primary complaint also have PCO and have indices of abnormal androgen production. Since PCO is a well known risk factor for development of type 2 diabetes, this association has important implications for long-term management.

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Section: Introductionmentioning

confidence: 99%

Prevalence of polycystic ovaries in women with androgenic alopecia

Cela¹,

Robertson²,

Rush³

et al. 2003

Eur J Endocrinol

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“…The etiologies of hirsutism in this study were PCOS (79%), IH (13%), IHA (6%), and NCAH (2%), which was similar to the previous literature (26,35,36,37,38). Patients were checked for the presence of ovulation, and hirsute patients with anovulatory regular cycles were included in the PCOS group.…”

Section: Discussionmentioning

confidence: 57%

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Karaca

Acmaz

Açmaz

et al. 2013

European Journal of Endocrinology

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Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.

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“…Women with OH typically present with a long history of slowly progressive hyperandrogenism often resulting in virilization. Their hormonal profile is characterized by markedly increased serum testosterone levels (O150 ng/dl) in the absence of other elevated androgens, accompanied with high gonadotropin levels (39,40,41); ultrasound examination usually reveals bilaterally bigger than normal postmenopausal ovaries (mean size 7.7G2.3 vs 2.3G0.01 ml respectively) (39,42,43). The diagnosis is confirmed histologically demonstrating the characteristic nests of differentiated ovarian interstitial cells into steroidogenically active luteinized stromal cells throughout the ovarian stroma (44).…”

Section: Ovarian Hyperthecosismentioning

confidence: 82%

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

Markopoulos

Kassi

Alexandraki

et al. 2015

European Journal of Endocrinology

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Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from either the adrenals and/or the ovaries, clinically manifested as the appearance and/or increase in terminal hair growth or the development of symptoms/signs of virilization. In either settings, physicians need to evaluate such patients and exclude the presence of the relatively rare but potentially life-threatening underlying tumorous causes, particularly adrenal androgen-secreting tumors. It has been suggested that the rapidity of onset along with severity of symptom and the degree of androgen excess followed by relevant imaging studies may suffice to identify the source of excessive androgen secretion. However, up to date, there is no consensus regarding specific clinical and hormonal indices and/or imaging modalities required for diagnostic certainty. This is particularly relevant as the aging population is increasing and more cases of postmenopausal women with clinical/biochemical evidence of hyperandrogenism may become apparent. Furthermore, the long-term sequels of nontumorous hyperandrogenism in postmenopausal women in respect to cardiovascular morbidity and mortality still remain unsettled. This review delineates the etiology and pathophysiology of relative and absolute androgen excess in postmenopausal women. Also, it attempts to unravel distinctive clinical features along with specific hormonal cut-off levels and/or appropriate imaging modalities for the facilitation of the differential diagnosis and the identification of potential long-term sequels.

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A prospective study of the prevalence of clear‐cut endocrine disorders and polycystic ovaries in 350 patients presenting with hirsutism or androgenic alopecia

Abstract: For the exclusion of enzyme deficiencies and virilizing tumours clinical assessment and a single serum testosterone measurement will suffice.

Cited by 145 publications

References 24 publications

Prevalence of polycystic ovaries in women with androgenic alopecia

Prevalence of polycystic ovaries in women with androgenic alopecia

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

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