Cetrorelix Suppression Test in the Diagnostic Work-up of Severe Hyperandrogenism in Adolescence

Abstract

The Cetrorelix suppression test appears to be a promising instrument to help solve the differential diagnosis of severe hyperandrogenism in adolescence.

Cardiovascular disease among diabetic women with bilateral oophorectomy.

“…This study (297), challenges the assumption that an adverse CVD risk profile is the culprit for the elevated risk in CVD among oophorectomized women, but offers another biological mechanism by which hysterectomy with bilateral oophorectomy may influence women's cardiovascular health.…”

“…In premenopausal women, luteinizing hormone (LH) is known to drive the production of testosterone (297), and increased production of LH in the menopause may stimulate the ovaries to produce more testosterone (35). Diabetic women are insulin resistant, and hyperinsulinemia stimulates ovarian production of testosterone while insulin resistance results in lower levels of SHBG (298), which together may result in increased testosterone in diabetic women (36).…”

“…Some studies have even argued that post-surgical use of estrogens in women who have oophorectomy at an early age may not protect against the progression of atherosclerosis. The Los Angeles Atherosclerosis Study, which assessed the cross-sectional relationship between years since bilateral oophorectomy and common carotid artery intima-media thickness in 269 women aged 45 to 60, reported that bilateral oophorectomy was associated with increasing atherosclerosis independent of high density lipoprotein or low density lipoprotein cholesterol (297).…”

“…Interestingly, 90 percent of women with oophorectomy (at an average age of 40 years) had a history of hormone therapy use, which suggests that postsurgical estrogen use may not entirely compensate for the loss of estrogen or loss of the overall imbalance of multiple sex hormones that occur when the ovaries are removed (297).…”

“…These prospective studies were also of sufficient size and duration (> 18 years) to allow associations with incident cardiovascular outcomes to be assessed with good precision. Furthermore, total testosterone was measured by radioimmunoassay after extraction and aluminum oxide column chromatography which exhibits good precision, sensitivity, and high accuracy comparable to liquid chromatography-tandem mass spectrometry, in measuring female androgen concentrations, (297).…”