Usually, women with hyperandrogenism suffer from a lack of menstruation, have problems conceiving and wear the fetus. In many cases, the symptoms of the condition are mild, which is why those affected do not suspect its presence. The body, among others, synthesizes specific hormones on which its ability to reproduce and the manifestation of external genitalia depend. The special thing about these hormones is that they are synthesized in both men and women, but in different amounts according to gender. For example, the female organism produces, in addition to the typical female, male sex hormones, but in a limited concentration. The same is true for men. It is normal for men to synthesize more androgens, for women estrogens. However, there are conditions in which there is a higher than normal synthesis of hormones characteristic of the opposite sex. Such a condition is hyperandrogenism. With it, the amounts of androgens synthesized in the female organism are above the permissible limits for the norm. Increased synthesis of male sex hormones in women affects certain organs, such as ovaries, and certain tissues, such as skin, sweat and sebaceous glands, and hair. The pathological condition can be due to problems coming from the ovaries, adrenal glands, pituitary gland and hypothalamus. Causes of hyperandrogenism: congenital dysfunction of the adrenal glands, functional changes in the ovaries and adrenal glands, tumor process in the ovaries and adrenal glands, diseases of the hypothalamic-pituitary system, hypofunction of the thyroid gland, increased synthesis of prolactin, taking drugs with an androgenic effect, such as steroids agents, gestagens, doping, etc. stress – which affects the functions of the adrenal glands and increases the secretion of male sex hormones. Symptoms A sign of hyperandrogenism is the appearance of male-type hair on a woman’s face and body – hair over the upper lip, chin, neck, cheeks, around the areola of the breasts, the midline of the abdomen, thighs, etc. The condition is known under the term hirsutism. Appearance of seborrhea and thinning of the hair (diffuse alopecia). Disorders of the menstrual cycle – irregular cycle, amenorrhea. In case of congenital hyperandrogenism, the first menstruation occurs later than in other girls. Hyperandrogenism is also reflected in the appearance of the woman – the physique resembles a man’s, the shoulder girdle is highly developed, the pelvis is narrower, the musculature is more pronounced, there are almost no fat deposits on the hips, the breasts are small, the timbre of the voice is lower. The presence of acne, oily and porous skin on the face and back is also an indicator of increased secretion of androgens. Obesity is a specific sign of hyperandrogenism of pituitary origin. In hyperandrogenism, it is disturbed tissue sensitivity to insulin, which leads to an increased presence of insulin in the blood and becomes a predisposing factor for the development of diabetes mellitus. The excess amount of androgens affects the menstrual cycle and ovarian functions.Anovulatory cycles occur, in which the mature ovum cannot be separated from the follicle due to the formation of a too dense covering of the ovary. The condition can be a cause of infertility and requires treatment at planning and during pregnancy. Hyperandrogenism is a cause of placental insufficiency, it also affects the development of the fetus. During childbirth, it is possible to observe insufficiently active labor activity (insufficiently strong contractions). Hyperandrogenism in menopause appears as a consequence of the decrease in the synthesis of estrogens in the female organism, a decrease in sex-hormone binding globulin and an increase in testosterone secretion from the ovary. . Diagnosis Making the diagnosis is a complex process, especially in cases of a milder form of hyperandrogenism. A careful evaluation is required for symptoms that may be present at birth, appear gradually after puberty, or appear suddenly at a sexually active age. Laboratory and instrumental tests are ordered. Blood analysis and hormonal tests of luteinizing hormone, follicle-stimulating hormone, estradiol, 17-OHP, testosterone, androstenedione, DNEAS and the products of the breakdown of androgens are performed; urine analysis to determine the level of 17-OHP and testosterone; as well as ultrasound examination of the uterus, ovaries and adrenal glands; x-ray examination to rule out pituitary pathology (the Turkish saddle of the skull is looked at), tomography. Treatment Treatment methods are tailored according to the degree of hyperandrogenism and the goal: overcoming changes in appearance, restoring reproductive capacity, successful development of pregnancy. Surgery is required when a tumor of the ovaries or adrenal glands is detected. When the cause is in the pituitary gland and hypothalamus, special therapy is undertaken. Contraceptive tablets (Diane-35, Janin) are prescribed to normalize the functions of the sebaceous glands and against acne. Glucocorticoids (dexamethasone) are prescribed for the oversecretion of androgens from the adrenal glands and to maintain the pregnancy. In the case of polycystic ovary syndrome, appropriate hormone therapy is prescribed, laparoscopic surgery is also possible at the doctor’s discretion.A careful evaluation is required for symptoms that may be present at birth, appear gradually after puberty, or appear suddenly at a sexually active age. Laboratory and instrumental tests are ordered. Blood analysis and hormonal tests of luteinizing hormone, follicle-stimulating hormone, estradiol, 17-OHP, testosterone, androstenedione, DNEAS and the products of the breakdown of androgens are performed; urine analysis to determine the level of 17-OHP and testosterone; as well as ultrasound examination of the uterus, ovaries and adrenal glands; x-ray examination to rule out pituitary pathology (the Turkish saddle of the skull is looked at), tomography. Treatment Treatment methods are tailored according to the degree of hyperandrogenism and the goal: overcoming changes in appearance, restoring reproductive capacity, successful development of pregnancy. Surgery is required when a tumor of the ovaries or adrenal glands is detected. When the cause is in the pituitary gland and hypothalamus, special therapy is undertaken. Contraceptive tablets (Diane-35, Janin) are prescribed to normalize the functions of the sebaceous glands and against acne. Glucocorticoids (dexamethasone) are prescribed for the oversecretion of androgens from the adrenal glands and to maintain the pregnancy. In the case of polycystic ovary syndrome, appropriate hormonal therapy is prescribed, laparoscopic surgery is also possible at the doctor’s discretion.A careful evaluation is required for symptoms that may be present at birth, appear gradually after puberty, or appear suddenly at a sexually active age. Laboratory and instrumental tests are ordered. Blood analysis and hormonal tests of luteinizing hormone, follicle-stimulating hormone, estradiol, 17-OHP, testosterone, androstenedione, DNEAS and the products of the breakdown of androgens are performed; urine analysis to determine the level of 17-OHP and testosterone; as well as ultrasound examination of the uterus, ovaries and adrenal glands; x-ray examination to rule out pituitary pathology (the Turkish saddle of the skull is looked at), tomography. Treatment Treatment methods are tailored according to the degree of hyperandrogenism and the goal: overcoming changes in appearance, restoring reproductive capacity, successful development of pregnancy. Surgery is required when a tumor of the ovaries or adrenal glands is detected. When the cause is in the pituitary gland and hypothalamus, special therapy is undertaken. Contraceptive tablets (Diane-35, Janin) are prescribed to normalize the functions of the sebaceous glands and against acne. Glucocorticoids (dexamethasone) are prescribed for the oversecretion of androgens from the adrenal glands and to maintain the pregnancy. In the case of polycystic ovary syndrome, appropriate hormonal therapy is prescribed, laparoscopic surgery is also possible at the doctor’s discretion.
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