Hyperandrogenism

Hyperandrogenism is one of the common causes of female infertility. This is an anomaly of the function of the hormonal system, characterized by hypersynthesis of androgenic hormones. According to statistics, hyperandrogenism is diagnosed in 10–20% of women of reproductive age and in 5% of girls during puberty and is one of the most common diseases of the endocrine system.

If the pathology has arisen due to a disruption of the endocrine glands, a diagnosis of primary hyperandrogenism is made. Primary hyperandrogenism depending on genesis happens:

• ovarian;
• adrenal;
• mixed.

When disorders associated with damage to the pituitary gland are talking about a secondary type of hyperandrogenic. It is also customary to distinguish between absolute (characterized by elevated levels of male sex hormones) and relative (hypersensitivity of the endings of target organs with normal androgen concentration) hyperandrogenism.

The main causes of hyperandrogenism are:

• congenital dysfunction of the adrenal cortex;
• polycystic ovaries;
• neoplasia (tumor) of the adrenal glands, ovaries, pituitary;
• persistent galactorrhea amenorrhea syndrome;
• use of androgenic steroids.

Regardless of origin, in women with hyperandrogenism the following symptoms are most often observed:

• hirsutism;
• dysfunction of the sebaceous glands;
• virilism (1 case per 100 patients);
• acne;
• partial baldness (with advanced form of the disease);
• irregular menstruation.

For correct diagnosis, an analysis of the clinical picture, an objective examination and a number of additional examinations are necessary. Due to the specificity of the clinical picture, it is possible to make a presumptive diagnosis at the initial examination stage. For the final diagnosis study of the level of sex hormones (both male and female), ultrasound of the ovaries and adrenal glands, as well as MRI of the pituitary gland should be prescribed.

Only a doctor can determine the reason of endocrinopathy and prescribe the correct therapy. Since hyperandrogenism is a manifestation of other pathologies, treatment is aimed at eliminating the underlying disease. In case of polycystic ovary syndrome, hormonal contraceptives are usually prescribed, and sometimes surgery is necessary. In congenital dysfunction of the adrenal cortex, glucocorticoid therapy is quite effective. Neoplastic processes, as one of the forms of neoplasm development, require complex specific medical treatment under the supervision of an oncologist and, often, surgical intervention.