Ovarian overproduction of androgens

Definition
This condition involves overproduction by the ovaries of hormones (such as testosterone) that stimulate the development of male characteristics.

Causes, incidence, and risk factors
In healthy women, the ovaries and adrenal glands produce about 40% to 50% of the body’s testosterone. Excess androgen production in the ovaries may result from tumors of the ovaries or adrenal glands, polycystic ovarian disease (characterized by enlarged ovaries containing multiple fluid-filled cysts), Cushing’s disease (an abnormality in the pituitary gland resulting in excess amounts of corticosteroids, hormones which alter body fat distribution), and congenital adrenal hyperplasia (a group of disorders caused by an enzyme defect during fetal development).

Symptoms

     
  • Increase in body hair in a male pattern (hirsutism)  
  • Oily skin  
  • Acne  
  • Virilization (development of masculine characteristics, such as a low-pitched voice)  
  • Decrease in breast size  
  • Changes in female body contour  
  • Temporal balding (thinning hair and Hair loss)  
  • Increase in muscle mass  
  • Clitoromegaly (enlargement of the clitoris)  
  • Amenorrhea (absence of menstrual periods)

Signs and tests

     
  • Testosterone  
  • DHEA-S  
  • 17-hydroxyprogesterone  
  • ACTH test  
  • Pelvic ultrasound  
  • CT scan

Treatment
Treatment depends on the underlying diagnosis causing the increased androgen production. Medications can be given to decrease hair production for patients who have hirsutism or to regulate menstrual cycles. In some cases, surgery may be necessary to remove an ovarian or adrenal tumor.

Expectations (prognosis)
The success of the treatment depends on what caused the excess androgen production. If the condition is caused by an ovarian tumor, surgical removal of the tumor may correct the problem. Most ovarian tumors are benign, and will not recur after surgical removal.

Complications

infertility is a possible complication.

Prevention
There is no known prevention.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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