Hyperandrogenism in Adolescent Girls

Mild symptoms of hyperandrogenism, such as acne or hyperseborrhea, are frequent in adolescent girls, and are often associated with irregular menstrual cycles. In most instances, these symptoms are transient and only reflect the immaturity of the hypothalamic-pituitary-ovary axis during the first years following menarche. In some subjects, however, these manifestations can persist and even worsen, and hirsutism may appear, thus revealing an adrenal or ovarian disorder whose most common cause is the polycystic ovary syndrome (PCOS).

The management of an adolescent hyperandrogenic girl must achieve three main goals: (1) eliminate a severe cause of hyperandrogenism, such as an adrenal or ovarian tumor, or the non-classic adrenal hyperplasia (NCAH); (2) recognize PCOS early on, in order to set up antiandrogen therapy without delay and to initiate the prevention of obesity and insulin resistance, and (3) distinguish the so-called physiological hyperandrogenism of puberty, which will resume within 1 - 2 years, from a nascent PCOS.

Christine Cortet-Rudelli, Didier Dewailly


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Revision date: July 7, 2011
Last revised: by Sebastian Scheller, MD, ScD