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Obstetrics & Gynecology 2002;99:893-897
© 2002 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Postmenopausal Hyperthecosis: Functional Dysregulation of Androgenesis in Climacteric Ovary

Esther Krug, MD and Sarah L. Berga, MD

Division of Endocrinology, Department of Medicine, and the Division of Reproductive Endocrinology and Infertility, Departments of Obstetrics, Gynecology and Reproductive Sciences and Psychiatry, The University of Pittsburgh School of Medicine and Magee-Womens Hospital, Pittsburgh, Pennsylvania

Address reprint requests to: Sarah L. Berga, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA15213; E-mail: sberga{at}mail.magee.edu.

ABSTRACT

BACKGROUND: Hyperandrogenism of ovarian origin is rare in postmenopausal women. However, there is evidence that the ovaries of postmenopausal women are active endocrine glands, secreting mainly androgens.

CASE: A postmenopausal woman sought treatment for progressive hirsutism. Endocrine evaluation revealed androgen excess. Transvaginal ultrasound revealed enlarged ovaries. Hysterectomy and bilateral oophorectomy were recommended. However, surgery had to be withheld for 6 months while the patient recovered from an acute myocardial infarction. In the interim, the patient’s hyperandrogenemia was successfully treated with monthly injections of the gonadotropin-releasing hormone agonist (GnRH), leuprolide acetate.

CONCLUSION: This report illustrates the potential for post-menopausal ovaries to become active androgen-secreting endocrine organs. It also demonstrates the efficacy of pharmacologic intervention for postmenopausal ovarian hyperthecosis when the patient is a poor surgical candidate.




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