title: Investigative strategy of hyperandrogenism in women.
abstract: Investigative procedures in the assessment of female hyperandrogenism are reviewed. Based on their experience, the authors suggest an inexpensive investigative strategy in hyperandrogenic females consisting of the following: the first step depends upon the clinical symptoms--in cases of hirsutism with regular menstrual cycles, plasma testosterone (T) and plasma dehydroepiandrosterone sulfate (DHA-S) are assayed, and the basal body temperature chart is recorded. In cases of hirsutism with irregular or anovulatory menstrual cycles, in addition to T and DHA-S, plasma 17-hydroxyprogesterone and urinary-free cortisol are assayed. In case of anovulation without hirsutism, T and DHA-S are assayed, and the LHRH test is performed. The results of this first investigation allow to attribute to the woman one of the six following hormone profiles: (1) metabolic hyperadrenalism; (2) tumoral hyperandrogenism; (3) 21-hydroxylase defect; (4) nontumoral DHA-S increase; (5) nontumoral ovarian hyperandrogenism; (6) idiopathic hirsutism. The additional investigative procedures required in each of these groups are detailed.
mesh_terms: D000312:Adrenal Hyperplasia, Congenital; D000728:Androgens / Q000378:metabolism*; D003480:Cushing Syndrome / Q000175:diagnosis; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology; D006628:Hirsutism / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008598:Menstruation; D010048:Ovarian Cysts / Q000175:diagnosis; D010060:Ovulation; D012306:Risk; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D003687:Dehydroepiandrosterone