Ovarian hyperthecosis, diabetes and hirsuties in post-menopausal women.
OBJECTIVE
We describe four patients with ovarian hyperthecosis and the effects of gonadotrophin releasing hormone on clinical and metabolic variables.


METHODS
Open out-patient study.


METHODS
Four women presented with post-menopausal hirsuties. They had significant hair growth across the chest, upper back and shoulders. Three had histologically proven ovarian hyperthecosis and a fourth had large ovaries visualized on ultrasound. All four women had pronounced risk factors for vascular disease; hypertension, hyperlipidaemia and glucose intolerance, and three had already developed symptomatic vascular disease.


RESULTS
Gonadotrophin releasing hormone agonist therapy resulted in significant reduction in plasma androgens and cosmetic reduction in hair growth but had no effect on hyperlipidaemia.


CONCLUSIONS
The post-menopausal women described in this report were clinically considered to have hyperandrogenism due to the pathological pattern of marked body hair over the upper trunk. Treatment with GnRH was very effective at reducing the severity of the hirsuties. The post-menopausal women with hyperthecosis in this report had a high prevalence of cardiovascular disease. Since hyperandrogenism and insulin are considered risk factors for cardiovascular disease in premenopausal women with polycystic ovaries, we discuss the possible relationship between insulin and the post-menopausal ovary.
Barth
J H
JH
Department of Chemical Pathology, Leeds General Infirmary, UK. J.H.Barth@Leeds.ac.uk
Jenkins
M
M
Belchetz
P E
PE
D000368:Aged; D000728:Androgens / Q000097:blood*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D017273:Goserelin / Q000627:therapeutic use; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D010049:Ovarian Diseases / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D010053:Ovary / Q000473:pathology; D017698:Postmenopause / Q000097:blood*; D012907:Smoking
D000728:Androgens; D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin