title: Gonadotropin-releasing hormone agonist treatment in postmenopausal women with hyperandrogenism of ovarian origin.
abstract: BACKGROUND
  The most frequent cause of virilization in postmenopausal women is excessive androgen production of ovarian origin. Bilateral oophorectomy is usually performed, even in cases of benign tumors or hyperthecosis. This is the first report of a case series of long-term GnRH-agonist treatment of hyperandrogenism in postmenopausal women.
  
  
  OBJECTIVE
  We present three women with postmenopausal hyperandrogenism of ovarian origin who were treated with GnRH agonists.
  
  
  METHODS
  We describe three cases of postmenopausal women with virilization and hyperandrogenism of presumed ovarian origin, all with slight enlargement of the ovaries but without visualization of a tumor, who had long-term treatment with GnRH agonists. No histological diagnosis was available, and therefore all patients received careful follow-up, including periodic testing of androgen levels and ovarian imaging by computed tomography scans. The three patients responded in different ways to treatment with GnRH agonists.
  
  
  CONCLUSIONS
  Long-term GnRH agonist treatment is an acceptable choice for treatment of postmenopausal hyperandrogenism in patients where ovarian origin of androgen excess is ascertained, and especially in those patients who have an increased risk for surgery due to comorbidities or who are unwilling to undergo bilateral oophorectomy.
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands. esthertuinman@gmail.com
authors.forename: Esther S
authors.initials: ES
authors.lastname: Vollaard
authors.forename: André P
authors.initials: AP
authors.lastname: van Beek
authors.forename: Frederik A J
authors.initials: FA
authors.lastname: Verburg
authors.forename: Annemieke
authors.initials: A
authors.lastname: Roos
authors.forename: Jolande A
authors.initials: JA
authors.lastname: Land
mesh_terms: D000368:Aged; D000505:Alopecia / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000502:physiology*; D006628:Hirsutism / Q000150:complications; D006801:Humans; D017588:Hyperandrogenism / Q000188:drug therapy* / Q000503:physiopathology; D006973:Hypertension / Q000150:complications; D016729:Leuprolide / Q000627:therapeutic use*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D017698:Postmenopause / Q000502:physiology*; D014057:Tomography, X-Ray Computed
chemical_list: D012739:Gonadal Steroid Hormones; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide