Hyperandrogenemia
Classification according to ICD-10 | |
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E29.0 | Hyperandrogenemia |
ICD-10 online (WHO version 2019) |
The hyperandrogenaemia provides increased androgen production both in men and in women is. It therefore is one of the hormonal disorders and is in clinical relevance of endocrine treatment specialists.
Occurrence
Hyperandrogenic disorders are common in adolescents and, in the context of polycystic ovary syndrome, in women. There are also other rarer genetic and other diseases that lead to this hormonal imbalance.
Clinical symptoms
- Acne (particularly severe in 50% of cases of hyperandrogenemia)
- Androgenic alopecia
- Seborrhea
- Cycle irregularities
- Hirsutism
- Increases in libido
- Breast atrophy
- Virilization
- Metabolic syndrome
Diagnosis
Laboratory diagnostics can result in:
- increased free such as total testosterone , androstenedione and dehydroepiandrosterone sulfate levels
- increased cortisol levels (with steroid abuse )
- decreased SHBG mirrors
- increased LH / FSH quotient
- Hyperinsulinemia
- increased AMH
- increased free androgen index
Possible tests:
The determination of these levels allows etiological conclusions to be drawn in the diagnosis based on the different production sites of these hormones and thus clarification of ovarian , testicular or adrenal pathogenesis in the patient.
Causes and differential diagnosis
- Polycystic ovary syndrome
- Adrenal enzyme defect
- Hypercortisolism
- Androgen-forming tumor
- Adrenogenital Syndrome
- Steroid abuse
Possible consequences and complications
- infertility
- Hypercholesterolemia
- Cardiovascular diseases
- Endometrial cancer risk (3-fold increased)
- Pregnancy complications
- mental disorders
- social problems
- increased miscarriages
therapy
Essentially, the therapy depends on the respective cause in the present case and aims to eliminate any existing tissue growth or underlying hormonal or alimentary disorders. The individual therapy options and steps are described for the individual clinical pictures depending on the cause.
literature
- Michael Ludwig, Frank Nawroth, Christoph Keck: fertility consultation . 3. Edition. Springer, 2015, ISBN 978-3-662-46013-9 .
- M. Kaufmann: Gynecology. Springer, 2013, ISBN 978-3-642-20923-9 .
- Freimut Leidenberger, Thomas Strowitzki , Olaf Ortmann : Clinical endocrinology for gynecologists. 5th edition. Springer, 2014, ISBN 978-3-642-38042-6 .
Individual evidence
- ↑ A. Gambineri, R. Pasquali: Prevalence of hyperandrogenic states in late adolescent and young women: epidemiological survey on italian high-school students. In: The Journal of Clinical Endocrinology and Metabolism. Volume 98, Number 4, April 2013, pp. 1641-1650. PMID 23436925 .
- ↑ Dissertation on PCOS. (PDF) Freie Universität Berlin, accessed on November 4, 2015 .
- ↑ a b Basic diagnosis of hyperandrogenemia in women - summary overview. IMD Labor Berlin-Potsdam, accessed on November 4, 2015 .
- ↑ M. Noll-Hussong, A. Birkhofer, H. Forstl: Schizophrenic psychosis with polycystic ovarian syndrome and lupus erythematosus. In: Neuropsychiatr. [Case Reports]. 25 (4), 2011, pp. 216-218.