Yildiz Bulent O
Endocrinology and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100 Hacettepe, Ankara, Turkey.
Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):167-76. doi: 10.1016/j.beem.2006.02.004.
Hyperandrogenism or androgen excess is a common endocrine disorder of women of reproductive-age, with a prevalence of 5-10%. The majority of patients with hyperandrogenism will have polycystic ovary syndrome. Hyperandrogenism presents a complex diagnostic challenge for both the practicing physician and the clinical investigator. Clinical manifestations of hyperandrogenism include hirsutism, acne, androgenic alopecia, and virilization. Hirsutism, defined as excessive growth of terminal hair in women in a male-like pattern, is the most commonly used clinical diagnostic criterion of hyperandrogenism. The presence of hirsutism is usually determined by using a standardized scoring system of hair growth. Depending on the definition, hirsutism is present in up to 80% of patients with hyperandrogenism. Acne and androgenic alopecia are other common androgenic skin changes, and might be observed without hirsutism in some hyperandrogenic women. However, isolated presence of any of these manifestations is not used as a diagnostic criterion for hyperandrogenism. Virilization is a relatively uncommon feature of hyperandrogenism, and its presence often suggests an androgen-producing tumor. A thorough history and a focused clinical examination are extremely helpful in diagnostic evaluation of patients with suspected hyperandrogenism.
高雄激素血症或雄激素过多是育龄期女性常见的内分泌紊乱疾病，患病率为5%至10%。大多数高雄激素血症患者会患有多囊卵巢综合征。高雄激素血症对执业医师和临床研究人员来说都是一个复杂的诊断挑战。高雄激素血症的临床表现包括多毛症、痤疮、雄激素性脱发和男性化。多毛症定义为女性终毛以男性样模式过度生长，是高雄激素血症最常用的临床诊断标准。多毛症的存在通常通过使用标准化的毛发生长评分系统来确定。根据定义，高达80%的高雄激素血症患者存在多毛症。痤疮和雄激素性脱发是其他常见的雄激素性皮肤变化，在一些高雄激素血症女性中可能没有多毛症也会出现。然而，这些表现单独出现均不作为高雄激素血症的诊断标准。男性化是高雄激素血症相对不常见的特征，其出现往往提示存在分泌雄激素的肿瘤。全面的病史和有针对性的临床检查对疑似高雄激素血症患者的诊断评估非常有帮助。
