Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
J Clin Endocrinol Metab. 2011 May;96(5):1197-201. doi: 10.1210/jc.2010-1991. Epub 2011 Feb 9.
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.
We present three women with postmenopausal hyperandrogenism of ovarian origin who were treated with GnRH agonists.
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.
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.
绝经后妇女雄激素过多症最常见的原因是卵巢来源的雄激素产生过多。通常会进行双侧卵巢切除术，即使是良性肿瘤或卵泡膜细胞瘤也是如此。这是首例关于 GnRH 激动剂治疗绝经后妇女高雄激素血症的病例系列报告。
我们报告了三例接受 GnRH 激动剂治疗的绝经后高雄激素血症的女性患者。
我们描述了三例绝经后女性出现高雄激素血症和雄激素过多症，推测为卵巢来源，所有患者的卵巢均有轻度增大，但未发现肿瘤，均接受了 GnRH 激动剂的长期治疗。由于没有进行组织学诊断，因此所有患者都接受了仔细的随访，包括定期检测雄激素水平和计算机断层扫描的卵巢成像。这三例患者对 GnRH 激动剂的治疗反应不同。
对于已确定雄激素过多症源自卵巢的绝经后妇女，尤其是因合并症而手术风险增加或不愿接受双侧卵巢切除术的患者，长期 GnRH 激动剂治疗是一种可接受的选择。
