Ajith S, Beena George, Mathew Nitu Mariam, Omana E K
Department of Obstetrics and Gynaecology, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
J Midlife Health. 2016 Oct-Dec;7(4):189-192. doi: 10.4103/0976-7800.195699.
In postmenopausal women presenting with virilization and elevated testosterone levels, laparoscopic salpingo-oophorectomy should be considered after exclusion of adrenal causes. A clinicopathological study was conducted among those women who presented with features of hyperandrogenism in our postmenopausal clinic over a period of 2 years. Relevant past medical and surgical histories were elicited. Basic hormonal evaluation and radiological imaging were done. Laparoscopic bilateral salpingo-oophorectomy was done. Six weeks postoperatively, serum testosterone was undetectable with significant clinical improvement. There was no recurrence of symptoms during the follow-up period of 2 years. Treatment of postmenopausal women with hyperandrogenism and virilization with laparoscopic bilateral salpingo-oophorectomy is effective if she has no pronounced ovarian enlargement or adrenal tumor on imaging. An extensive endocrine testing and a detailed search for metastatic disease may be unnecessary.
对于出现男性化表现且睾酮水平升高的绝经后女性，在排除肾上腺病因后应考虑行腹腔镜输卵管卵巢切除术。对在我们绝经后门诊出现高雄激素血症特征的女性进行了一项为期2年的临床病理研究。询问了相关既往病史和手术史。进行了基础激素评估和影像学检查。实施了腹腔镜双侧输卵管卵巢切除术。术后六周，血清睾酮检测不到，临床症状有显著改善。在2年的随访期内症状未复发。对于有高雄激素血症和男性化表现的绝经后女性，如果影像学检查未发现明显的卵巢肿大或肾上腺肿瘤，采用腹腔镜双侧输卵管卵巢切除术治疗是有效的。可能无需进行广泛的内分泌检查和对转移性疾病的详细排查。
