Sarfati J, Moraillon-Bougerolle M, Christin-Maitre S
Service d'endocrinologie, hôpital Saint-Antoine, 184, rue du faubourg Saint-Antoine, 75012 Paris, France.
Service de gynécologie, centre hospitalier Montluçon Neris-les-Bains, 18, avenue du 8 Mai 1945, 03100 Montluçon, France.
Gynecol Obstet Fertil Senol. 2022 Oct;50(10):675-681. doi: 10.1016/j.gofs.2022.05.002. Epub 2022 May 21.
Postmenopausal hyperandrogenism is an androgen excess originating from either the adrenals and/or the ovaries. Clinically, symptoms can be moderate (increase in terminal hair growth, acnea) or severe with signs of virilization (alopecia, clitoridomegaly). In either setting, physicians need to exclude relatively rare but potentially life-threatening underlying tumorous causes, such as adrenal androgen-secreting tumors. The objectives of this review are to evaluate which hormonal measurements (T, delta 4 androstenedione, 17 OH progesterone, SDHEA, FSH, LH) and/or imaging (pelvic ultrasound, MRI or adrenal CT-scan) could be useful identifying the origin of the androgen excess. Our review illustrates that the rate of progression of hirsutism and/or alopecia, and serum testosterone levels are in favor of tumors. Pelvic MRI and adrenal CT-scan are useful tools for identifying the different causes of androgen excess.
绝经后高雄激素血症是一种源于肾上腺和/或卵巢的雄激素过多症。临床上，症状可能较轻（终毛增多、痤疮），也可能严重并伴有男性化体征（脱发、阴蒂肥大）。在任何一种情况下，医生都需要排除相对罕见但可能危及生命的潜在肿瘤病因，如肾上腺雄激素分泌肿瘤。本综述的目的是评估哪些激素检测（睾酮、δ4雄烯二酮、17-羟孕酮、硫酸脱氢表雄酮、促卵泡生成素、促黄体生成素）和/或影像学检查（盆腔超声、磁共振成像或肾上腺CT扫描）有助于确定雄激素过多的来源。我们的综述表明，多毛症和/或脱发的进展速度以及血清睾酮水平提示肿瘤的可能性。盆腔磁共振成像和肾上腺CT扫描是确定雄激素过多不同病因的有用工具。
