Endocrine Abstracts

Introduction: There are numerous conditions which can cause elevated testosterone levels in women. PCOS being the commonest. Other causes include ovarian/adrenal androgen secreting tumours, CAH, Cushing syndrome, hyperprolactinemia, virilisation during pregnancy and finally idiopathic cause.

Objectives: Our objective was to look into the way in which women with elevated testosterone were evaluated. We looked into why testosterone levels were done, who requested them, what other investigations were done, what was the final diagnosis and what treatment was given.

Methods: Patients with elevated testosterone levels over a period of 2 years were randomly chosen. We reviewed their notes to find out how they were evaluated and what diagnosis was made.

Results: We reviewed a total of 60 patients. Mean age was 23.9 years. Fifty patients had initially presented to the Gynaecologists, 8 to the Endocrinologists and 2 to the Dermatologists. oligomenorrhoea/amenorrhoea was the most common presentation in 83% of patients. About 53% had hirsutism, 15% had acne and 36% had infertility. None had alopecia or acanthosis nigricans. About 58% of women were obese and 6% were overweight.

The following investigations were done: LH/FSH – 59/60 – 98% Prolactin – 55/60 – 92%; 17 hydroxyprogesterone – 33/60 – 55% Androstenedione – 22/60 – 37%; Thyroid function tests – 59/60 – 98% SHBG 52/60 – 87%; ultrasound abdomen – 50/60 – 83% 24 h urinary cortisol −11/60 −PCOS was diagnosed in 44 women. Of the 16 who had other diagnoses, 1 patient had a ovarian androgen secreting tumour, 1 had primary amenorrhoea with absent uterus, 1 had hypothyroidism, 2 patients were diagnosed as having acne, in 3 women the diagnosis was obesity related, 1 patient was pregnant and 1 had repeat testosterone levels which were normal. Six patients had no cause identified and were diagnosed as Idiopathic.