Endocrine Abstracts

Introduction: Severe hyperandrogenism is not only associated with cosmetic concerns but it also increases the risk of neoplastic (endometrial, breast cancer), cardiovascular, respiratory and metabolic complications.

Case report: A 68 years-old woman with a recent history of severe arterial hypertension, cardiogenic pulmonary edema, diabetes mellitus, severe respiratory failure, marked obesity was referred to our department due to the markedly androgenic phenotype.

Clinical examination showed android obesity, severe male-pattern alopecia, marked hirsutism involving the face and the trunk, deepening of the voice. Severe, resistant arterial hypertension with hypertrophic cardiomyopathy and congestive heart failure was present. The patient associated chronic respiratory failure, severe obstructive sleep apnea syndrome, diabetes mellitus. The endocrine evaluation revealed an extremely elevated serum testosterone level (>16.6 ng/ml), high serum estradiol (186 pg/ml) with low gonadotropins (FSH 0.3 mIU/ml, LH 0.42 mIU/ml), normal adrenal function, with normal androstenedione, DHEAS and 17OHP levels. Computed tomography of the abdomen showed normal adrenal glands, right ovarian tumor, markedly increased uterine volume with severe endometrial hyperplasia. Surgery was recommended and performed very recently with significant clinical improvement.

Conclusions: The presence of severe hyperandrogenism in postmenopausal women is frequently the result of an androgen-secreting tumor and can be associated with important complications