Polycystic Ovary Syndrome (PCOS) |
Irregular menstruation, acne, obesity, insulin resistance, infertility |
Serum testosterone, LH/FSH ratio, pelvic ultrasound |
Weight loss, oral contraceptives, anti-androgens (e.g., spironolactone), metformin |
Congenital Adrenal Hyperplasia (CAH) |
Virilization, ambiguous genitalia in newborns, early pubarche, acne |
17-hydroxyprogesterone levels, ACTH stimulation test |
Glucocorticoid therapy, mineralocorticoid replacement if necessary |
Cushing's Syndrome |
Moon face, central obesity, purple striae, muscle weakness, hypertension |
24-hour urinary free cortisol, dexamethasone suppression test, serum ACTH |
Surgical removal of adrenal or pituitary tumour, radiation, cortisol-lowering medications |
Androgen-Secreting Tumours |
Rapid onset of hirsutism, virilization, menstrual irregularities |
Serum testosterone, DHEA-S levels, imaging studies (CT/MRI) |
Surgical removal of the tumour, possible chemotherapy or radiotherapy |
Idiopathic Hirsutism |
Excessive hair growth without other clinical signs, normal menstruation |
Normal hormone levels, exclusion of other causes |
Cosmetic hair removal (laser, electrolysis), anti-androgens (e.g., spironolactone) |
Medications (e.g., Anabolic Steroids, Phenytoin) |
Hirsutism, possibly other signs depending on the specific medication |
Review of medication history, serum testosterone levels |
Discontinuation of offending medication, alternative drugs, cosmetic treatment |
Acromegaly |
Coarsening of facial features, enlarged hands and feet, joint pain |
Serum IGF-1, glucose tolerance test, MRI of the pituitary gland |
Surgical removal of pituitary adenoma, medication (somatostatin analogs), radiation therapy |