Cystic ovary high testosterone

I believe that everyone is not very familiar with the term "cystic ovary high testosterone". In fact, this is mainly used to describe a disease in women. For girls, if the cystic ovary testosterone is high, they must go to the hospital in time to ask the doctor for treatment methods. The main symptoms of high testosterone in cystic ovary are irregular menstruation in women and more obvious male characteristics.

[Clinical manifestations] The more common ones are menstrual changes such as oligomenorrhea, amenorrhea or dysfunctional uterine bleeding, anovulation and infertility. Some have masculine changes, such as excessive hair growth, enlarged Adam's apple, and deeper voice. Some are obese, have acne, poor breast development, poor uterine development, enlarged ovaries, and in a few cases, clitoromegaly.

【diagnosis】

1. Based on the clinical manifestations, especially those with oligomenorrhea, amenorrhea or dysfunctional uterine bleeding, plus certain masculinization manifestations, the possibility of this disease should be considered. The diagnosis is based on an increase in blood testosterone >7.0ng/ml or >2.44nmol/L.

2. To distinguish whether the lesion originates from the ovary or adrenal cortex, the ACTH stimulation test can be used: 20 mg of ACTH is injected intramuscularly, and the 24-hour urinary 17-keto and 17-hydroxysteroid excretion is measured before and after injection. If the excretion volume increases significantly after injection, it proves that the adrenal cortex function is abnormal; if there is no obvious change in the excretion volume before and after injection, it indicates that the lesion is in the ovary.

3. B-ultrasound can measure the ratio of the size of the ovaries to the size of the uterus. If the ovaries are more than 1/4 larger than the uterine body, it can be considered as polycystic ovary.

4. Clomiphene treatment trial: Take clomiphene for 3 consecutive cycles. If ovulation occurs, it is probably polycystic ovary. If there is no ovulation in 3 cycles, it may be considered as theca hyperplasia.

5. Posterior abdominal wall pneumatic angiography can examine the size and shape of the adrenal glands to distinguish between adrenal cortical hyperplasia and hyperfunction.

Corticosteroids such as prednisone 5 mg, 2/d; dexamethasone 0.5-0.75 mg, 2/d, both should be taken continuously for 3-6 months. The biggest effect of corticosteroids is to inhibit adrenal cortex function, thereby reducing the secretion of dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione (Δ4A) and testosterone (T). Therefore, it is suitable for hypertestosteroneemia originating from the adrenal glands. The ovulation rate of this product alone is ≥50%; if used in combination with clomiphene, the ovulation rate can reach 80% to 100%.