Hyperandrogenism syndrome: diagnostics and treatment from the position of clinical endocrinology

Abstract

Hyperandrogenism, a pathological condition caused by the effect of excess production of androgens on target organs and tissues, is one of the most common hormonal disorders observed in 5–20 % of women of reproductive age in the population and in 35–41 % of women suffering from infertility due to chronic ano­vulation. Hyperandrogenism is manifested by a combination of signs of damage to the skin and its appendages (seborrhea, acne, hirsutism, alopecia) and is defined by the term androgen-dependent dermopathy. In combination with other manifested signs of virilization, hyperandrogenism greatly aggravates socio-psychological, interpersonal relationships in most patients, often cau­sing anxiety, depression, and a decrease in the quality of life. In this regard, the problem of hyperandrogenism is not only of medical but also of social significance. An urgent problem, widely studied by both endocrinologists and gynecologists, is a clinical variant of hyperandrogenism syndrome such as polycystic ovary syndrome. The article presents a discussion of the National Consensus on the management of patients with hyperandrogenism (2016), makes proposals and additions to the diagnosis and management of patients with syndromic forms of hyperandrogenism (pubertal dyspituitarism and its equivalent in adults — hypothalamic-pituitary dysfunction, nonclassical form of congenital dysfunction of the cortex adrenal glands). The key positions concerning the assessment of the state of carbohydrate metabolism in patients with polycystic ovary syndrome are considered. The regimens of treatment with antiandrogens and the expediency of their use in patients with polycystic ovary of endocrine origin are discussed.

Keywords

• hyperandrogenism, carbohydrate metabolism, polycystic ovary syndrome, diagnosis, therap