Management of Adolescent Hyperandrogenism

Abstract

Androgen excess during puberty produces a variety of clinical signs and symptoms that need to be recognized, evaluated, and promptly treated. In addition to the cosmetic concerns and psychological distress it causes, hyperandrogenism impairs hypothalamic sensitivity to progesterone, resulting in a persistent, rapid gonadotropin-releasing hormone (GnRH) pulse frequency that favors LH hypersecretion, which in turn stimulates excessive androgen production. Management of an adolescent with HA must begin with the diagnosis of the underlying cause, which may be an ovarian/adrenal tumor, nonclassical congenital adrenal hyperplasia, or polycystic ovarian syndrome; HA may also be a clinical and chemical feature of idiopathic hirsutism.