Management of Adolescent Hyperandrogenism: Still a Challenge?
Androgen excess in adolescent girls produces a variety of clinical signs that must be appropriately recognized, evaluated, and treated. Hyperandrogenism must be considered in any adolescents with excessive development of acne, hirsutism, menstrual irregularities, abdominal obesity, or masculinization of the body habitus. Management of adolescent girls with hyperandrogenism is sometimes difficult and must distinguish the so-called physiological hyperandrogenism that occurs during puberty, especially in obese girls, from an endocrine pathology. We also have to eliminate severe causes of hyperandrogenism, such as ovarian tumors and nonclassical congenital adrenal hyperplasia. In about 30% of cases, PCOS is revealed by peri-pubertal hyperandrogenism. Its diagnostic criteria should follow the international consensus. Other causes include abdominal obesity and hypersensitivity to androgens. Each diagnosis implies a specific treatment to reduce clinical signs as well as psychological concerns of hyperandrogenism.
KeywordsAdolescent hyperandrogenism Hirsutism PCOS NC-CAH Abdominal obesity
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