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Androgen Excess Disorders in Women

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Androgens in Health and Disease

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References

  1. Knochenhauer ES, Key TJ, Kahsar-Miller M, et al. Prevalence of the polycystic ovary syndrome in unselected Black and White women of the Southeastern United States: a prospective study. J Clin Endocrinol Metab 1998;83:3078–3082.

    Article  PubMed  CAS  Google Scholar 

  2. Dunaif A, Givens JR, Haseltine FP, et al. Polycystic ovary syndrome. Current Issues in Endocrinology and Metabolism. Blackwell Scientific, Boston, MA, 1992.

    Google Scholar 

  3. Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol 1977;97:247–254.

    Article  PubMed  CAS  Google Scholar 

  4. Tagatz GE, Kopher RA, Nagel TC, Okagaki T. The clitoral index: a bioassay of androgenic stimulation. Obstet Gynecol 1979;54:562–564.

    PubMed  CAS  Google Scholar 

  5. Barbieri RL, Smith S, Ryan KJ. The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. Fertil Steril 1988;50:197–212.

    PubMed  CAS  Google Scholar 

  6. Givens JR, Kurtz BR. Understanding the polycystic ovary syndrome. Prog Clin Biol Res 1986;225: 355–376.

    PubMed  CAS  Google Scholar 

  7. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997;18:774–800.

    Article  PubMed  CAS  Google Scholar 

  8. Azziz R, Waggoner WT, Ochoa T, et al. Idiopathic hirsutism: an uncommon cause of hirsutism in alabama. Fertil Steril 1998;70:274–278.

    Article  PubMed  CAS  Google Scholar 

  9. Ibanez L, de Zegher F, Potau N. Anovulation after precocious pubarche: early markers and time course in adolescence. J Clin Endocrinol Metab 1999;84:2691–2695.

    Article  PubMed  CAS  Google Scholar 

  10. Elting MW, Korsen TJ, Rekers-Mombarg LT, Schoemaker J: Women with polycystic ovary syndrome gain regular menstrual cycles when ageing. Hum Reprod 2000:15:24–28.

    Article  PubMed  CAS  Google Scholar 

  11. Winters SJ, Talbott E, Guzick DS, Zborowski J, McHugh KP. Serum testosterone levels decrease in middle age in women with the polycystic ovary syndrome. Fertil Steril 2000;73:724–729.

    Article  PubMed  CAS  Google Scholar 

  12. Goldzieher JW, Axelrod LR: Clinical and biochemical features of polycystic ovarian disease. Fertil Steril 1963;14:631–653.

    PubMed  CAS  Google Scholar 

  13. Elchalal U, Schenker JG. The pathophysiology of ovarian hyperstimulation syndrome-views and ideas. Hum Reprod 1997;12:1129–1137.

    Article  PubMed  CAS  Google Scholar 

  14. Fulghesu AM, Villa P, Pavone V, et al. The impact of insulin secretion on the ovarian response to exogenous gonadotropins in polycystic ovary syndrome. J Clin Endocrinol Metab 1997;82:644–648.

    Article  PubMed  CAS  Google Scholar 

  15. Dale PO, Tanbo T, Haug E, Abyholm T. The impact of insulin resistance on the outcome of ovulation induction with low-dose follicle stimulating hormone in women with polycystic ovary syndrome. Hum Reprod 1998;13:567–570.

    Article  PubMed  CAS  Google Scholar 

  16. Dahlgren E, Friberg LG, Johansson S, et al. Endometrial carcinoma; ovarian dysfunction-a risk factor in young women. Eup J Obstet Gynecol Reprod Biol 1991;41:143–150.

    Article  CAS  Google Scholar 

  17. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999:84;165–169.

    Article  PubMed  CAS  Google Scholar 

  18. Ehrmann DA, Barnes RB, Rosenfield RL, et al. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabet Care 1999;22:141–146.

    Article  CAS  Google Scholar 

  19. Anonymous. American Diabetes Association: clinical practice recommendations 1997. Diabetes Care 1997;20(Suppl 1): S 1-S70.

    Google Scholar 

  20. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595–1607.

    CAS  Google Scholar 

  21. Haffner SM, Miettinen H, Gaskill SP, Stern MP: Metabolic precursors of hypertension. The San Antonio Heart Study. Arch Intern Med 1996;156:1994–2001.

    Article  CAS  Google Scholar 

  22. Lind L, Lithell H, Pollare T. Is it hyperinsulinemia or insulin resistance that is related to hypertension and other metabolic cardiovascular risk factors? J Hypertens 1993;11(Suppl): S11–S16

    Article  Google Scholar 

  23. Talbott E, Clerici A, Berga SL, et al. Adverse lipid and coronary heart disease risk profiles in young women with polycystic ovary syndrome: results of a case-control study. J Clin Epidemiology 1998;51:415–422.

    Article  CAS  Google Scholar 

  24. Zimmermann S, Phillips RA, Dunaif A, et al. Polycystic ovary syndrome: lack of hypertension despite profound insulin resistance. J Clin Endocrinol Metab 1992;75:508–513.

    Article  PubMed  CAS  Google Scholar 

  25. Holte J, Gennarelli G, Berne C, et al. Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state? Hum Reprod 1996;11:23–28.

    Article  PubMed  CAS  Google Scholar 

  26. Talbott EO, Guzick DS, Sutton-Tyrrell K, et al. Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middleaged women. Arterio Thromb Vasc Biol (Online) 2000:20(11):2414–2421.

    Article  CAS  Google Scholar 

  27. Chetkowski RJ, De Fazio J, Shamonki I, et al. The incidence of late-onset congenital adrenal hyperplasia due to 21-hydroxylase deficiency among hirsute women. J Clin Endocrinol Metab 1984;58:595–598.

    Article  PubMed  CAS  Google Scholar 

  28. New MI, Speiser PW. Genetics of adrenal steroid 21-hydroxylase deficiency. Endocr Rev 1986;7:331–349.

    Article  PubMed  CAS  Google Scholar 

  29. Azziz R, Hincapie LA, Knochenhauer ES, et al. Screening for 21-hydroxylase-deficient nonclassic adrenal hyperplasia among hyperandrogenic women: a prospective study. Fertil Steril 1999;72:915–925.

    Article  PubMed  CAS  Google Scholar 

  30. New MI, Lorenzen F, Lerner AJ, et al. Genotyping steroid 21-hydroxylase deficiency: hormonal reference data. J Clin Endocrinol Metab 1983;57:320–326.

    Article  PubMed  CAS  Google Scholar 

  31. Speiser PW, Dupont J, Zhu D, et al. Disease expression and molecular genotype in congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Invest 1992;90:584–595.

    Article  PubMed  CAS  Google Scholar 

  32. Azziz R, Dewailly D, Owerbach D. Clinical review 56: nonclassic adrenal hyperplasia: current concepts. J Clin Endocrinol Metab 1994;78: 810–815.

    Article  PubMed  CAS  Google Scholar 

  33. Cizza G, Chrousos GP. Adrenocorticotrophic hormone-dependent Cushing s syndrome. Canc Treat Res 1997;89:25–40.

    Article  CAS  Google Scholar 

  34. Plotz CM, Knowlton AL, Ragan C. The natural history of Cushing’s syndrome. Am J Med 1952;13:597–605.

    Article  PubMed  CAS  Google Scholar 

  35. Polson DW, Adams J, Wadsworth J, et al. Polycystic ovaries-a common finding in normal women. Lancet 1988;1:870–872.

    Article  PubMed  CAS  Google Scholar 

  36. Farquhar CM, Birdsall M, Manning P, et al. The prevalence of polycystic ovaries on ultrasound scanning in a population of randomly selected women. Aust NZJ Obstet Gynaecol 1994;34:67–72.

    Article  CAS  Google Scholar 

  37. Carmina E, Koyama T, Chang L., et al. Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome? Am J Obstet Gynecol 1992;167:1807–1812.

    Article  PubMed  CAS  Google Scholar 

  38. Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin Reprod Endocrinol 1997;15:111–122.

    Article  PubMed  CAS  Google Scholar 

  39. Lee O, Farquhar C, Toomath R, Jepson R. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database of Systematic Reviews CD000194 2000.

    Google Scholar 

  40. Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med 1997;337:396–407.

    Article  CAS  Google Scholar 

  41. Pasquali R, Antenucci D, Casimirri F, et al. Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab 1989;68:173–179.

    Article  PubMed  CAS  Google Scholar 

  42. Jaatinen TA, Anttila L, Erkkola R, et al. Hormonal responses to physical exercise in patients with polycystic ovarian syndrome. Fertil Steril 1993;60:262–267.

    PubMed  CAS  Google Scholar 

  43. Braun B, Zimmermann MB, Kretchmer N. Effects of exercise intensity on insulin sensitivity in women with noninsulin-dependent diabetes mellitus. J Appl Physiol 1995;78:300–306.

    PubMed  CAS  Google Scholar 

  44. McCann PP, Pegg AE. Ornithine decarboxylase as an enzyme target for therapy. Pharmacol Therapeut 1992;54:195–215.

    Article  CAS  Google Scholar 

  45. Givens JR, Andersen RN, Wiser WL, et al. The effectiveness of two oral contraceptives in suppressing plasma androstenedione, testosterone, LH, and FSH, and in stimulating plasma testosteronebinding capacity in hirsute women. Am J Obstet Gynecol 1976.124:333–339.

    PubMed  CAS  Google Scholar 

  46. Azziz R, Ochoa TM, Bradley EL Jr, et al. Leuprolide and estrogen versus oral contraceptive pills for the treatment of hirsutism: a prospective randomized study. J Clin Endocrinol Metab 1995.80.3406–3411

    Article  PubMed  CAS  Google Scholar 

  47. Heiner JS, Greendale GA, Kawakami AK, et al. Comparison of a gonadotropin-releasing hormone agonist and a low dose oral contraceptive given alone or together in the treatment of hirsutism. J Clin Endocrinol Metab 1995; 80 3412–3418

    Article  PubMed  CAS  Google Scholar 

  48. Elkind-Hirsch KE, Anania C, Mack M, Malinak R: Combination gonadotropinreleasing hormone agonist and oral contraceptive therapy improves treatment of hirsute women with ovarian hyperandrogenism. Fertil Steril 1995;63:970–978.

    PubMed  CAS  Google Scholar 

  49. Carr BR, Breslau NA, Givens C, et al. Oral contraceptive pills, gonadotropin-releasing hormone agonists, or use in combination for treatment of hirsutism: a clinical research center study. J Clin Endocrinol Metab 1995;80:1169–1178.

    Article  PubMed  CAS  Google Scholar 

  50. Velazquez EM, Mendoza S, Hamer T, et al. Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancy. Metabol 1994;43:647–654.

    Article  CAS  Google Scholar 

  51. Nestler JE, Jakubowicz DJ. Lean women with polycystic ovary syndrome respond to insulin reduction with decreases in ovarian p450c17 alpha activity and serum androgens. J Clin Endocrinol Metab 1997;82:4075–4079.

    Article  PubMed  CAS  Google Scholar 

  52. Nestler JE, Jakubowicz DJ, Evans WS, Pasquali R. Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome. N Engl J Med 1998;338:1876–1880.

    Article  PubMed  CAS  Google Scholar 

  53. Nestler JE, Jakubowicz DJ, Reamer P, et al. Ovulatory and metabolic effects of dchiroinositol in the polycystic ovary syndrome. N Engl J Med 1999;340:1314–1320.

    Article  PubMed  CAS  Google Scholar 

  54. Coetzee EJ, Jackson WP. Metformin in management of pregnant insulin-independent diabetics. Diabetologia 1979;16:241–245.

    Article  PubMed  CAS  Google Scholar 

  55. Callahan TL, Hall JE, Ettner SL, et al. The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence. N Engl J Med 1994;331: 244–249.

    Article  PubMed  CAS  Google Scholar 

  56. Coetzee EJ, Jackson WP. Pregnancy in established non-insulin-dependent diabetics. A five-and-a-half year study at Groote Schuur Hospital. S Afric Med J 1980;58:795–802.

    CAS  Google Scholar 

  57. Sarlis NJ, Weil SJ, Nelson LM. Administration of metformin to a diabetic woman with extreme hyperandrogenemia of nontumoral origin: management of infertility and prevention of inadvertent masculinization of a female fetus. J Clin Endocrinol Metab 1999;84:1510–1512.

    Article  PubMed  CAS  Google Scholar 

  58. Diamanti-Kandarakis E, Kouli C, Tsianateli T, Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur J Endocrinol 1998;138: 269–274.

    Article  PubMed  CAS  Google Scholar 

  59. Velazquez E, Acosta A, Mendoza SG: Menstrual cyclicity after metformin therapy in polycystic ovary syndrome. Obstet Gynecol 1997;90:392–395.

    Article  PubMed  CAS  Google Scholar 

  60. Vandermolen DT, Ratts VS, Evans WS, et al. Metformin increases the ovulatory rate and pregnancy rate from clomiphene citrate in patients with polycystic ovary syndrome who are resistant to clomiphene citrate alone. Fertil Steril 2001;75:310–315.

    Article  PubMed  CAS  Google Scholar 

  61. Moghetti P, Castello R, Negri C, et al. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, doubleblind, placebocontrolled 6-month trial, followed by open, longterm clinical evaluation. J Clin Endocrinol Metab 2000;85:139–146.

    Article  PubMed  CAS  Google Scholar 

  62. Azziz R, Ehrmann D, Legro RS, et al. Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial. J Clin Endocrinol Metab 2001;86:1626–1632.

    Article  PubMed  CAS  Google Scholar 

  63. Eil C, Edelson SK. The use of human skin fibroblasts to obtain potency estimates of drug binding to androgen receptors. J Clin Endocrinol Metab 1984;59:51–55.

    Article  PubMed  CAS  Google Scholar 

  64. Helfer EL, Miller JL, Rose LI. Side-effects of spironolactone therapy in the hirsute woman. J Clin Endocrinol Metab 1988;66:208–211.

    Article  PubMed  CAS  Google Scholar 

  65. Groves TD, Corenblum B. Spironolactone therapy during human pregnancy. Am J Obstet Gynecol 1995;172:1655–1656.

    Article  PubMed  CAS  Google Scholar 

  66. Muhlemann MF, Carter GD, Cream JJ, Wise P. Oral spironolactone: an effective treatment tor acne vulgaris in women. Br J Dermatol 1986;115:227–232.

    Article  PubMed  CAS  Google Scholar 

  67. Fruzzetti F, De Lorenzo D, Ricci C, Fioretti P. Clinical and endocrine effects of flutamide in hyperandrogenic women. Fertil Steril 1993;60:806–813.

    PubMed  CAS  Google Scholar 

  68. Moghetti P, Castello R, Magnani CM, et al. Clinical and hormonal effects of the 5 alpha-reductase inhibitor finasteride in idiopathic hirsutism. J Clin Endocrinol Metab 1994;79:1115–1121.

    Article  PubMed  CAS  Google Scholar 

  69. Fruzzetti F, de Lorenzo D, Parrini D, Ricci C. Effects of finasteride, a 5 alpha-reductase inhibitor, on circulating androgens and gonadotropin secretion in hirsute women. J Clin Endocrinol Metab 1994;79:831–835.

    Article  PubMed  CAS  Google Scholar 

  70. Moghetti P, Tosi F, Tosti A, et al. Comparison of spironolactone, flutamide, and finasteride efficacy in the treatment of hirsutism: a randomized, double blind, placebo-controlled trial. J Clin Endocrinol Metab 2000;85:89–94.

    Article  PubMed  CAS  Google Scholar 

  71. Wong IL, Morris RS, Chang L, et al. A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. J Clin Endocrinol Metab 1995;80:233–238.

    Article  PubMed  CAS  Google Scholar 

  72. Katz M, Carr PJ, Cohen BM, Millar RP: Hormonal effects of wedge resection of polycystic ovaries. Obstet Gynecol 1978;51:437–444.

    Article  PubMed  CAS  Google Scholar 

  73. Greenblatt E, Casper RF. Endocrine changes after laparoscopic ovarian cautery in polycystic ovarian syndrome. Am J Obstet Gynecol 1987;156:279–285.

    PubMed  CAS  Google Scholar 

  74. Adashi EY, Rock JA, Guzick D, et al. Fertility following bilateral ovarian wedge resection: a critical analysis of 90 consecutive cases of the polycystic ovary syndrome. Fertil Steril 1981;36:320–325.

    PubMed  CAS  Google Scholar 

  75. Farquhar C, Vandekerckhove P, Arnot M, Lilford R. Laparoscopic “drilling” by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database of Systematic (2), CD001122. 2000.

    Google Scholar 

  76. Donesky BW, Adashi EY. Surgically induced ovulation in the polycystic ovary syndrome: wedge resection revisited in the age of laparoscopy. Fertil Steril 1995;63:439–463.

    PubMed  CAS  Google Scholar 

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Legro, R.S. (2003). Androgen Excess Disorders in Women. In: Bagatell, C.J., Bremner, W.J. (eds) Androgens in Health and Disease. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-388-0_7

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  • DOI: https://doi.org/10.1007/978-1-59259-388-0_7

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