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Hyperandrogenism

Hyperandrogenism, or androgen excess, is a medical condition characterized by excessive levels of androgens in the body and the associated effects of these excessive levels of androgens.

Hyperandrogenism is one of the primary symptoms of polycystic ovary syndrome (PCOS). In such cases, it presents with symptoms such as acne and seborrhea, is frequent in adolescent girls and is often associated with irregular menstrual cycles. In most instances, these symptoms are transient and reflect only the immaturity of the hypothalamic-pituitary-ovarian axis during the first years following menarche.[1] Approximately three-quarters of patients with PCOS (by the diagnostic criteria of NIH/NICHD 1990) have evidence of hyperandrogenism, with free testosterone being the single most predictive marker with ~60% of patients demonstrating supranormal levels.[2]

Hyperandrogenism can also be the result of excessive production of adrenal or gonadal androgens by adrenal adenomas, carcinomas, or hyperplasia, Leydig cell tumors in men, and arrhenoblastomas in women.[3]:501–2

In women, signs and symptoms of hyperandrogenism frequently include acne, scalp hair loss (androgenic alopecia), excessive facial and body hair (hirsutism), atypically high libido, breast atrophy, and others. Collectively, these symptoms are described as virilization.

Management of hyperandrogenism symptoms like androgenic alopecia, include the use of antiandrogens such as cyproterone acetate, spironolactone, and flutamide.[4][5][6][7]

Sports

In international sports and the Olympic Games, a female athlete is not eligible to participate in the female category if the amount of androgenic hormone exceeds the permissible limits, on the ground that the condition could confer an unfair advantage.[8][9]

In September 2014, Dutee Chand, a sprinter from India who was barred by the International Association of Athletics Federations (IAAF) from competing against other female runners, sought to appeal the ruling and asked for reinstatement.[10] In July 2015, the Court of Arbitration for Sport suspended the IAAF ban, thus reinstating Chand's right to compete. The IAAF was given two years in which to file scientific evidence justifying the ban. In the absence of that, the ban will be declared void.[11][12][13]

See also

References

  1. ^ Christine Cortet-Rudelli, Didier Dewailly (Sep 21, 2006). "Diagnosis of Hyperandrogenism in Female Adolescents". Hyperandrogenism in Adolescent Girls. Armenian Health Network, Health.am. Retrieved 2006-11-21. 
  2. ^ Huang A, Brennan K, Azziz R (April 2010). "Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria". Fertil. Steril. 93 (6): 1938–41.  
  3. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0721629210.
  4. ^ Tosti A, Camacho-Martinez F, Dawber R. Management of androgenetic alopecia. J Eur Acad Dermatol Venereol. 1999 May;12(3):205-14
  5. ^ Diamanti-Kandarakis E. Current aspects of antiandrogen therapy in women. Curr Pharm Des. 1999;5(9):707-23
  6. ^ Sinclair R, Wewerinke M, Jolley D.Treatment of female pattern hair loss with oral antiandrogens. Br J Dermatol. 2005 Mar;152(3):466-73
  7. ^ Vierhapper H, Maier H, Nowotny P, Waldhäusl W. Production rates of testosterone and of dihydrotestosterone in female pattern hair loss. Metabolism. 2003 Jul;52(7):927-9
  8. ^ http://pib.nic.in/newsite/PrintRelease.aspx?relid=94015
  9. ^ http://pib.nic.in/archieve/others/2013/mar/d2013032001.pdf
  10. ^ http://www.nytimes.com/2014/10/07/sports/sprinter-dutee-chand-fights-ban-over-her-testosterone-level.html?module=Search&mabReward=relbias%3Aw&_r=0
  11. ^ http://www.nytimes.com/2015/07/28/sports/international/dutee-chand-female-sprinter-with-high-male-hormone-level-wins-right-to-compete.html
  12. ^ http://www.tas-cas.org/fileadmin/user_upload/Media_Release_3759_FINAL.pdf
  13. ^ "Dutee Chand cleared to race as IAAF suspends 'gender test' rules".  



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