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Reproductive Physiology, Endocrinology, and Infertility

Question
42 out of 56
 

A 20 year old female complains of oligome-norrhea along with facial hair. Preliminary investingations reveal raised free testosterone levels and an ultrasound ovaries was normal. Which of the following could be likely etiology? (AIIMS Nov. 2010)



A Idiopathic hirsutism

B PCOD

C adrenal hyperplasia

D Testosterone secreting tumor

Ans. B

PCOD

1. Idiopathic hirsutism (IH) is defined as hirsutism in the presence of a normal total Testosterone, alone or combined with normal levels of androstenedione, dehydroepiandrosterone sulfate (DHEAS), LH/FSH, and 17-hydroxyprogesterone levels, although the status of ovulatory function was not considered.

2. There is excess terminal hair production in a male-like pattern in androgen-receptive body parts of patients who show no signs of endocrine or androgen disorders. This kind of hirsutism occurs in the presence of regular ovulation and normal androgen levels.

3. Idiopathic hirsutism is the second most common cause of hirsutism after Polycystic Ovarian Syndrome (PCOS), which is associated with androgen dysfunction. Idiopathic hirsutism accounts for approximately five to 17 percent of hirsute cases. However, menses (i.e. ovulation) and circulating androgen levels remain unaffected.

4. Many patients with PCOS can have a normal ultrasound picture. The criteria of PCOS mainly consists of androgen excess and anovulation with the major and minor criteria’s (described in earlier literature) considered obsolete.

5. Congenital adrenal hyperplasia would require DHEAS and 17 OHP to be shown rising in the lab parameters.

6. If there was a tumor in the ovary, then it should have been shown in the ultrasound

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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