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Semin Reprod Med 2022; 40(01/02): 042-052
DOI: 10.1055/s-0041-1742259
Review Article

Non-PCOS Hyperandrogenic Disorders in Adolescents

M. Rebeca Esquivel-Zuniga
1   Division of Endocrinology and Metabolism, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
,
Cassandra K. Kirschner
2   Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia
,
Christopher R. McCartney 
3   Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
4   Center for Research in Reproduction, University of Virginia School of Medicine, Charlottesville, Virginia
,
Christine M. Burt Solorzano 
1   Division of Endocrinology and Metabolism, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
4   Center for Research in Reproduction, University of Virginia School of Medicine, Charlottesville, Virginia
› Author Affiliations Funding Financial support for the writing, permission requests, and article processing charges related to this manuscript was provided by the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development research grant NIH R01 HD102060. NIH/NICHD. NIH R01 HD102060.
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Abstract

Hyperandrogenism—clinical features resulting from increased androgen production and/or action—is not uncommon in peripubertal girls. Hyperandrogenism affects 3 to 20% of adolescent girls and often is associated with hyperandrogenemia. In prepubertal girls, the most common etiologies of androgen excess are premature adrenarche (60%) and congenital adrenal hyperplasia (CAH; 4%). In pubertal girls, polycystic ovary syndrome (PCOS; 20–40%) and CAH (14%) are the most common diagnoses related to androgen excess. Androgen-secreting ovarian or adrenal tumors are rare (0.2%). Early pubic hair, acne, and/or hirsutism are the most common clinical manifestations, but signs of overt virilization in adolescent girls—rapid progression of pubic hair or hirsutism, clitoromegaly, voice deepening, severe cystic acne, growth acceleration, increased muscle mass, and bone age advancement past height age—should prompt detailed evaluation. This article addresses the clinical manifestations of and management considerations for non-PCOS-related hyperandrogenism in adolescent girls. We propose an algorithm to aid diagnostic evaluation of androgen excess in this specific patient population.

Keywords

hyperandrogenism - adolescent - puberty - girls - androgen


Publication History

Article published online:
20 January 2022

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