Hirsutism and virilization.
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Journal: 1967/November - California medicine
ISSN: 0008-1264
PUBMED: 6044295
Abstract:
In normal females, androstenedione from both the adrenal cortex and ovary, as a result of peripheral conversion, is the source of the majority of biologically active testosterone in the circulation. The control of the secretion of precursor steroid and androgenic hormone (testosterone) in females is not clear at this time. There are a number of possibilities to explain various types of hirsutism and virilization. The presence of true virilization indicates a significant disorder and requires complete investigation. The presence of increased amounts of 17-ketosteroids in the urine implicates the adrenal cortex as a source of the pathologic manifestations. The suppressibility of elevated 17-ketosteroids with cortisol analogues aids in distinguishing between adrenal hyperplasia and autonomous neoplasm of the adrenal cortex. By far the most common entity in this area is simple hirsutism without virilization. Although our knowledge of this disorder is quite incomplete, conservative management is indicated. Further progress in this field is rapidly occurring. An informed clinician can do an adequate job of diagnosis and treatment with the clinical and laboratory tools generally available.
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Calif Med 106(2): 87-91
PMID: 6044295

Hirsutism and Virilization

Abstract

In normal females, androstenedione from both the adrenal cortex and ovary, as a result of peripheral conversion, is the source of the majority of biologically active testosterone in the circulation. The control of the secretion of precursor steroid and androgenic hormone (testosterone) in females is not clear at this time. There are a number of possibilities to explain various types of hirsutism and virilization. The presence of true virilization indicates a significant disorder and requires complete investigation.

The presence of increased amounts of 17-ketosteroids in the urine implicates the adrenal cortex as a source of the pathologic manifestations. The suppressibility of elevated 17-ketosteroids with cortisol analogues aids in distinguishing between adrenal hyperplasia and autonomous neoplasm of the adrenal cortex.

By far the most common entity in this area is simple hirsutism without virilization. Although our knowledge of this disorder is quite incomplete, conservative management is indicated. Further progress in this field is rapidly occurring. An informed clinician can do an adequate job of diagnosis and treatment with the clinical and laboratory tools generally available.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Boris A, Stevenson RH. Further studies on a nonsteroidal anti-androgen. Endocrinology. 1966 Mar;78(3):549–555. [PubMed] [Google Scholar]
  • CAMACHO AM, MIGEON CJ. STUDIES ON THE ORIGIN OF TESTOSTERONE IN THE URINE OF NORMAL ADULT SUBJECTS AND PATIENTS WITH VARIOUS ENDOCRINE DISORDERS. J Clin Invest. 1964 Jun;43:1083–1089.[PMC free article] [PubMed] [Google Scholar]
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  • LAMB EJ, DIGNAM WJ, PION RJ, SIMMER HH. PLASMA ANDROGENS IN WOMEN. I. NORMAL AND NON-HIRSUTE FEMALES, OOPHORECTOMIZED AND ADRENALECTOMIZED PATIENTS. Acta Endocrinol (Copenh) 1964 Feb;45:243–253. [PubMed] [Google Scholar]
  • RIONDEL A, TAIT JF, GUT M, TAIT SA, JOACHIM E, LITTLE B. Estimation of testosterone in human peripheral blood using S35-thiosemicarbazide. J Clin Endocrinol Metab. 1963 Jul;23:620–628. [PubMed] [Google Scholar]
Copyright notice
Abstract
In normal females, androstenedione from both the adrenal cortex and ovary, as a result of peripheral conversion, is the source of the majority of biologically active testosterone in the circulation. The control of the secretion of precursor steroid and androgenic hormone (testosterone) in females is not clear at this time. There are a number of possibilities to explain various types of hirsutism and virilization. The presence of true virilization indicates a significant disorder and requires complete investigation.
The presence of increased amounts of 17-ketosteroids in the urine implicates the adrenal cortex as a source of the pathologic manifestations. The suppressibility of elevated 17-ketosteroids with cortisol analogues aids in distinguishing between adrenal hyperplasia and autonomous neoplasm of the adrenal cortex.
By far the most common entity in this area is simple hirsutism without virilization. Although our knowledge of this disorder is quite incomplete, conservative management is indicated. Further progress in this field is rapidly occurring. An informed clinician can do an adequate job of diagnosis and treatment with the clinical and laboratory tools generally available.
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