Hyperandrogenism in postmenopausal woman: Is surgery reasonable for diagnosis and treatment?

Abstract

Hyperandrogenism with severe signs of virilism is rare in postmenopausal period. Androgenic drug intake, malign and benign androgen-secreting tumors, gonadotropin depending ovarian stromal disorders have been reported as causes of hyperandrogenism after menopause. We present a 78-year-old woman referred to our gynecology department with hirsutism, male pattern baldness, and deepening voice. Bilateral ovarian enlargement was noted in the gynecologic examination. There was no evidence of adrenal or ovarian tumor with magnetic resonance imaging. The patient's clinic and laboratory data pointed out an ovarian origin. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Both frozen and histopathologic evaluation revealed bilateral ovarian stromal hyperplasia and right ovarian stromal luteoma. The patient was discharged. Three months later, patient's serum total testosterone level was normal and symptomatic improvement was obtained. Surgery may be reasonable for definitive diagnosis and appropriate treatment of hyperandrogenism of ovarian origin in postmenopausal women who completed childbearing age.