Testosterone high cystic ovary

You may not have heard of the term testosterone. In fact, this is a kind of hormone in people's bodies. Both boys and girls have it, but boys have more of it. For girls, high testosterone is not a very good thing, because if a woman has high testosterone, she is prone to symptoms such as infrequent menstruation and excessive hair growth. The following is a detailed introduction.

1. Based on the clinical manifestations, especially those with oligomenorrhea, amenorrhea or dysfunctional uterine bleeding, plus certain masculinization manifestations, the possibility of this disease should be considered. The diagnosis is based on an increase in blood testosterone >7.0ng/ml or >2.44nmol/L.

2. To distinguish whether the lesion originates from the ovary or adrenal cortex, the ACTH stimulation test can be used: 20 mg of ACTH is injected intramuscularly, and the 24-hour urinary 17-keto and 17-hydroxysteroid excretion is measured before and after injection. If the excretion volume increases significantly after injection, it proves that the adrenal cortex function is abnormal; if there is no obvious change in the excretion volume before and after injection, it indicates that the lesion is in the ovary.

3. B-ultrasound can measure the ratio of the size of the ovaries to the size of the uterus. If the ovaries are more than 1/4 larger than the uterine body, it can be considered as polycystic ovary.

4. Clomiphene treatment trial: Take clomiphene for 3 consecutive cycles. If ovulation occurs, it is probably polycystic ovary. If there is no ovulation in 3 cycles, it may be considered as theca hyperplasia.

5. Posterior abdominal wall pneumatic angiography can examine the size and shape of the adrenal glands to distinguish between adrenal cortical hyperplasia and hyperfunction.

6. On the 9th day of the menstrual cycle, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and testosterone (T) were measured by radioimmunoassay or enzyme labeling method. LH is high, LH/FSH ratio is high, and T is high.

7. Adrenal cortical tumors and ovarian tumors were excluded.

【treat】

1. Spironolactone Spironolactone can compete with androgens, especially dihydrotestosterone (DHT), for receptors on target cells, interfering with the normal formation of dihydrotestosterone. It can also inhibit the activity of some enzymes and interfere with the biosynthesis of testosterone. On the 5th to 21st day of the menstrual cycle, 100 mg/d for 4 to 6 consecutive cycles. After stopping the drug, LH and T can return to normal levels, while FSH and PRL have no changes compared with before treatment. Side effects such as polydipsia, polyuria, fatigue, and headache are rare and mild, and there is no need to stop the drug.