ovarian hirsutism
Introduction
Introduction Ovarian hairy hair is a type of hirsutism. Hypertrichosis generally refers to the excessive growth and distribution of female hair. It is the increase of androgen in the blood circulation including testosterone, dihydrotestosterone, androstenedione, dehydroepiandrosterone and dehydroepiandrosterone sulfate. . Clinically, female sexual characteristics can be overgrown and the distribution is masculine. Mainly manifested in the face, ears, around the mouth, chest, around the nipple, armpits, back, lower abdomen, pubic hair more dense, diamond-shaped distribution to the umbilicus, and the lower extremities and the front of the thigh, often accompanied by irregular menstruation, cold Wait. Female hairy is often considered to have a certain masculine disease and psychological pressure to seek treatment.
Cause
Cause
(1) Polycystic ovary syndrome: is the cause of more common hirsutism, may be associated with clitoris hypertrophy. Due to the inhibition of aromatase, 3-hydroxysteroid dehydrogenase and the enhancement of P450C, 17 and 20-lyase activity in polycystic ovary, the follicular cells proliferate, and the synthesis of androgens increases, resulting in hirsutism and masculinization.
(2) ovarian tumors: such as ovarian germ cell tumor, portal cell tumor, ovarian cord tumor and adrenal residual cell tumor can synthesize and secrete androgen, causing hirsutism and masculinity.
Examine
an examination
Related inspection
Adrenocorticotropic hormone (ACTH) excitatory test luteinizing hormone (LH) urinary follicle-stimulating hormone
Testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and DHEAS should be checked first. Free testosterone (FT), 17-hydroxyprogesterone an examination. First, observe whether T has increased, and the initial consideration is adrenal or ovarian. If LH rises or the ratio of LH to FSH increases, it may be polycystic ovary syndrome. If DHEAS is elevated, it is often adrenal; while DHEAS is significantly elevated in normal T, mostly ovarian. It is best to check the PRL at the same time to rule out anovulation caused by high prolactin. If the hairy is progressing rapidly, consider a tumor that secretes androgen, and its total T level is higher than 7nmol/L (200ng/dl).
1. B-ultrasound: ovarian tumors can be found basically, and ovarian enlargement or polycystic ovary can also be found, but the diagnosis rate is lower for adrenal diseases.
2. CT or MRI: very sensitive to adrenal tumors, can also be located, can also show the contralateral adrenal gland, but sometimes adrenal hyperplasia will be misdiagnosed, the diagnosis of ovarian tumors is also of great value.
3. Laparoscopy: If there is no abnormality in the non-invasive examination, and the laboratory examination is highly suggestive of ovarian tumors (such as total T>7mmol/L), laparoscopic diagnosis should be performed, and the tumor should be removed under laparoscopic surgery. ready.
Diagnosis
Differential diagnosis
Need to be identified with the following symptoms:
Hairy hair during pregnancy: In addition to hairy, women with no other symptoms and signs of endocrine dysfunction are called idiopathic women with hirsutism, mainly found in pregnant women and menopausal women. During pregnancy, a series of physiological endocrine changes occur in women, in which the anterior pituitary gland secretes more adrenocorticotropic hormone and gonadotropin, which causes an increase in adrenocortical hormone and androgen secreted by the ovaries and adrenal glands. Excessive androgenic hormones prolong the growth of the hair, and the hair is therefore longer than usual; at the same time, the number of hairs can be increased, so that hairy can occur early in pregnancy. This disease is a type of hirsutism in idiopathic women.
Female body hair: body hair is thick, do not think hirsutism. Medically, female hirsutism refers to an increase in body hair density in any part of a woman's body surface, which becomes longer, thicker, and darker, and the distribution pattern is masculine.
Hair hyperplasia: Hyperplasia and hirsutism are excessive hair growth in the body's non-androgen-dependent parts, which may be congenital or acquired, general or local. However, under normal circumstances, different race hairs may vary, not only in different colors, but also in different quantities. For example, Greek males have a lot of chest hair, while Chinese men have fewer chest hairs. Unlike hairy hyperplasia, hirsutism refers to excessive hairiness in females, which occurs only in the androgen-dependent parts, and the slender bristles become thick and short hairs. Female hair is too much, with masculine performance, affecting the appearance.
