Cases reported "Hirsutism"

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1/6. polycystic ovary syndrome after menopause: a case report.

    BACKGROUND: polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by characteristic ovarian morphology on ultrasound, hyperandrogenism and chronic anovulation. Little is known about zhat happens to ovarian morphology or testosterone production in women with PCOS after menopause, and it is unclear how these women should be treated for the complaint of hirsutism. CASE: A 65-year-old woman presented with elevated testosterone levels, hirsutism and insulin resistance. Laparoscopic bilateral salpingo-oophorectomy (BSO) was performed, and following the procedure the testosterone levels normalized, although the ovaries were normal histologically. CONCLUSION: Laparoscopic BSO is a relatively safe, definitive treatment for postmenoapusal women with PCOS.
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ranking = 1
keywords = ovulation
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2/6. Bilateral ovarian lipid cell hyperplasia in a young hirsute patient.

    Virilizing lipid cell ovarian hyperplasia occurred in a 24-year-old woman referred with secondary amenorrhea, hirsutism, and weight gain. Hormone analyses revealed abnormal androgen production shown in a suppression test to be autonomic and of ovarian origin. Ovarian vein catheterization revealed abnormally increased androgen levels in the left ovarian vein and in the caval vein where it was entered by the right ovarian vein. As the patient wanted to become pregnant, three-quarters of her ovarian tissue was resected. menstruation and ovulation returned. Two years after the operation the patient conceived. Histopathological and electron microscopic examinations revealed bilateral lipid cell hyperplasia.
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ranking = 1
keywords = ovulation
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3/6. Clinical evaluation of the effects of combined treatment with bromocriptine and spironolactone in two women with the polycystic ovary syndrome.

    Two women with the polycystic ovary syndrome were treated with bromocriptine (15 to 20 mg/day) in combination with spironolactone (100 mg/day). In the first woman the combined therapy induced a marked reduction of hirsutism, with ensuing ovulation and pregnancy. In the second woman, who had hyperthecosis and had been refractory to treatment with clomiphene and wedge resection, the combined therapy resulted in abolition of hirsutism, normalization of blood pressure, weight reduction, and improvement in glucose intolerance. In this patient fertility could not be established by the above treatment, but the symptomatic amelioration was so great that she accepted no further attempt to induce ovulation. In view of the marked amelioration of the polycystic ovary syndrome induced by combined bromocriptine and spironolactone treatment, this mode of therapy should receive further consideration.
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ranking = 2
keywords = ovulation
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4/6. pregnancy after unilateral oophorectomy in a woman with hyperthecosis ovarii. A case report.

    Ovarian hyperthecosis has been described exclusively as bilateral. It occurs predominantly in perimenopausal women but may be seen at any age after puberty. In a young woman, stromal hyperthecosis is characterized by virilism, menstrual disorders and infertility. Ovarian suppression therapy, induction of ovulation and wedge resection of the ovaries have been ineffective, and only bilateral oophorectomy has caused regression of virilism in these patients. Conservative surgery in appropriate cases may save many young women desiring pregnancy from having bilateral oophorectomy. This case report describes a unique situation in which a young woman with ovarian hyperthecosis achieved three pregnancies after unilateral oophorectomy, indicating the possibility of unilateral ovarian hyperthecosis in our patient.
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ranking = 1
keywords = ovulation
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5/6. testosterone-producing solitary ovarian cyst with luteinized stromal-cell hyperplasia.

    BACKGROUND: Hormone production is a characteristic associated with the presence of solid tumors in the ovary. We present a case of a solitary ovarian cyst producing large amounts of testosterone and presenting with rapid onset of hirsutism. CASE: A woman presented approximately 6 months postpartum with irregular menses and rapid onset of hirsutism. Laboratory and radiologic evaluation indicated an ovarian cyst as the source. On removal, the cyst was found to have high amounts of testosterone in its fluid and the surrounding stroma had nests of luteinized cells. CONCLUSION: The chronic anovulation in the postpartum period may have prolonged the lifespan of the luteinized stromal cells, resulting in high levels of circulating testosterone and causing rapid progression of hirsutism.
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ranking = 1
keywords = ovulation
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6/6. Induction of ovulation with the sole use of clomiphene citrate in late-onset 21-hydroxylase deficiency.

    Late-onset 21-hydroxylase deficiency (21-OHD) is a congenital enzymatic defect in the glucocorticoid and mineralocorticoid steroidogenic pathways. The manifestations, including hirsutism and infertility, usually occur at puberty or young adulthood. In infertile, anovulatory women with late-onset 21-OHD, the usual therapy is glucocorticoids for ovulation induction. In this case, we report the sole use of clomiphene citrate to induce ovulation in a patient with late-onset 21-OHD. A hirsute and oligomenorrheic woman was diagnosed as having polycystic ovary syndrome at age 25. Her hirsutism responded to oral contraceptives. At age 31, she was given clomiphene citrate alone for ovulation induction and conceived in her fourth cycle. At age 36, because of increased hirsutism she was diagnosed with late-onset 21-OHD by an ACTH stimulation test. The induction of ovulation in late-onset 21-OHD patients has been with glucocorticoids. Given the success in inducing ovulation with clomiphene citrate alone in this patient with well-documented late-onset 21-OHD, it may be worthwhile to study the sole use of clomiphene citrate for ovulation induction in these patients.
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ranking = 10
keywords = ovulation
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