Patient's question:
Girl, currently 19 years old, weighing 150 pounds, height 1.64 meters. At the age of 10, her legs were hairy and dense, with the longest hair reaching over an inch, more than a man's leg hair. She has well-developed muscles. This child has been fat since childhood, around the early 9th year. Bone age development was advanced, and at 15, she stopped menstruating for three months, increasing her weight to 180 pounds. On her back, there is a coffee-colored birthmark that expanded with age, extending to her arms. Cell genetics: 46; XX. She grew very quickly in childhood: at 1 year old, she weighed 1 pound; at 2 years old, 25 pounds; at 4 years old, 48 pounds; at 5 years old, 68 pounds. She couldn't eat much but gained weight significantly. At 15, when she weighed 180 pounds, she lost 30 pounds in three months on Qumei. Now she is in college.Doctor's answer:
Hello, it is likely not polycystic ovary syndrome (PCOS) because estrogen levels are elevated in patients with PCOS. The reasons for hirsutism in women include:(1) Polycystic ovary syndrome. Some patients may have hirsutism, but it is not very pronounced. Its clinical features include amenorrhea, infertility, and obesity. Enlarged ovaries are the main sign.
(2) Cushing's syndrome. The adrenal cortex secretes excessive cortisol and androgens. Its characteristics include hirsutism, central obesity, hypertension, amenorrhea or menstrual disorders, and osteoporosis.
(3) Adrenal androgen syndrome. The adrenal cortex secretes excessive androgens. This condition is often congenital and related to adrenal cortex enzyme system defects. The main signs include hirsutism, pseudohermaphroditism, a large and long clitoris, a masculine body shape, low voice, underdeveloped breasts, and amenorrhea.
(4) Ovarian Sertoli-Leydig cell tumors and ovarian adrenal cortex tumors. These can secrete large amounts of androgens. The main signs include hirsutism and personality changes. A unilateral ovarian tumor can be palpated in the pelvis.
Additionally, temporary hirsutism may occur after long-term or excessive use of adrenal cortex hormones or androgen drugs, which gradually disappears after discontinuation.
If a woman's hirsutism is widespread, severe, and shows a progressive trend, it should be taken seriously, especially if accompanied by male-like symptoms. She should seek further medical evaluation and treatment.