Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women

Author:

Elhassan Yasir S.12ORCID,Hawley James M.34,Cussen Leanne5,Abbara Ali6ORCID,Clarke Sophie A.6,Kempegowda Punith27,Dhillon‐Smith Rima K.18,Thadani Puja9,Busby Maureen10,Owusu‐Darkwah Lucy11,Marrington Rachel12,Duncan W. Colin13,Semple Robert K.1415,Quinton Richard1617ORCID,O'Reilly Michael W.5ORCID

Affiliation:

1. Department of Metabolism and Systems Science, College of Medicine and Health University of Birmingham Birmingham UK

2. Department of Endocrinology Queen Elizabeth Hospital Birmingham Birmingham UK

3. Department of Clinical Biochemistry Manchester University NHS Foundation Trust Manchester UK

4. Medical Research Council Laboratory of Medical Sciences London UK

5. Department of Medicine, Androgens in Health and Disease Research Group, Academic Division of Endocrinology Royal College of Surgeons in Ireland (RCSI) Dublin Ireland

6. Section of Investigative Medicine Imperial College London London UK

7. School of Health Sciences, College of Medicine and Health University of Birmingham Birmingham UK

8. Birmingham Women and Children's NHS Healthcare Trust Birmingham UK

9. Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust Coventry UK

10. PCOS Vitality Patient Support Group Belfast UK

11. Department of Endocrinology The London Clinic London UK

12. Birmingham Quality (UK NEQAS), University Hospitals NHS Foundation Trust Birmingham UK

13. Centre for Reproductive Health, Institute for Regeneration and Repair The University of Edinburgh Edinburgh UK

14. Centre for Cardiovascular Science University of Edinburgh Edinburgh UK

15. MRC Human Genetics Unit, Institute of Genetics and Cancer University of Edinburgh Edinburgh UK

16. Department of Metabolism, Digestion & Reproduction Imperial College London London UK

17. Northern Regional Gender Dysphoria Service, Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust Newcastle‐on‐Tyne UK

Abstract

ABSTRACTContextAndrogen excess is common in women and refers to clinical or biochemical evidence of elevated androgenic steroids such as testosterone. It is associated with underlying polycystic ovary syndrome in the majority of cases. However severe androgen excess is less common and may indicate the presence of underlying adrenal or ovarian neoplasms, genetic disorders or severe insulin resistance syndromes. Currently there are few consensus guidelines to assist clinicians with a standardised management approach to the patient with severe androgen excess.DesignClinical practice guideline.MethodsThis guideline has been developed with expertise from colleagues in endocrinology, gynaecology, clinical biochemistry and nursing, and furthermore provides a unique patient perspective to guide clinicians.ResultsThe Society for Endocrinology commissioned this new guideline to collate multi‐disciplinary guidance for clinical practitioners in the investigation of severe androgen excess. Recommendations have been made in the areas of clinical assessment, biochemical work up, dynamic testing and imaging, informed where possible by the best available evidence.ConclusionThis guideline will provide guidance for clinicians in their approach to patients with severe androgen excess.

Publisher

Wiley

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