Main syndromes of hyperandrogenia in women: pathogenesis, differential diagnosis (literature review and own observation)

P.M. Liashuk, R.P. Liashuk


Hyperandrogenic syndrome is a pathological condition caused by an excessive production of androgens by ovaries and/or adrenal glands or increased local tissue sensitivity to circulating androgens. This is the most common endocrinopathy in women. The importance of timely diagnosis of hyperandrogenic states is due to their consequences: androgen-dependent dermopathy, menstrual disorders, endocrine infertility, increased risk of non-pregnancy, preterm labor, gestational diabetes. The prevalence and possible consequences of hyperandrogenism in women of reproductive age predetermine the importance of timely differential diagnosis of the major syndromes of hyperandrogenic states — adrenogenital syndrome and polycystic ovary syndrome. Since the symptoms of these syndromes have much in common, based on the data of literature review and own observations, a differential diagnosis is supplemented and presented in the form of an original table that to some extent will help endocrinologists and gynecologists to distinguish between these pathological conditions.


adrenogenital syndrome; polycystic ovaries; reproductive function; pathogenesis; differential diagnosis; review


Pishak VP, Myslyc'kyj VF, Tkachuk SS. Spadkovi syndromy z osnovamy fenotypovoi' diagnostyky: slovnyk-dovidnyk [Hereditary syndromes with the basics of phenotypic diagnosis: a reference dictionary]. Chernivtsi: Meduniversytet; 2010. 608 p. (in Ukrainian).

Lutsenko LA. Adrenal hyperandrogenism: multidisciplinary approach to solving problemss. Mìžnarodnij endokrinologìčnij žurnal. 2016;(80):29-34. doi: 10.22141/2224-0721.8.80.2016.89535. (in Ukrainian).

Reznikov AG. Pathophysiological and pharmacotherapeutic aspects of hyperandrogenic conditions in women. Zdorov’ja Ukrai'ny. Diabetologija, Tyreoi'dologija, Metabolichni rozlady. 2010;(2):70-71. (in Russian).

Molashenko NV, Troshina EA, Sazonova AI, authors; Dedov II, Mel'nichenko GA, editors. Diagnostika i lechebno-profilakticheskie rekomendatsii pri vrozhdennoi disfunktsii kory nadpochechnikov u patsientov vo vzroslom vozraste: klinicheskie rekomendatsii [Diagnosis and treatment-and-prophylactic recommendations for congenital dysfunction of the adrenal cortex in patients in adulthood: clinical guidelines]. Moscow; 2016. 27 p. (in Russian).

Semeniuk LM. Hyperandrogenism as a factor of reproductive losses. Clinical Endocrinology and Endocrine Surgery. 2013;(42):71-79. (in Ukrainian).

Molashenko NV, Sazonova AI, Troshina EA. Diagnosis, treatment and preventive measures in congenital adrenal hyperplasia due to 21-hydroxylase deficiency in patients in adulthood. Arkhiv Akusherstva i Ginekologii im VF Snegiryova. 2016;3(1):26-32. doi: 10.18821/2313-8726-2016-3-1-26-32. (in Russian).

Pishak VP, Ryznychuk MO. Adrenogenital syndrome: molecular mechanisms of development. Mìžnarodnij endokrinologìčnij žurnal. 2017;13(2):195-202. doi: 10.22141/2224-0721.13.2.2017.100612. (in Ukrainian).

Urbanovych AM. Polycystic ovary syndrome in every day practice. Mìžnarodnij endokrinologìčnij žurnal. 2018;14(1):40-45. doi: 10.22141/2224-0721.14.1.2018.127090. (in Ukrainian).

Sidel'nikova VM, Sukhikh GT. Nevynashivanie beremennosti: rukovodstvo dlia vrachei [Miscarriage of pregnancy: a guide for doctors]. Moscow: MIA; 2010. 534p. (in Russian).

Dedov MI, Goncharov NP, Marova EI, authors; Dedov MI, editor. Sovremennye metody gormonal'noi diagnostiki patologii nadpochechnikov: posobie dlia vrachei i vrachei–laborantov [Modern methods of hormonal diagnosis of adrenal pathology: a manual for doctors and laboratory technicians].Moscow; 2010. 28 p. (in Russian).

Iliushina AA, Liashuk PM, Protsenko OV, Lenkovska GS, Vatamaniuk MM. Adrenogenital syndrome in women. Klinicna ta eksperimentalʹna patologia. 2014;13(1):173-177. (in Ukrainian).

Liashuk RP, Stankova NI, Skhodnytskyi IV. A case of androsteroma. Buk Med Herald. 2015;19(74):245-246. (in Ukrainian).

Baquedano MS, Guercio G, Marino R, et al. Unique dominant mutation in the N-terminal mitochondrial targeting secuence of StAR, causing a variant form of congenital lipoid adrenal hyperplasia. J Clin Endocrinol Metab. 2013 Jan;98(1):E153-61. doi: 10.1210/jc.2012-2865.

Speiser PW, White PC. Congenital Аdrenal Нyperplasia. N Engl J Med. 2003 Aug 21;349(8):776-788. doi: 10.1056/NEJMra021561.

Zimmermann A, Grigorescu-Sido P, Alkhzouz C, et al. Alterations in lipid and carbohydrate metabolism in patients with classic congenital adrenal hyperplasia duo to 21- hidroxylase deficiency. Horm Res Paediatr. 2010;74(1):41-9. doi: 10.1159/000313368.

Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hidroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018 Nov 1;103(11):4043-4088. doi: 10.1210/jc.2018-01865.

Rykova OV. Polycystic ovary syndrome: laboratory diagnosis of hyperandrogenic status of a woman. Mìžnarodnij endokrinologìčnij žurnal. 2015;(72):69-71. doi: 10.22141/2224-0721.8.72.2015.72340. (in Russian).

Barnes RB, Rosenfield RL, Burstein S, Ehrmann DA. Pituitary-ovarian responses to nafarelin testing in the polycystic ovary syndrome. N Engl J Med. 1989 Mar 2;320(9):559-65. doi: 10.1056/NEJM198903023200904.

Gopchuk OM. Polycystic ovary syndrome - generalized aspects of the clinic, diagnosis, treatment. Health of Woman. 2011;(59):207-210. (in Ukrainian).

Vlasenko MV. Hypothalamic syndrome. Mìžnarodnij endokrinologìčnij žurnal. 2012;(43):70-76. (in Ukrainian).

Liashuk PM, Liashuk RP. Metabolic syndrome as an interdisciplinary problem (literature review). Mìžnarodnij endokrinologìčnij žurnal. 2017;13(7):499-502. doi: 10.22141/2224-0721.13.7.2017.115748. (in Ukrainian).

Liashuk PM, Olenovych OA, Protsenko OV. Differential diagnostics of adrogenital syndrome in women. Mìžnarodnij endokrinologìčnij žurnal. 2013;(54):109-110. (in Ukrainian).

Tereshchenko IV. Non-classical form of congenital dysfunction of the adrenal cortex. In: Karachentsev IuI, Kazakov AV, Kravchun NA, Il'ina IM, editors. 100 izbrannykh lektsii po endokrinologii. 2 izd. [100 selected lectures on endocrinology. 2nd ed.]. Kharkiv: SAM; 2014. 939-955 pp. (in Russian).

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© "Publishing House "Zaslavsky", 1997-2019


   Seo анализ сайта