II. Symptoms and Signs

  1. General appearance
    1. Muscular male body habitus (e.g. Shoulder girdle)
    2. Android Obesity
  2. Miscellaneous Changes
    1. Deepening of voice
    2. Clitorimegaly
    3. Increased Libido
  3. Menstrual irregularity
    1. Amenorrhea
    2. Infertility
  4. Endocrine changes
    1. Hypertension
    2. Hyperlipidemia
    3. Glucose Intolerance
  5. Skin changes
    1. Hirsutism involving face, chin, chest and perineum
    2. Alopecia
      1. Vertex or crown Hair Loss
      2. Bitemporal Hair Loss may also occur
    3. Acanthosis Nigricans (HAIR-AN Syndrome)
    4. Oily skin
    5. Acne Vulgaris
    6. Male sweat changes (malodorous perspiration)

III. Associated Conditions: Hyperandrogenic Syndromes

V. Labs

  1. Serum Testosterone (normally 20-80 ng/dl)
    1. Measure on 2 separate occasions
    2. Level <200: Hyperandrogenic chronic Anovulation
    3. Level >200: Assess for virilizing tumor
  2. Serum 17a-Hydroxyprogesterone (normally <2 ng/ml)
    1. Test >4 ng/ml suggests Congenital Adrenal Hyperplasia
    2. Check adrenocorticotropic stimulation test
  3. Dehydroepiandrosterone sulfate (normal 250-300 ng/dl)
    1. DHEAS <700 ng/dl: Hyperandrogenic chronic Anovulation
    2. DHEAS >700 ng/dl: Adrenal tumor secreting androgens
  4. Other labs to consider
    1. Dexamethasone Suppression Test (AM Serum Cortisol)
      1. Assess for Cushing's Syndrome
    2. Luteinizing hormone and Follicle Stimulating Hormone
      1. Assess for ovarian tumors
    3. Lipid profile
      1. Lipids elevated in Hyperandrogenism

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Ontology: Virilism (C0042755)

Definition (NCI) The abnormal development of male secondary sexual characteristics due to excessive androgens.(NICHD)
Definition (NCI_CTCAE) A disorder characterized by inappropriate masculinization occurring in a female or prepubertal male.
Definition (MSH) Development of male secondary SEX CHARACTERISTICS in the FEMALE. It is due to the effects of androgenic metabolites of precursors from endogenous or exogenous sources, such as ADRENAL GLANDS or therapeutic drugs.
Definition (CSP) abnormal possession of mature masculine somatic characteristics by a girl, woman, or prepubescent; may be present at birth or may appear first later in life, depending on its cause; it may be relatively mild (hirsutism) or severe; commonly the result of gonadal or adrenocortical dysfunction, or may be produced by androgenic therapy.
Concepts Sign or Symptom (T184)
MSH D014770
SnomedCT 190517002, 15160007
English Virilism, VIRILIZATION, MASCULINIZATION, VIRILISM, virilism, Virilism [Disease/Finding], virilization, virilisation, Virilisation, Masculinisation, Masculinization, Virilization (finding), masculinization, Masculinization, NOS, Virilization, NOS, Virilization
French VIRILISME, Masculinisation, MASCULINISATION, VIRILISATION, Virilisme, Virilisation
Portuguese VIRILISMO, Masculinização, MASCULINIZACAO, VIRILIZACAO, Virilismo, Virilização
Spanish VIRILISMO, Masculinización, MASCULINIZACION, VIRILIZACION, masculinización, virilismo, virilización (hallazgo), virilización, Virilismo, Virilización
German VIRILISMUS, MASKULINISIERUNG, VERMAENNLICHUNG, Maskulinisierung, Virilisierung, Virilismus, Vermännlichung
Dutch masculinisatie, virilisatie, virilisme, Virilisme, Virilisatie
Italian Mascolinizzazione, Virilizzazione, Virilismo
Japanese ダンセイカ, 男性化, ビリリズム, 男性化症
Czech virilismus, Maskulinizace, Virilismus, Virilizace
Finnish Virilismi
Russian VIRILIZIRUIUSHCHII SINDROM, VIRILIZM, MASKULINIZM, ВИРИЛИЗИРУЮЩИЙ СИНДРОМ, ВИРИЛИЗМ, МАСКУЛИНИЗМ
Swedish Virilism
Polish Wirylizacja
Hungarian Virilisatio, Virilismus, Masculinisatio
Croatian VIRILIZACIJA, VIRILIZAM
Norwegian Virilisme, Mannlige trekk hos kvinner

Ontology: Hyperandrogenism (C0206081)

Definition (MSH) A condition caused by the excessive secretion of ANDROGENS from the ADRENAL CORTEX; the OVARIES; or the TESTES. The clinical significance in males is negligible. In women, the common manifestations are HIRSUTISM and VIRILISM as seen in patients with POLYCYSTIC OVARY SYNDROME and ADRENOCORTICAL HYPERFUNCTION.
Concepts Disease or Syndrome (T047)
MSH D017588
SnomedCT 237793004
English Hyperandrogenism, Hyperandrogenism [Disease/Finding], hyperandrogenism, Hyperandrogenisation syndrome, Hyperandrogenization syndrome (disorder), Hyperandrogenization syndrome
Dutch hyperandrogenisme, Androgenisme, hyper-, Hyperandrogenisme
French Hyperandrogénisme, Hyperandrogénie
Japanese アンドロゲン過剰症, アンドロゲンカジョウショウ
Swedish Hyperandrogenism
Czech hyperandrogenismus, Hyperandrogenismus
Finnish Hyperandrogenismi
Russian GIPERANDROGENIZM, ГИПЕРАНДРОГЕНИЗМ
Polish Hiperandrogenizm
Hungarian Hyperandrogenismus
Norwegian Hyperandrogenisme
Spanish hiperandrogenismo, síndrome de hiperandrogenización (trastorno), síndrome de hiperandrogenización, Hiperandrogenismo
German Hyperandrogenismus
Italian Iperandrogenismo
Portuguese Hiperandrogenismo

Ontology: Androgen excess (C0235461)

Definition (NCI) Excessive secretion of androgens from the adrenal glands or gonads. Clinical manifestations may include virilization.(NICHD)
Concepts Finding (T033)
ICD10 E28.1
French HYPERANDROGENISME, Effet excessivement androgène
English ANDROGEN EXCESS EFFECT, Androgen excess, Androgen excess effect, androgens excess, excess androgen, androgen excess, Hyperandrogenism, Androgen Excess, excess; androgens, androgen; excess
Portuguese HIPERANDROGENISMO, Efeito de excesso de androgénios
Dutch androgeen surpluseffect, androgeen; overmaat, overmaat; androgenen, Overmaat aan androgenen
German Androgenueberschuss Auswirkung, ANDROGENIS-ERSCHEINUNG, Ovarielle Dysfunktion: Androgenueberschuss
Italian Effetto da eccesso di ormoni androgeni
Spanish Efecto por exceso de andrógenos, ANDROGENOS, HIPERACTIVIDAD
Japanese アンドロゲン過剰効果, アンドロゲンカジョウコウカ
Czech Účinek nadbytku androgenů
Korean 안드로겐 과다
Hungarian Túlzott androgén hatás

Ontology: Hyperandrogenemia (C1299574)

Concepts Finding (T033)
SnomedCT 371131009
English HYPERANDROGENEMIA, Hyperandrogenemia, Hyperandrogenaemia, Hyperandrogenemia (finding)
Czech Hyperandrogenemie, Hyperandrogenémie
Dutch hyperandrogenemie
French Hyperandrogénie
German Hyperandrogenaemie
Hungarian Hyperandrogenemia, Hyperandrogenaemia
Italian Iperandrogenemia
Japanese コウアンドロゲンケツショウ, 高アンドロゲン血症, コウアンドロゲンケッショウ
Portuguese Hiperandrogenemia
Spanish Hiperandrogenemia, hiperandrogenemia (hallazgo), hiperandrogenemia