Hypersecretion of ovarian androgens may be gonadotrophin dependent many years after menopause

• Background: In fertile women both adrenals and ovaries contribute to androgen production, whereas after the menopause the ovarian contribution normally decreases. Objective: The objective of this case study was to assess whether ovarian androgen secretion was responsive to decreased gonadotrophin stimulation and whether gonadotrophins were sensitive to negative feedback from sex steroids many years after the menopause. Methods: In this uncontrolled case study a 72 years old slightly overweight woman with noninsulin-dependent diabetes mellitus presented with hirsuitism and elevated serum testosterone concentrations. The woman was reluctant to have an oophorectomy, and received an oral estradiol/progestagene preparation. Serum testosterone and gonadotrophin concentrations were measured before and after steroid hormone therapy. Results: Serum gonadotrophin concentrations decreased and testosterone levels returned to normal during therapy. When the hormone therapy was stopped for 1 month the high testosterone concentrations returned, but were again normalized when the hormone therapy was reinitiated. Conclusion: The ovaries of this woman were apparently still responsive to pituitary stimulation and her hypothalamic-pituitary-ovarian feed-back system still seemed to be working after 70 years of age.

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