Hyperandrogenism in postmenopausal women: a case report and literature review

A 71-year-old female complained of hirsutism, androgenetic alopecia and enlarged clitoris after 10 years of post-menopause. Laboratory examination of total testosterone level was elevated (1.55-1.79 ng/mL, reference range: 0.08-0.60 ng/mL), while dehydroepiandrosterone sulfate was within normal range. No obvious adrenal or ovarian mass was shown on imaging. Laparoscopy exploration was refused owing to advanced age and multiple comorbidities. After the 8-month trial of gonadotropin-releasing hormone analogue triptorelin, improved hirsutism and reduced androgenetic alopecia were observed, with decreased luteinizing hormone levels from 31 to 0.2 IU/L and normalized testosterone levels to 0.47 ng/mL. No signs of tumor metastasis or ovarian enlargement were found on imaging examination. At the same time, the combination of lifestyle intervention and lipid lowering treatment can improve patients ' metabolic abnormalities, alleviate psychological anxiety, and improve their quality of life.