Androgen Excess Disorders in Women (eBook)

Ricardo Azziz (Herausgeber)

eBook Download: PDF
2007 | 2007
488 Seiten
Humana Press (Verlag)
978-1-59745-179-6 (ISBN)

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The field of androgen excess disorders has advanced substantially since the original publication of this book. The Androgen Excess Society (AES) was founded to bring together investigators in the field. A better understanding of the screening, progression, and molecular genetics of nonclassic adrenal hyperplasia (NCAH) has improved the clinical care and diagnostic accuracy of these patients. New criteria for the diagnosis of the polycystic ovary syndrome (PCOS) were proposed in Rotterdam, criteria that have resulted in controversy and, hopefully, initiation of new studies. The association of insulin resistance with PCOS has been strengthened, and the role of metformin in tre- ing the infertility of the PCOS has been validated. Risks for diabetes and, more cont- versially, cardiovascular disease in women with PCOS have received substantial investigation. Our understanding of the epidemiology and economic impact of these disorders has expanded, emphasizing their critical importance. These are but a few highlights of how the terrain has changed in a relatively brief period of time. In keeping with these advances, the title of this book has been revised to reflect the growing importance of PCOS as the most prevalent androgen excess disorder in women, and arguably, as the one that might have the most serious adverse consequences for general health. There are fewer chapters to provide a more focused elucidation of the area. Several chapters were penned by new (and young) authors who are conducting cutting-edge research in the field.
The field of androgen excess disorders has advanced substantially since the original publication of this book. The Androgen Excess Society (AES) was founded to bring together investigators in the field. A better understanding of the screening, progression, and molecular genetics of nonclassic adrenal hyperplasia (NCAH) has improved the clinical care and diagnostic accuracy of these patients. New criteria for the diagnosis of the polycystic ovary syndrome (PCOS) were proposed in Rotterdam, criteria that have resulted in controversy and, hopefully, initiation of new studies. The association of insulin resistance with PCOS has been strengthened, and the role of metformin in tre- ing the infertility of the PCOS has been validated. Risks for diabetes and, more cont- versially, cardiovascular disease in women with PCOS have received substantial investigation. Our understanding of the epidemiology and economic impact of these disorders has expanded, emphasizing their critical importance. These are but a few highlights of how the terrain has changed in a relatively brief period of time. In keeping with these advances, the title of this book has been revised to reflect the growing importance of PCOS as the most prevalent androgen excess disorder in women, and arguably, as the one that might have the most serious adverse consequences for general health. There are fewer chapters to provide a more focused elucidation of the area. Several chapters were penned by new (and young) authors who are conducting cutting-edge research in the field.

DEDICATION 6
PREFACE 7
ACKNOWLEDGMENTS 8
CONTENTS 9
CONTRIBUTORS 12
Introduction 16
A Brief History of Androgen Excess 17
Physiology of Androgens 31
Androgens Throughout the Life of Women 47
Physiological Effects of Androgens in Women 60
Androgen Measurements 74
Uncommon Causes of Androgen Excess 84
Androgen-Secreting Adrenal and Ovarian Neoplasms 85
The Nonclassic Adrenal Hyperplasias 100
Pregnancy-Related Androgen Excess 116
Drug-Induced Hyperandrogenism 129
Severe Insulin-Resistance Hyperandrogenic Syndromes 136
Idiopathic Hirsutism 146
The Polycystic Ovary Syndrome 152
Definition and Epidemiology of the Polycystic Ovary Syndrome 153
Clinical Features of the Polycystic Ovary Syndrome 162
Biochemical Features of the Polycystic Ovary Syndrome 175
Ovarian Histology, Morphology, and Ultrasonography in the Polycystic Ovary Syndrome 189
Hypothalamic–Pituitary–Gonadotropic Dysfunction in the Polycystic Ovary Syndrome 200
Ovarian Steroidogenic Abnormalities in the Polycystic Ovary Syndrome 208
Hypothalamic–Pituitary–Adrenal Dysfunction in the Polycystic Ovary Syndrome 217
The Genetic Basis of the Polycystic Ovary Syndrome 227
Pediatric Hyperandrogenism and the Polycystic Ovary Syndrome in Adolescence 238
Environmental Factors in the Polycystic Ovary Syndrome 250
Animal Models and Fetal Programming of the Polycystic Ovary Syndrome 261
Insulin Resistance and Hyperinsulinism in the Polycystic Ovary Syndrome 275
The Endocrine Impact of Obesity and Body Habitus in the Polycystic Ovary Syndrome 284
Molecular Mechanisms of Insulin Resistance in the Polycystic Ovary Syndrome 293
Menstrual Dysfunction and Endometrial Neoplasia in the Polycystic Ovary Syndrome and Other Androgen Excess Disorders 303
Cell Dysfunction, Glucose Intolerance, and Diabetes in the Polycystic Ovary Syndrome 319
Hypertension and Cardiovascular and Lipoprotein Abnormalities in the Polycystic Ovary Snydrome 325
Reproductive and Obstetrical Consequences of the Polycystic Ovary Syndrome 332
Psychosocial and Quality-of-Life Consequences of Androgen Excess and the Polycystic Ovary Syndrome 341
Overview of Long-Term Morbidity and Economic Cost of the Polycystic Ovary Syndrome 351
Evaluation and Treatment of Androgen Excess 361
Clinical and Hormonal Evaluation of Androgen Excess 362
Ovarian Suppression and Treatment of Hirsutism 373
Polycystic Ovary Syndrome and Ovulation Induction 384
In Vitro Fertilization for the Polycystic Ovary Syndrome 400
Surgical Management of the Polycystic Ovary Syndrome 410
Use of Insulin Sensitizers in the Polycystic Ovary Syndrome 416
Weight Reduction and Lifestyle Modifiction in the Treatment of Androgen Excess 430
INDEX 439

Erscheint lt. Verlag 8.11.2007
Reihe/Serie Contemporary Endocrinology
Contemporary Endocrinology
Zusatzinfo 488 p. 81 illus.
Verlagsort Totowa
Sprache englisch
Themenwelt Medizin / Pharmazie Medizinische Fachgebiete Gynäkologie / Geburtshilfe
Medizinische Fachgebiete Innere Medizin Endokrinologie
Schlagworte Diabetes • Infertility • Insulin • insulin resistance • pathophysiology • Physiology
ISBN-10 1-59745-179-7 / 1597451797
ISBN-13 978-1-59745-179-6 / 9781597451796
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