Transtornos Menstruais na SOP: Guia Rápido sobre Hiperandrogenismo

Menstrual Disorders – Hyperandrogenism and Polycystic Ovary Syndrome (PCOS) Hyperandrogenism is a disorder characterized by an excess of androgenic hormones (testosterone and its derivatives) in women, resulting in symptoms such as menstrual irregularity, acne, hirsutism (excessive hair growth), and hair loss. Polycystic Ovary Syndrome (PCOS) is the main cause of female hyperandrogenism and is associated with hormonal and metabolic dysfunctions, which can impact fertility and increase the risk of diseases such as type 2 diabetes and cardiovascular disease. 1. Main Symptoms 📌 Menstrual Disorders → Irregular cycles, oligomenorrhea (long cycles) or amenorrhea (absence of menstruation). 📌 Clinical Hyperandrogenism → Acne, seborrhea, androgenetic alopecia (male pattern hair loss), hirsutism (excessive hair growth in male areas). 📌 Infertility → Due to chronic anovulation (lack of ovulation). 📌 Metabolic Alterations → Insulin resistance, obesity, increased cardiovascular risk. 2. PCOS Diagnosis (Rotterdam Criteria - 2003) For diagnosis, the patient must present at least 2 of the 3 criteria below: ✅ Menstrual Irregularity → Anovulatory cycles (oligomenorrhea or amenorrhea). ✅ Hyperandrogenism → Clinical (hirsutism, acne, alopecia) or laboratory (elevated testosterone). ✅ Polycystic Ovaries → Detected by transvaginal ultrasound (≥ 12 small follicles or increased ovarian volume). 🚨 Other conditions, such as congenital adrenal hyperplasia, Cushing's syndrome, and androgen-secreting tumors, should be ruled out! 3. Complementary Examinations 🔹 Hormone Levels → Total and free testosterone, DHEA-S, LH/FSH, prolactin. 🔹 Glycemic Profile → Glucose, insulin, HOMA-IR (for insulin resistance). 🔹 Lipid Profile → Cardiovascular risk assessment. 🔹 Pelvic/Transvaginal Ultrasound → For ovarian evaluation. 4. Treatment of PCOS and Hyperandrogenism Treatment is individualized, depending on the patient's symptoms and goals (hormonal control, aesthetics, or fertility). 🔸 Lifestyle Modifications ✅ Balanced diet and physical activity → For weight control and improved insulin resistance. 🔸 Medication Treatment 💊 Combined hormonal contraceptives → Regulate the menstrual cycle and control hyperandrogenism. 💊 Spironolactone → Androgen blocker, indicated for hirsutism and acne. 💊 Metformin → Reduces insulin resistance and improves ovulatory cycles. 💊 Ovulation Inducers (Clomiphene, Letrozole) → For women who wish to become pregnant. 5. Long-Term Complications 🚨 Metabolic Syndrome → Increased risk of type 2 diabetes and cardiovascular disease. 🚨 Infertility → Due to chronic anovulation. 🚨 Risk of Endometrial Cancer → Due to prolonged exposure to estrogen without progesterone opposition. Conclusion Hyperandrogenism and PCOS are common conditions that hinder early diagnosis and adequate follow-up to prevent metabolic complications, improve quality of life, and preserve fertility. Remember to continue helping our channel maintain free content. pix: +55 21 982108838. Thank you very much for your help, happy studying.