Abstract
Many drugs can induce hyperandrogenic symptoms, such as hirsutism, acne, seborrheic dermatitis, male-pattern baldness, menstrual irregularities, clitoral hypertrophy, or deepening of voice. Anabolic-androgenic steroids, synthetic progestins, and antiepileptics are the most frequently implicated drugs in hyperandrogenism. The mechanisms of androgen excess are various: (1) intrinsic androgenic activity of the drug, (2) interaction with sex hormone-binding globulin, or (3) functional alterations of the hypothalamic-pituitary-ovary axis. Nevertheless, the physiology of these drugs remains generally unclear. Such is the case for valproate, which seems to induce a form of polycystic ovary syndrome (PCOS) by increasing ovarian androgen synthesis. It should be remembered that it is always necessary to rule out other causes of androgen excess, especially an ovarian or adrenal tumor or PCOS, before attributing the symptom(s) to a drug.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Song S, Chen J, Lu C, et al. Effects of different doses of norethisterone on ovarian function, serum sex hormone binding globulin and high density lipoprotein-cholesterol. Contraception 1993;47:527–537.
Rogol A, Yesalis CE. Anabolic-androgenic steroids and the adolescent. Pediatr Ann 1992;21:175–188.
Wilson JD, Griffin JE. Progress in endocrinology and metabolism: the use and misuse of androgens. Metabolism 1980;29:1278–1295.
Barbieri RL, Evans S, Kistner RW. Danazol in the treatment of endometriosis: analysis of 100 cases with a 4 year follow-up. Fertil Steril 1982;37:737–746.
Cirkel U, Ochs H, Schneider HPG. A randomized, comparative trial of triptorelin depot (D-Trp-LHRH) and danazol in the treatment of endometriosis. Eur J Obstet Gynecol 1995;59:61–69.
Wright S, Valdes CT, Dunn RC, Franklin RR. Short-term Lupron or danazol therapy for pelvic endometriosis. Fertil Steril 1995;63:504–507.
Elfman T, Falanga V. Stanazolol as a novel therapeutic agent in dermatology. J Am Acad Dermatol 1995;33:254–258.
Nilsson KO, Albertsson-Wikland K, Alm J, et al. Improved final height in girls with Turner’s syndrome treated with growth hormone and oxandrolone. J Clin Endocrinol Metab 1996;81:635–640.
Isojarvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllyla VV. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 1993;329:1383–1388.
Verrotti A, Greco R, Latini G, Chiarelli F. Endocrine and metabolic changes in epileptic patients receiving valproic acid. J Pediatr Endocr Metab 2005;18:423–430.
Ferin M, Morrell M, Xiao E, et al. Endocrine and metabolic responses to long-term monotherapy with the antiepileptic drug valproate in the normally cycling rhesus monkey. J Clin Endocrinol Metab 2003;88:2908–2915.
Bilo L, Meo R, Valentino R, Di Carlo C, Striano S, Nappi C. Characterization of reproductive endocrine disorders in women with epilepsy. J Clin Endocrinol Metab 2001;86:2950–2956.
Nelson-DeGrave V, Wickenheisser J, Cockrell J, et al. Valproate potentiates androgen biosynthesis in human ovarian theca cells. Endocrinology 2003;145:799–808.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Neraud, B., Dewailly, D. (2006). Drug-Induced Hyperandrogenism. In: Azziz, R., Nestler, J.E., Dewailly, D. (eds) Androgen Excess Disorders in Women. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-179-6_10
Download citation
DOI: https://doi.org/10.1007/978-1-59745-179-6_10
Publisher Name: Humana Press
Print ISBN: 978-1-58829-663-4
Online ISBN: 978-1-59745-179-6
eBook Packages: MedicineMedicine (R0)