Now doctors recommend a total hysterectomy because they feel my ovaries are the problem. What other treatments do I need to correct this condition besides a gallon of Nair and a turban or wig? — G.N.
ANSWER: It’s the very high levels of testosterone that are causing the problems. These levels, which would be normal for men, cause male pattern hair loss, as well as unwanted body hair and acne in a female. The big concern is where the testosterone is coming from. It can come either from the adrenal glands, which sit right on top of the kidney and normally produce some male hormones in women, or from the ovaries. The negative MRI scan makes a tumor unlikely, since the test is very sensitive. I am concerned about your enlarged adrenal gland; it sounds like your doctors think the ovary is the cause. A blood test called DHEA-S can help identify whether the hormone is coming from the adrenal gland. I suspect you have already had that done.
If it’s not a tumor, the most likely cause is ovarian hyperthecosis. In this condition, the ovaries make excess testosterone, which causes hair loss from the head, often deepens voices and produces body hair similar to men’s. The diagnosis can be made only by examination of the ovaries, removal of which is also the treatment. It’s important to make this diagnosis, because the risk of diabetes is very high.
I recognize the importance of the hair loss and growth, but it’s a symptom of the excess testosterone, which must be treated.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.