Iatrogenic Androgen Excess

IATROGENIC ANDROGEN EXCESS

Some drugs with androgen activity have been implicated in hirsutism and virilization, including danazol and progestin-containing oral contraceptives.

Danazol

Danazol is an attenuated androgen used for the suppression of pelvic endometriosis. It has androgenic properties, and somewomen develop hirsutism, acne, and deepening of the voice while taking the drug. If these symptoms occur, the value of the danazol should be weighed against the side effects before continuing therapy. Symptoms of voice changes may be irreversible upon discontinuation of treatment. Pregnancy should be ruled out before initiating a course of danazol therapy, because it can produce virilization of the female fetus.

Oral Contraceptives

The progestins in oral contraceptives are impeded andro-gens. Rarely, a woman taking oral contraceptives develops acne and even hirsutism. If this occurs, another product with a less-androgenic progestin should be selected, or the pill should be discontinued. Moreover, evaluation for the coincidental development of late-onset adrenal hyperplasia should be done.