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