{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:21:03Z","timestamp":1783477263698,"version":"3.55.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"S1","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Endocrinol Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Endogenous Cushing\u2019s syndrome (CS) is rare, with an incidence of 0.7\u20132.4 per million population per year according to population-based studies. However, evaluation of patients presenting disorders potentially related to cortisol excess, and therefore with a \u2018high risk of clinical suspicion\u2019 profile, could bring out several unrecognized cases. CS represents one of the most challenging endocrine diseases, with clinical features overlapping with those of common conditions affecting general population, invariably resulting in potential mis- or delayed diagnosis with negative consequences in terms of morbidity and mortality. CS is remarkably prevalent among young females, variably presenting with menstrual irregularities and\/or signs and symptoms of hyperandrogenism. Herein we briefly reviewed literature on prevalence and clinical impact of menses abnormalities, acne and hirsutism -also coexisting in the context of a polycystic ovary syndrome- in CS, aiming at clarifying if, when and how to screen for hypercortisolism young women with these disorders.<\/jats:p>","DOI":"10.1007\/s40618-025-02537-0","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:39:06Z","timestamp":1740148746000},"page":"83-89","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["\u201cWho and how to screen for endogenous hypercortisolism among young women presenting with clinical hyperandrogenism and\/or menstrual abnormalities \u201d"],"prefix":"10.1007","volume":"48","author":[{"given":"Francesco","family":"Ferra\u00f9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ylenia","family":"Alessi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Nista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Roux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1410-6143","authenticated-orcid":false,"given":"Diego","family":"Ferone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Arvat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"2537_CR1","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000486002","volume":"49","author":"F Ferrau","year":"2018","unstructured":"Ferrau F, Korbonits M (2018) Metabolic syndrome in Cushing\u2019s syndrome patients. Front Horm Res 49:85\u2013103","journal-title":"Front Horm Res"},{"issue":"6","key":"2537_CR2","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s40618-022-01754-1","volume":"45","author":"G Giuffrida","year":"2022","unstructured":"Giuffrida G, Crisafulli S, Ferrau F, Fontana A, Alessi Y, Calapai F et al (2022) Global Cushing\u2019s disease epidemiology: a systematic review and meta-analysis of observational studies. J Endocrinol Invest 45(6):1235\u20131246","journal-title":"J Endocrinol Invest"},{"issue":"12","key":"2537_CR3","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/S2213-8587(21)00235-7","volume":"9","author":"M Fleseriu","year":"2021","unstructured":"Fleseriu M, Auchus R, Bancos I, Ben-Shlomo A, Bertherat J, Biermasz NR et al (2021) Consensus on diagnosis and management of Cushing\u2019s disease: a guideline update. Lancet Diabetes Endocrinol 9(12):847\u2013875","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"9522","key":"2537_CR4","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1016\/S0140-6736(06)68699-6","volume":"367","author":"J Newell-Price","year":"2006","unstructured":"Newell-Price J, Bertagna X, Grossman AB, Nieman LK (2006) Cushing\u2019s syndrome. Lancet 367(9522):1605\u20131617","journal-title":"Lancet"},{"issue":"7","key":"2537_CR5","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/S2213-8587(16)00086-3","volume":"4","author":"R Pivonello","year":"2016","unstructured":"Pivonello R, Isidori AM, De Martino MC, Newell-Price J, Biller BM, Colao A (2016) Complications of Cushing\u2019s syndrome: state of the art. Lancet Diabetes Endocrinol 4(7):611\u2013629","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"2537_CR6","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/EJE-16-0467","volume":"175","author":"M Fassnacht","year":"2016","unstructured":"Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A et al (2016) Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the study of adrenal tumors. Eur J Endocrinol 175(2):G1\u2013G34","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2537_CR7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.ecl.2005.02.001","volume":"34","author":"JW Findling","year":"2005","unstructured":"Findling JW, Raff H (2005) Screening and diagnosis of Cushing\u2019s syndrome. Endocrinol Metab Clin North Am 34(2):385\u2013402 ix-x","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"8","key":"2537_CR8","doi-asserted-by":"publisher","first-page":"582","DOI":"10.7326\/0003-4819-147-8-200710160-00012","volume":"147","author":"LK Nieman","year":"2007","unstructured":"Nieman LK (2007) Screening for reversible osteoporosis: is cortisol a culprit? Ann Intern Med 147(8):582\u2013584","journal-title":"Ann Intern Med"},{"issue":"9","key":"2537_CR9","doi-asserted-by":"publisher","first-page":"4106","DOI":"10.1210\/jc.2010-0457","volume":"95","author":"LK Nieman","year":"2010","unstructured":"Nieman LK (2010) Approach to the patient with an adrenal incidentaloma. J Clin Endocrinol Metab 95(9):4106\u20134113","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2537_CR10","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1210\/jc.2008-0125","volume":"93","author":"LK Nieman","year":"2008","unstructured":"Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM et al (2008) The diagnosis of Cushing\u2019s syndrome: an endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 93(5):1526\u20131540","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2537_CR11","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1111\/cen.14710","volume":"97","author":"L Cussen","year":"2022","unstructured":"Cussen L, McDonnell T, Bennett G, Thompson CJ, Sherlock M, O\u2019Reilly MW (2022) Approach to androgen excess in women: clinical and biochemical insights. Clin Endocrinol (Oxf) 97(2):174\u2013186","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2537_CR12","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1007\/s11102-022-01292-2","volume":"26","author":"A Akirov","year":"2023","unstructured":"Akirov A, Dery L, Fleseriu M, Rudman Y, Shimon I, Manisterski Y et al (2023) Cushing\u2019s syndrome in women: age-related differences in etiology and clinical picture. Pituitary 26(1):144\u2013151","journal-title":"Pituitary"},{"issue":"3","key":"2537_CR13","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1530\/EJE-11-0272","volume":"165","author":"E Valassi","year":"2011","unstructured":"Valassi E, Santos A, Yaneva M, Toth M, Strasburger CJ, Chanson P et al (2011) The European Registry on Cushing\u2019s syndrome: 2-year experience. Baseline demographic and clinical characteristics. Eur J Endocrinol 165(3):383\u2013392","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2537_CR14","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.beem.2011.08.001","volume":"25","author":"D Unuane","year":"2011","unstructured":"Unuane D, Tournaye H, Velkeniers B, Poppe K (2011) Endocrine disorders & female infertility. Best Pract Res Clin Endocrinol Metab 25(6):861\u2013873","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"5","key":"2537_CR15","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1210\/jcem-40-5-892","volume":"40","author":"G Boccuzzi","year":"1975","unstructured":"Boccuzzi G, Angeli A, Bisbocci D, Fonzo D, Giadano GP, Ceresa F (1975) Effect of synthetic luteinizing hormone releasing hormone (LH-RH) on the release of gonadotropins in Cushing\u2019s disease. J Clin Endocrinol Metab 40(5):892\u2013895","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2537_CR16","first-page":"3083","volume":"83","author":"J Lado-Abeal","year":"1998","unstructured":"Lado-Abeal J, Rodriguez-Arnao J, Newell-Price JD, Perry LA, Grossman AB, Besser GM et al (1998) Menstrual abnormalities in women with Cushing\u2019s disease are correlated with hypercortisolemia rather than raised circulating androgen levels. J Clin Endocrinol Metab 83(9):3083\u20133088","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2537_CR17","doi-asserted-by":"publisher","first-page":"e13114","DOI":"10.1111\/jne.13114","volume":"34","author":"E Valassi","year":"2022","unstructured":"Valassi E (2022) Clinical presentation and etiology of Cushing\u2019s syndrome: data from ERCUSYN. J Neuroendocrinol 34(8):e13114","journal-title":"J Neuroendocrinol"},{"key":"2537_CR18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1159\/000494904","volume":"53","author":"G Arnaldi","year":"2019","unstructured":"Arnaldi G, Martino M (2019) Androgens in Cushing\u2019s syndrome. Front Horm Res 53:77\u201391","journal-title":"Front Horm Res"},{"issue":"3","key":"2537_CR19","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1080\/09513590802531567","volume":"25","author":"D Shah","year":"2009","unstructured":"Shah D, Patel S, Hirsutism (2009) Gynecol Endocrinol 25(3):140\u2013148","journal-title":"Gynecol Endocrinol"},{"issue":"3","key":"2537_CR20","first-page":"168","volume":"100","author":"E Matheson","year":"2019","unstructured":"Matheson E, Bain J (2019) Hirsutism in Women. Am Fam Physician 100(3):168\u2013175","journal-title":"Am Fam Physician"},{"key":"2537_CR21","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1159\/000494907","volume":"53","author":"B Yilmaz","year":"2019","unstructured":"Yilmaz B, Yildiz BO (2019) Endocrinology of Hirsutism: from androgens to androgen excess disorders. Front Horm Res 53:108\u2013119","journal-title":"Front Horm Res"},{"issue":"5","key":"2537_CR22","doi-asserted-by":"publisher","first-page":"567","DOI":"10.4158\/EP15914.OR","volume":"22","author":"MS Broder","year":"2016","unstructured":"Broder MS, Chang E, Cherepanov D, Neary MP, Ludlam WH (2016) Identification of potential markers for Cushing Disease. Endocr Pract 22(5):567\u2013574","journal-title":"Endocr Pract"},{"issue":"2","key":"2537_CR23","doi-asserted-by":"publisher","first-page":"151","DOI":"10.3892\/etm.2021.11074","volume":"23","author":"DE Branisteanu","year":"2022","unstructured":"Branisteanu DE, Toader MP, Porumb EA, Serban IL, Pinzariu AC, Branisteanu CI et al (2022) Adult female acne: clinical and therapeutic particularities (review). Exp Ther Med 23(2):151","journal-title":"Exp Ther Med"},{"issue":"1","key":"2537_CR24","first-page":"37","volume":"10","author":"JA Zeichner","year":"2017","unstructured":"Zeichner JA, Baldwin HE, Cook-Bolden FE, Eichenfield LF, Fallon-Friedlander S, Rodriguez DA (2017) Emerging issues in adult female acne. J Clin Aesthet Dermatol 10(1):37\u201346","journal-title":"J Clin Aesthet Dermatol"},{"issue":"9","key":"2537_CR25","doi-asserted-by":"publisher","first-page":"3121","DOI":"10.1210\/jc.2009-0612","volume":"94","author":"M Boscaro","year":"2009","unstructured":"Boscaro M, Arnaldi G (2009) Approach to the patient with possible Cushing\u2019s syndrome. J Clin Endocrinol Metab 94(9):3121\u20133131","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2537_CR26","doi-asserted-by":"publisher","first-page":"272","DOI":"10.5114\/ada.2018.74639","volume":"36","author":"F Erden","year":"2019","unstructured":"Erden F, Borlu M, Simsek Y, Kelestemur HF (2019) Differences in skin lesions of endogenous and exogenous Cushing\u2019s patients. Postepy Dermatol Alergol 36(3):272\u2013275","journal-title":"Postepy Dermatol Alergol"},{"issue":"4","key":"2537_CR27","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1046\/j.1365-2265.2000.01117.x","volume":"53","author":"GA Kaltsas","year":"2000","unstructured":"Kaltsas GA, Korbonits M, Isidori AM, Webb JA, Trainer PJ, Monson JP et al (2000) How common are polycystic ovaries and the polycystic ovarian syndrome in women with Cushing\u2019s syndrome? Clin Endocrinol (Oxf) 53(4):493\u2013500","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2537_CR28","doi-asserted-by":"publisher","first-page":"R1","DOI":"10.1530\/EC-19-0435","volume":"9","author":"C Scaroni","year":"2020","unstructured":"Scaroni C, Albiger NM, Palmieri S, Iacuaniello D, Graziadio C, Damiani L et al (2020) Approach to patients with pseudo-cushing\u2019s states. Endocr Connect 9(1):R1\u2013R13","journal-title":"Endocr Connect"},{"issue":"3","key":"2537_CR29","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1080\/09513590400027190","volume":"20","author":"Z Penezic","year":"2005","unstructured":"Penezic Z, Zarkovic M, Vujovic S, Ciric J, Beleslin B, Ivovic M et al (2005) Gonadotropin pulsatility in Cushing\u2019s syndrome compared with polycystic ovary syndrome. Gynecol Endocrinol 20(3):150\u2013154","journal-title":"Gynecol Endocrinol"},{"key":"2537_CR30","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.ejogrb.2013.12.038","volume":"175","author":"J Brzana","year":"2014","unstructured":"Brzana J, Yedinak CG, Hameed N, Plesiu A, McCartney S, Fleseriu M (2014) Polycystic ovarian syndrome and Cushing\u2019s syndrome: a persistent diagnostic quandary. Eur J Obstet Gynecol Reprod Biol 175:145\u2013148","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"4 Pt 1","key":"2537_CR31","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.lpm.2014.02.005","volume":"43","author":"L Guignat","year":"2014","unstructured":"Guignat L, Bertherat J (2014) [Cushing syndrome: when to suspect and how to confirm?]. Presse Med 43(4 Pt 1):366\u2013375","journal-title":"Presse Med"},{"key":"2537_CR32","doi-asserted-by":"crossref","unstructured":"Yesiladali M, Yazici MGK, Attar E, Kelestimur F (2022) Differentiating polycystic ovary syndrome from adrenal disorders. Diagnostics (Basel).;12(9)","DOI":"10.3390\/diagnostics12092045"},{"issue":"3","key":"2537_CR33","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1210\/jc.2014-3344","volume":"100","author":"LT Fourman","year":"2015","unstructured":"Fourman LT, Fazeli PK (2015) Neuroendocrine causes of amenorrhea\u2013an update. J Clin Endocrinol Metab 100(3):812\u2013824","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2537_CR34","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1210\/jc.2018-00241","volume":"103","author":"KA Martin","year":"2018","unstructured":"Martin KA, Anderson RR, Chang RJ, Ehrmann DA, Lobo RA, Murad MH et al (2018) Evaluation and treatment of Hirsutism in Premenopausal women: an endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 103(4):1233\u20131257","journal-title":"J Clin Endocrinol Metab"},{"key":"2537_CR35","doi-asserted-by":"publisher","first-page":"1075785","DOI":"10.3389\/fendo.2022.1075785","volume":"13","author":"CE Lam-Chung","year":"2022","unstructured":"Lam-Chung CE, Cuevas-Ramos D (2022) The promising role of risk scoring system for Cushing syndrome: time to reconsider current screening recommendations. Front Endocrinol (Lausanne) 13:1075785","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2537_CR36","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s11102-022-01222-2","volume":"25","author":"C Scaroni","year":"2022","unstructured":"Scaroni C, Mondin P, Ceccato F (2022) How to rule out non-neoplastic hypercortisolemia (previously known as pseudo-cushing). Pituitary 25(5):701\u2013704","journal-title":"Pituitary"},{"key":"2537_CR37","doi-asserted-by":"crossref","unstructured":"Mondin A, Barbot M, Voltan G, Tizianel I, Vedolin CK, Mazzeo P et al Second-line tests in the differential diagnosis of neoplastic and non-neoplastic hypercortisolism: a systematic review and meta-analysis. J Endocrinol Invest 6(10):1947\u20131959","DOI":"10.1007\/s40618-023-02099-z"},{"issue":"1","key":"2537_CR38","first-page":"28","volume":"125","author":"C Invitti","year":"1991","unstructured":"Invitti C, Pecori Giraldi F, Dubini A, De Martin M, Cavagnini F (1991) Increased urinary free cortisol and decreased serum corticosteroid-binding globulin in polycystic ovary syndrome. Acta Endocrinol (Copenh) 125(1):28\u201332","journal-title":"Acta Endocrinol (Copenh)"},{"issue":"6","key":"2537_CR39","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/BF03345217","volume":"26","author":"P Putignano","year":"2003","unstructured":"Putignano P, Bertolini M, Losa M, Cavagnini F (2003) Screening for Cushing\u2019s syndrome in obese women with and without polycystic ovary syndrome. J Endocrinol Invest 26(6):539\u2013544","journal-title":"J Endocrinol Invest"},{"issue":"10","key":"2537_CR40","doi-asserted-by":"publisher","first-page":"e937","DOI":"10.1210\/clinem\/dgad242","volume":"108","author":"BG Issa","year":"2023","unstructured":"Issa BG, Hanna FWF, Fryer AA, Ensah G, Ebere I, Marshall D, Keevil B (2023) The utility of salivary cortisone in the overnight dexamethasone suppression test in adrenal incidentalomas. J Clin Endocrinol Metab 108(10):e937\u2013e943","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2537_CR41","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.4158\/EP171887.OR","volume":"23","author":"HM Ozkaya","year":"2017","unstructured":"Ozkaya HM, Keskin FE, Tuten A, Korkmaz E, Oktay HZ, Kadioglu P (2017) Late-night salivary cortisol is unaltered in patients with polycystic ovarian syndrome (Pcos), irrespective of Disease phenotype, and in obese women, irrespective of the Presence of Pcos. Endocr Pract 23(9):1045\u20131052","journal-title":"Endocr Pract"},{"issue":"6","key":"2537_CR42","doi-asserted-by":"publisher","first-page":"dgaa105","DOI":"10.1210\/clinem\/dgaa105","volume":"105","author":"BP Galm","year":"2020","unstructured":"Galm BP, Qiao N, Klibanski A, Biller BMK, Tritos NA (2020) Accuracy of Laboratory tests for the diagnosis of Cushing Syndrome. J Clin Endocrinol Metab 105(6):dgaa105","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2537_CR43","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1111\/1523-1747.ep12874121","volume":"94","author":"P Vexiau","year":"1990","unstructured":"Vexiau P, Husson C, Chivot M, Brerault JL, Fiet J, Julien R et al (1990) Androgen excess in women with acne alone compared with women with acne and\/or hirsutism. J Invest Dermatol 94(3):279\u2013283","journal-title":"J Invest Dermatol"},{"issue":"2","key":"2537_CR44","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1111\/j.1365-2265.1994.tb02535.x","volume":"41","author":"JB O\u2019Driscoll","year":"1994","unstructured":"O\u2019Driscoll JB, Mamtora H, Higginson J, Pollock A, Kane J, Anderson DC (1994) A prospective study of the prevalence of clear-cut endocrine disorders and polycystic ovaries in 350 patients presenting with hirsutism or androgenic alopecia. Clin Endocrinol (Oxf) 41(2):231\u2013236","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"2537_CR45","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1097\/00003081-199009000-00028","volume":"33","author":"RL Barbieri","year":"1990","unstructured":"Barbieri RL (1990) Hyperandrogenic disorders. Clin Obstet Gynecol 33(3):640\u2013654","journal-title":"Clin Obstet Gynecol"},{"issue":"4","key":"2537_CR46","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1016\/S0015-0282(01)03241-1","volume":"77","author":"AH Zargar","year":"2002","unstructured":"Zargar AH, Wani AI, Masoodi SR, Laway BA, Bashir MI, Salahuddin M (2002) Epidemiologic and etiologic aspects of hirsutism in Kashmiri women in the Indian subcontinent. Fertil Steril 77(4):674\u2013678","journal-title":"Fertil Steril"},{"issue":"9","key":"2537_CR47","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1055\/s-2004-821307","volume":"112","author":"K Unluhizarci","year":"2004","unstructured":"Unluhizarci K, Gokce C, Atmaca H, Bayram F, Kelestimur F (2004) A detailed investigation of hirsutism in a Turkish population: idiopathic hyperandrogenemia as a perplexing issue. Exp Clin Endocrinol Diabetes 112(9):504\u2013509","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"3","key":"2537_CR48","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1530\/EJE-12-0938","volume":"168","author":"Z Karaca","year":"2013","unstructured":"Karaca Z, Acmaz B, Acmaz G, Tanriverdi F, Unluhizarci K, Aribas S et al (2013) Routine screening for Cushing\u2019s syndrome is not required in patients presenting with hirsutism. Eur J Endocrinol 168(3):379\u2013384","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2537_CR49","doi-asserted-by":"publisher","first-page":"e3723","DOI":"10.1210\/clinem\/dgac379","volume":"107","author":"LT Braun","year":"2022","unstructured":"Braun LT, Vogel F, Zopp S, Marchant Seiter T, Rubinstein G, Berr CM et al (2022) Whom should we screen for Cushing Syndrome? The Endocrine Society Practice Guideline recommendations 2008 Revisited. J Clin Endocrinol Metab 107(9):e3723\u2013e30","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2537_CR50","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1001\/archinte.1994.00420070099011","volume":"154","author":"B Corenblum","year":"1994","unstructured":"Corenblum B, Kwan T, Gee S, Wong NC (1994) Bedside assessment of skin-fold thickness. A useful measurement for distinguishing Cushing\u2019s disease from other causes of hirsutism and oligomenorrhea. Arch Intern Med 154(7):777\u2013781","journal-title":"Arch Intern Med"},{"issue":"2","key":"2537_CR51","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1210\/jc.2003-031122","volume":"89","author":"R Azziz","year":"2004","unstructured":"Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC et al (2004) Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 89(2):453\u2013462","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2537_CR52","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1016\/j.fertnstert.2004.06.040","volume":"82","author":"D Glintborg","year":"2004","unstructured":"Glintborg D, Henriksen JE, Andersen M, Hagen C, Hangaard J, Rasmussen PE et al (2004) Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril 82(6):1570\u20131579","journal-title":"Fertil Steril"}],"container-title":["Journal of Endocrinological Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40618-025-02537-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40618-025-02537-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40618-025-02537-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T10:04:15Z","timestamp":1746007455000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40618-025-02537-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,21]]},"references-count":52,"journal-issue":{"issue":"S1","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["2537"],"URL":"https:\/\/doi.org\/10.1007\/s40618-025-02537-0","relation":{},"ISSN":["1720-8386"],"issn-type":[{"value":"1720-8386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,21]]},"assertion":[{"value":"25 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}