{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:56:59Z","timestamp":1790848619448,"version":"4.1.0"},"reference-count":13,"publisher":"Walter de Gruyter GmbH","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2024-0223_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Ovarian hyperthecosis (OHT) is a rare cause of severe hyperandrogenism in the adolescent age group. We describe two case reports, and present an approach to management in this age group based on a review of the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0223_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>Patient A presented at age 13 years with a 2 year history of androphonia and hirsuitism. Her testosterone level was elevated at 8.3\u202fnmol\/L, and there was marked enlargement of her ovaries bilaterally. There were no focal adrenal or ovarian lesions identified on imaging. She was treated with a gonadotropin releasing hormone (GnRH) agonist and spironolactone with biochemical and clinical improvement. Patient B presented at age 14 years with secondary amenorrhoea, and a 2 year history of androphonia, hirsutism and androgenetic alopecia. Her testosterone level was 12\u202fnmol\/L, and a pelvic ultrasound revealed numerous follicles in each ovary which were otherwise normal in size. She was managed with GnRH agonist initially, and now continues on a combined oral contraceptive pill.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0223_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Ovarian hyperthecosis needs to be considered in pre-menopausal women presenting with severe hyperandrogenism, after exclusion of androgen-producing adrenal and ovarian tumours. The principles of management in this age group are gonadotropin suppression and hormone replacement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2024-0223","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T09:51:05Z","timestamp":1721901065000},"page":"829-834","source":"Crossref","is-referenced-by-count":2,"title":["Ovarian hyperthecosis in adolescent females: two case reports and a review of the literature"],"prefix":"10.1515","volume":"37","author":[{"given":"Eleanor","family":"Angley","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes , The Royal Children\u2019s Hospital , Parkville , Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley","family":"Vollenhoven","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Monash Health , Clayton , Victoria , Australia"},{"name":"Department of Obstetrics and Gynaecology , Monash University , Clayton , Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"White","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes , The Royal Children\u2019s Hospital , Parkville , Victoria , Australia"},{"name":"Murdoch Children\u2019s Research Institute , The Royal Children\u2019s Hospital , Parkville , Victoria , Australia"},{"name":"Department of Paediatrics , The University of Melbourne , Parkville , Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"2025030313151383586_j_jpem-2024-0223_ref_001","doi-asserted-by":"crossref","unstructured":"Goyal, A, Malhotra, R, Kulshrestha, V, Kachhawa, G. Severe hyperandrogenism due to ovarian hyperthecosis in a young woman. BMJ Case Rep 2019;12:e232783. https:\/\/doi.org\/10.1136\/bcr-2019-232783.","DOI":"10.1136\/bcr-2019-232783"},{"key":"2025030313151383586_j_jpem-2024-0223_ref_002","doi-asserted-by":"crossref","unstructured":"Ni, H, Schmidli, R, Savkovic, S, Strasser, SI, Hetherington, J, Desai, R, et al.. Depot pure GnRH antagonist for long-term treatment of ovarian hyperthecosis monitored by multisteroid LCMS profiling. J Environ Sci 2021;5:bvab167. https:\/\/doi.org\/10.1210\/jendso\/bvab167.","DOI":"10.1210\/jendso\/bvab167"},{"key":"2025030313151383586_j_jpem-2024-0223_ref_003","doi-asserted-by":"crossref","unstructured":"Kahraman, FC, Erdo\u011fan, SS. Grading of hirsutism: a practical approach to the modified Ferriman-Gallwey scoring system. 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