Society for Endocrinology clinical practice guideline for the evaluation of androgen excess in women
Elhassan, Yasir S Hawley, James M Cussen, Leanne Abbara, Ali Clarke, Sophie A Kempegowda, Punith Dhillon-Smith, Rima K Thadani, Puja Busby, Maureen Owusu-Darkwah, Lucy
Elhassan, Yasir S
Hawley, James M
Cussen, Leanne
Abbara, Ali
Clarke, Sophie A
Kempegowda, Punith
Dhillon-Smith, Rima K
Thadani, Puja
Busby, Maureen
Owusu-Darkwah, Lucy
Affiliation
University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; Manchester University NHS Foundation Trust; Medical Research Council Laboratory of Medical Sciences; Royal College of Surgeons in Ireland; Imperial College London; Birmingham Women and Children's NHS Healthcare Trust; University Hospitals Coventry and Warwickshire NHS Trust; PCOS Vitality Patient Support Group Belfast; The London Clinic; University of Edinburgh; Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust
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Publication date
2025-05-13
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Abstract
Context: Androgen excess is common in women and refers to clinical or biochemical evidence of elevated androgenic steroids such as testosterone. It is associated with underlying polycystic ovary syndrome in the majority of cases. However severe androgen excess is less common and may indicate the presence of underlying adrenal or ovarian neoplasms, genetic disorders or severe insulin resistance syndromes. Currently there are few consensus guidelines to assist clinicians with a standardised management approach to the patient with severe androgen excess.
Design: Clinical practice guideline.
Methods: This guideline has been developed with expertise from colleagues in endocrinology, gynaecology, clinical biochemistry and nursing, and furthermore provides a unique patient perspective to guide clinicians.
Results: The Society for Endocrinology commissioned this new guideline to collate multi-disciplinary guidance for clinical practitioners in the investigation of severe androgen excess. Recommendations have been made in the areas of clinical assessment, biochemical work up, dynamic testing and imaging, informed where possible by the best available evidence.
Conclusion: This guideline will provide guidance for clinicians in their approach to patients with severe androgen excess.
Citation
Elhassan YS, Hawley JM, Cussen L, Abbara A, Clarke SA, Kempegowda P, Dhillon-Smith RK, Thadani P, Busby M, Owusu-Darkwah L, Marrington R, Duncan WC, Semple RK, Quinton R, O'Reilly MW. Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women. Clin Endocrinol (Oxf). 2025 Oct;103(4):540-566. doi: 10.1111/cen.15265. Epub 2025 May 13.
Type
Journal Article