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Cetrorelix suppression test to assess the source of androgen overproduction in postmenopausal hirsutism

¹ Departments of Internal Medicine, ² Clinical Chemistry, ³ Clinical Pharmacy, Rijnstate Hospital, Arnhem, The Netherlands

(Correspondence should be addressed to H de Boer who is now at the Department of Internal Medicine, Ziekenhuis Rijnstate, Wagnerlaan 55, 6800 TA Arnhem, The Netherlands; Email: hdeboer{at}alysis.nl)

Abstract

A 75-year-old woman presenting with recent onset hirsutism and severely elevated serum androgen levels was evaluated to assess the source of excessive androgen production. Commonly recommended hormonal stimulation and suppression tests, and the usually employed imaging techniques were non-diagnostic. In this report, we describe a new suppression test based on the use of the GnRH receptor antagonist, cetrorelix, to determine whether androgen production was LH-dependent. Cetrorelix, administered in a daily dose of 250 µg subcutaneously, suppressed serum LH within 24 h and reduced serum androgen levels to normal within 48–72 h, indicating that androgen overproduction was of ovarian origin. This diagnosis was confirmed by laparoscopic ovariectomy.

Conclusion: The cetrorelix suppression test is a simple procedure that provides valuable information regarding the source of androgen excess in postmenopausal hirsutism.