In this article:
To understand ovarian hyperthecosis and how it can affect fertility, we spoke with Dr Manini Patel, Senior Consultant, Obstetrics & Gynaecology, Apollo Spectra Hospital Jaipur.
What Is Ovarian Hyperthecosis?
Ovarian hyperthecosis is a condition in which the ovarian tissue produces unusually high levels of androgens, which are hormones such as testosterone.It is different from typical polycystic ovary syndrome (PCOS), although both conditions can cause symptoms related to excess androgens. The condition is more commonly recognised around or after menopause, but it can also occur during the reproductive years.
What Causes Ovarian Hyperthecosis?
Factors associated with the condition may include:- Increased ovarian androgen production
- Insulin resistance
- Metabolic changes
- Hormonal changes associated with age
What Are the Symptoms of Ovarian Hyperthecosis?
Symptoms are mainly related to increased androgen levels and may develop gradually.Possible signs include:
- Irregular or absent periods
- Increased facial or body hair
- Acne
- Hair thinning or male-pattern hair loss
- Difficulty with ovulation
- Weight gain or difficulty managing weight
- Deepening of the voice in cases of significant androgen excess
- Increased muscle mass in more pronounced cases
How Is Ovarian Hyperthecosis Diagnosed?
No single test confirms ovarian hyperthecosis. Doctors usually combine symptoms, hormone testing, medical history and imaging.Evaluation may include:
- Blood tests: Doctors may check testosterone, DHEAS, and other hormone levels to assess androgen excess.
- Glucose testing: Blood sugar and insulin-related markers may be assessed when metabolic concerns are present.
- Pelvic ultrasound: Helps examine the ovaries and rule out other structural causes.
- Additional imaging: CT or MRI may sometimes be recommended when doctors need to identify the source of significant androgen production.
- Clinical assessment: The pattern and speed of symptoms can help distinguish hyperthecosis from other causes of androgen excess.
How Is Ovarian Hyperthecosis Different From PCOS?
Ovarian hyperthecosis and PCOS can have overlapping symptoms, including irregular periods, excess hair growth and high androgen levels. However, they are not the same condition.- In PCOS, hormonal changes are often associated with irregular ovulation and characteristic ovarian findings.
- In ovarian hyperthecosis, androgen production by the ovarian theca cells can be much more pronounced.
Understanding the underlying cause of hormonal imbalance is essential. A personalised treatment approach can help improve symptoms and support fertility planning when required.
How Can Ovarian Hyperthecosis Affect Fertility?
Ovarian hyperthecosis may affect fertility mainly by interfering with normal ovulation.Women may experience:
- Irregular ovulation
- Infrequent periods
- Difficulty predicting the fertile window
- Reduced chances of conception in cycles without ovulation
How Is Ovarian Hyperthecosis Treated?
Treatment may include:- Lifestyle changes: Weight management, regular physical activity and a balanced diet may support metabolic health.
- Medicines: Depending on the symptoms and fertility goals, doctors may use medicines to manage androgen-related symptoms or help regulate ovulation.
- Fertility treatment: If ovulation remains irregular and pregnancy is desired, fertility medicines or assisted reproductive treatment may be considered.
- Treatment of associated metabolic problems: Insulin resistance, diabetes or other metabolic concerns may need separate management.
- Surgery: In selected severe cases, particularly when other treatments are not appropriate, ovarian surgery may be discussed.
Does Ovarian Hyperthecosis Increase the Risk of Other Health Problems?
Ovarian hyperthecosis can be associated with metabolic problems, particularly when insulin resistance is also present.Your doctor may therefore assess:
- Blood glucose
- Insulin resistance
- Cholesterol levels
- Blood pressure
- Body weight and waist measurements
When Should You See a Doctor?
Consider seeing a gynaecologist or endocrinologist if you have:- Persistent irregular or absent periods
- New or rapidly increasing facial or body hair
- Sudden severe acne or hair loss
- Deepening of the voice
- Difficulty conceiving
- Blood tests showing significantly high androgen levels
You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.
FAQs on High Testosterone in Women: Can It Affect Fertility?
- Can ovarian hyperthecosis affect the menstrual cycle even if periods are still occurring?
Yes. Periods may continue but become irregular, less predictable or less frequent if excess androgen production interferes with normal ovulation. - Can ovarian hyperthecosis be discovered during a fertility evaluation?
Yes. It may come to attention when hormone tests show unexpectedly high androgen levels in someone being evaluated for irregular ovulation or difficulty conceiving. - Does ovarian hyperthecosis affect both ovaries?
It can involve both ovaries, with increased androgen-producing activity within the ovarian tissue. The exact pattern can vary and is assessed through clinical evaluation and investigations.
