Endo

HAIR-AN Syndrome

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HAIR-AN Syndrome

  • Definition
  • Hair-AN Acronym
  • Pathophysiology
  1. Primary abnormality
    1. Insulin Resistance causes increased Insulin
  2. Secondary abnormality
    1. Excess androgen secretion from ovaries
  • Labs
  1. General lab testing
    1. Complete Blood Count (CBC)
    2. Thyroid Stimulating Hormone (TSH)
    3. Serum Prolactin
    4. Serum electrolytes (Chem7)
  2. Labs associated with Insulin Resistance
    1. Fasting Serum Glucose
    2. Consider Glucose Tolerance Test
  3. Labs associated with Androgen Excess
    1. See Hyperandrogenism
  • Management
  1. General Measures
    1. Weight loss
    2. See Hirsutism
  2. Gonadotropin suppression
    1. Oral Contraceptives (low Androgenic Activity)
      1. Desogestrel (Desogen)
      2. Norgestimate (Ortho-Cyclen)
    2. Anti-androgens
      1. Spironolactone (Aldactone) 50 to 100 mg po bid
      2. Flutamide (Eulexin)
        1. Risk of hepatotoxicity
      3. Finasteride (Proscar) 5 mg per day
  3. Insulin Resistance Modifier
    1. Glucophage (Metformin) 500 - 850 mg PO qd to bid