Postmenopausal hyperandrogenism of ovarian origin

Introduction During the postmenopausal period, hyperandrogenic manifestations include hirsutism and variable degrees of virilization. Metabolic syndrome is often associated. True hirsutism and acne should not be considered normal as they may reveal tumorous sources of excessive androgen secretion originating from either the adrenals or the ovaries. Once adrenal causes are excluded, virilizing ovarian tumors must be considered, with Sertoli-Leydig cell tumor being the most common histological subtype. Cases presentations We report the observations of three female patients who presented with post-menopausal hyperandrogenism of ovarian origin during the year 2023, with details on clinical presentation, lab results, and aspects found both on ultrasound and magnetic resonance imaging. They all underwent surgery and two of them were diagnosed with Sertoli-Leydig cell tumors. Conclusion Postmenopausal hyperandrogenism, though rare, requires thorough assessment to avoid misdiagnosis of underlying androgen-secreting tumors, with Sertoli-Leydig cell tumors being the predominant subtype. Surgical intervention is the primary treatment modality, often resulting in complete postoperative recovery.