When is GnRH analog suppression testing indicated in the evaluation of androgen excess?

Updated: Mar 14, 2018
  • Author: Mohamed Yahya Abdel-Rahman, MD, MSc; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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A GnRH agonist (eg, leuprolide acetate) can be given by injection to confirm the ovarian origin of significant hyperandrogenemia when no obvious ovarian neoplasm can be found by ultrasonography. [79] The goal is to downregulate the pituitary to eliminate ovarian stimulation by FSH and LH. A GnRH agonist must be given for >2 weeks to attain this effect. More recently, GnRH agonists have become available that suppress ovarian function within days. Dexamethasone can be given as described above to suppress any contribution of the adrenal glands.

Normally, FSH, LH, estradiol, and testosterone are extremely low after suppression with a GnRH analog and dexamethasone. Inability to suppress some or all of these suggests a hormone secreting tumor.

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