Adrenal androgen secreting tumour in 39-year-old woman: hormones and sexuality

Abstract

Introduction: Androgen secreting adrenal tumours are rare and sometimes malignant. We report hormonal and sexual changes in 39-year-old woman with androgen secreting adrenal tumour completely healed by resection of the tumour. Case report: Androgen secreting adrenal tumour that manifested in 39-year-old woman with suddenly appeared amenorrhea, weight gain, hirsutism, epileptic seizures and elevated DHEA-S and testosterone is described. Right adrenal 6–10 cm tumour was detected by ultrasound and confirmed by computed tomography. DHEA-S was three times higher and testosterone was nine times higher than highest normal values. Complete surgical removal of androgen secreting adrenal adenoma conditioned decrease of DHEA-S, testosterone and other adrenal hormones in 2 and 24 h after the surgery. 1 month later all the hormones returned to normal levels. Menses reappeared spontaneously in 6 weeks after a short period of hot flashes and perspirations. Seizures did not appear in 8 months after the surgery. Sexual activity was investigated using FSFI total score (FSFI-TS). Woman was at sexual dysfunction risk (The FSFI-TS <=26.55). One month before and 1 month after surgery the FSFI-TS was respectively 19.0 and 25.0. The best sexual function was detected 6 months after the operation (FSFI-TS was 30.1). Desire, arousal and orgasm were better 6 months after the operation comparing before the manifestation of the disease, 1 month before and 1 month after the operation (6.0 vs 4.8 vs 3.0 vs 4.2; 5.7 vs 4.8 vs 2.4 vs 3.9; 6.0 vs 4.4 vs 3.6 vs 4.4). Conclusions: Appearance of an unusual symptom – seizures and their disappearance after successful removal of the adrenal tumour are highly suggestive about the DHEA-S – induced seizures. This case raises a hypothesis, that controversial changes of sexuality are conditioned by desensitization of testosterone receptors because of constant and long-lasting increase of testosterone secre