Differential diagnosis of clinical hyperandrogenism

Diagnosis	Frequency (percent)	Age of onset years	Time of onset to presentation	Menstrual disturbance	Virilization
PCOS and related disorders	>95	15 to 25	Years	+/-	Rare
CAH	1 to 2	Congenital	Birth/adolescence/adulthood	+	+/-
Adrenal tumor	<1	Any time	Weeks-months	+	+
Ovarian tumor	<1	Any time	Weeks-months	+	+
Cushing's syndrome	<1	Any time	Months-years	+	+/-
Hyperthecosis ovary	<1	Predominantly postmenopausal	Months-years	+	+

PCOS: polycystic ovary syndrome; CAH: congenital adrenal hyperplasia; (+): present; (-): absent; (+/-): present or absent.

From: Dennedy MC, Smith D, O'Shea D, McKenna TJ. Investigation of patients with atypical or severe hyperandrogenaemia including androgen-secreting ovarian teratoma. Eur J Endocrinol 2010; 162:213. Copyright © Society of the European Journal of Endocrinology 2010. Reproduced by permission.

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