Postmenopausal virilization after spousal use of topical androgens

• Published in: Fertility and sterility Vol. 87; no. 4; pp. 976.e13 - 976.e15
• Main Authors: Merhi, Zaher O., M.D, Santoro, Nanette, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2007
• Subjects: Administration, Topical; androgel; Androgens - administration & dosage; Androgens - adverse effects; exogenous androgen; Female; Humans; Internal Medicine; Male; Middle Aged; Obstetrics and Gynecology; Postmenopause; Skin Absorption; Spouses; testosterone; Virilism - etiology; Virilization; Virilization; exogenous androgen; testosterone; androgel
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2006.07.1547

Objective To increase awareness of the potential to cause virilization in postmenopausal woman secondary to a spouse’s use of topical androgen. Design Case report. Setting University-affiliated teaching hospital. Patient(s) A 63-year-old postmenopausal woman with virilization. Intervention(s) Removal of the source of androgen exposure. Main Outcome Measure(s) Regression of the biochemical and physical signs of androgen excess in a woman after cessation of T gel use by her partner, and reinitiation of use with precautions against potential methods of transfer. Result(s) This case highlights the unintentional transdermal absorption of testosterone sufficient to induce virilization in a couple who were aware of this potential problem. The apparent source of androgen absorption was a washcloth that the couple shared. The diagnosis can be established with a detailed history and a few blood tests (total and free T, and DHEAS) to exclude other sources of androgens. Conclusion(s) This report reinforces the need to consider exogenous androgen exposure in the differential diagnosis of virilization in adults when the more common causes have been excluded.