Postmenopausal virilization after spousal use of topical androgens

Abstract

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.