Which AI agents work with Endo Hirsutism Pelvic Us Severe Progressive Hyperandrogen?

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Who published Endo Hirsutism Pelvic Us Severe Progressive Hyperandrogen?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Hirsutism Pelvic Us Severe Progressive Hyperandrogen by dromlakhani

Name: Endo Hirsutism Pelvic Us Severe Progressive Hyperandrogen
Rating: 4.5 (4 reviews)
Author: dromlakhani

Endo Hirsutism Pelvic Us Severe Progressive Hyperandrogen

Perform pelvic ultrasonography to detect ovarian neoplasm in patients with severe or progressive hyperandrogenism, triggered by moderate/severe hirsutism, virilization, or rapid hair growth despite therapy. Third-person guidance for clinicians to gather data, rule in/out indication, classify findings, and decide next steps.

dromlakhani Updated Sep 8, 2026 10 repo stars

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Perform pelvic ultrasonography to detect ovarian neoplasm in severe or progressive hyperandrogenism

STEP 1 — Gather Information

Collect: hirsutism severity (Ferriman–Gallwey score), tempo of progression (weeks/months), signs of virilization (clitoromegaly, deepened voice, increased muscle mass), menstrual pattern, infertility, galactorrhea, central obesity, acanthosis nigricans, medication history (androgens, valproic acid, GnRH agonists), prior labs (total/free testosterone, DHEAS, 17‑OHP), pregnancy status, and family history of endocrine tumors or Cushing.

STEP 2 — Rule In / Rule Out

If patient has moderate/severe hirsutism (FG ≥15), rapid‑progression hirsutism, or clinical virilization or hirsutism progressing despite adequate anti‑androgen/OC therapy → Proceed to pelvic US.
If hirsutism is mild, stable, and no virilization or progression → Consider alternative etiologies; pelvic US for neoplasm not routinely indicated.

STEP 3 — Classify or Stratify

Interpret transvaginal pelvic US:

Low suspicion: normal ovarian volume, no discrete mass, simple cysts <3 cm, typical PCO morphology.
High suspicion: solid or complex mass >3 cm, irregular borders, increased vascularity on Doppler, ascites, or concerning for ovarian hyperthecosis (absent follicles with stromal hyperreactivity).

STEP 4 — Decide

High suspicion: Refer urgently to gynecologic oncology or surgical oncology for further imaging (MRI/CT) and possible excision.
Low suspicion: Reassess clinically; if hyperandrogenism persists, pursue adrenal workup (CT adrenal, 17‑OHP stimulation) or repeat US in 3–6 months if clinical concern rises.

Clinical Guardrails / Mimics / Pitfalls

Do not rely on a normal US to exclude neoplasm when clinical suspicion remains high (small androgen‑secreting tumors may be <2 cm). Avoid using US as a first‑line test in mild hirsutism without progression. Remember that ovarian hyperthecosis can mimic neoplasm; correlate with histology if uncertain. Always rule out pregnancy before interventions. Do not repeat US frequently without change in clinical picture.

Concrete Clinical Example

A 30‑year‑old woman presents with 4‑month history of rapidly worsening facial and chest hair (FG 24), new clitoromegaly, and normal total/free testosterone. Transvaginal US reveals a 3.8 cm solid left ovarian lesion with increased intratumoral flow. She is referred for laparoscopic oophorectomy; pathology shows a Sertoli‑Leydig cell tumor secreting testosterone.

Source: Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2018, DOI:10.1210/jc.2018-00241

---name: endo-hirsutism-pelvic-us-severe-progressive-hyperandrogendescription: Perform pelvic ultrasonography to detect ovarian neoplasm in patients with severe or progressive hyperandrogenism, triggered by moderate/severe hirsutism, virilization, or rapid hair growth despite therapy. Third-person guidance for clinicians to gather data, rule in/out indication, classify findings, and decide next steps.---# Perform pelvic ultrasonography to detect ovarian neoplasm in severe or progressive hyperandrogenism## STEP 1 — Gather InformationCollect: hirsutism severity (Ferriman–Gallwey score), tempo of progression (weeks/months), signs of virilization (clitoromegaly, deepened voice, increased muscle mass), menstrual pattern, infertility, galactorrhea, central obesity, acanthosis nigricans, medication history (androgens, valproic acid, GnRH agonists), prior labs (total/free testosterone, DHEAS, 17‑OHP), pregnancy status, and family history of endocrine tumors or Cushing.## STEP 2 — Rule In / Rule OutIf patient has moderate/severe hirsutism (FG ≥15), rapid‑progression hirsutism, or clinical virilization **or** hirsutism progressing despite adequate anti‑androgen/OC therapy → **Proceed to pelvic US**. If hirsutism is mild, stable, and no virilization or progression → **Consider alternative etiologies**; pelvic US for neoplasm not routinely indicated.## STEP 3 — Classify or StratifyInterpret transvaginal pelvic US: - **Low suspicion**: normal ovarian volume, no discrete mass, simple cysts <3 cm, typical PCO morphology. - **High suspicion**: solid or complex mass >3 cm, irregular borders, increased vascularity on Doppler, ascites, or concerning for ovarian hyperthecosis (absent follicles with stromal hyperreactivity). ## STEP 4 — Decide- **High suspicion**: Refer urgently to gynecologic oncology or surgical oncology for further imaging (MRI/CT) and possible excision. - **Low suspicion**: Reassess clinically; if hyperandrogenism persists, pursue adrenal workup (CT adrenal, 17‑OHP stimulation) or repeat US in 3–6 months if clinical concern rises.## Clinical Guardrails / Mimics / PitfallsDo **not** rely on a normal US to exclude neoplasm when clinical suspicion remains high (small androgen‑secreting tumors may be <2 cm). Avoid using US as a first‑line test in mild hirsutism without progression. Remember that ovarian hyperthecosis can mimic neoplasm; correlate with histology if uncertain. Always rule out pregnancy before interventions. Do not repeat US frequently without change in clinical picture.## Concrete Clinical ExampleA 30‑year‑old woman presents with 4‑month history of rapidly worsening facial and chest hair (FG 24), new clitoromegaly, and normal total/free testosterone. Transvaginal US reveals a 3.8 cm solid left ovarian lesion with increased intratumoral flow. She is referred for laparoscopic oophorectomy; pathology shows a Sertoli‑Leydig cell tumor secreting testosterone.**Source:** Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2018, DOI:10.1210/jc.2018-00241

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