**Author details**

**4. Chapter summary**

118 Contemporary Gynecologic Practice

logic corticosteroid dosages.

treating CAH.

vitamin D3.

PCOS.

**5. Nomenclature**

CAH-congenital adrenal hyperplasia

17-OHP-17-hydroxyprogesterone

eGFR estimated glomerular filtration rate

NCAH-non-classic congenital adrenal hyperplasia

PCOS-polycystic ovarian (Stein-Leventhal) syndrome

linemia.

**•** Insulin resistance/hyperinsulinemia is a constant feature of both classical and non-classic

**•** In vitro studies suggest that 2 mechanisms for the above observation are gain of 17-αhydroxylase activity and decrease of 21-hydroxylase activity in the presence of hyperinsu‐

**•** Interventions which reduce insulin resistance/hyperinsulinemia dependably ameliorate the phenotypic/biochemical course of CAH and acquired/unmasked adrenal hyperplasia as they do in PCOS. In the case of NCAH insulin sensitizing interventions eliminate the need for corticosteroids and their attendant side effects, while in classical CAH insulin sensitiza‐ tion shows at least an ability to ameliorate the condition without resorting to supraphysio‐

**•** Other drugs and herbals with insulin sensitizing properties may ultimately prove useful in

**•** Cysticercosis is able to evoke a 4 part endocrine disrupting effect in the human host: insulin resistance, hyperandrogenism, feminization, and enhance 1-α-hydroxylation of 25-OH-

**•** Modifying the cysticercosis-evoked hormonal milieu with the insulin sensitizer, metformin and the SERM, raloxifene is capable of effectively treating cysticercosis induced PCOS, reducing the parasite burden, and reversing the overexpression of 1-α-hydroxylase.

**•** Serial measurement of vitamin D metabolites may prove to be a fairly economical way of

**•** Cysticercosis may ultimately prove to be a fairly common cause of insulin resistance and

following parasite burden and treatment response compared to serial MRI.

adrenal hyperplasia as well medication induced/unmasked adrenal hyperplasia.

Alan Sacerdote1,2,3,4 and Gül Bahtiyar1,2,3,4

1 Division of Endocrinology, Woodhull Medical and Mental Health Center, Brooklyn, NY, USA

