Who and How to Screen for Endogenous Hypercortisolism Among Young Women Presenting with Clinical Hyperandrogenism and/or Menstrual Abnormalities

Endogenous Cushing's syndrome (CS) is a rare condition with an incidence of 0.7-2.4 per million per year, often presenting diagnostic challenges due to its overlapping symptoms with more common conditions. This review highlights the prevalence and clinical impact of menstrual irregularities, acne, and hirsutism in young women with CS, which can also occur in polycystic ovary syndrome. The study emphasizes the importance of screening for hypercortisolism in young women presenting with these symptoms to prevent misdiagnosis and reduce morbidity and mortality associated with delayed treatment.