A patient with central obesity, facial hair growth, and irregular menses most likely has which condition?

• A. Gigantism
• B. Addison disease
• C. Cushing syndrome
• D. Diabetes insipidus

Answer: (C)

Excess cortisol production leading to features of metabolic and reproductive system disruption is what this pattern points to. Cortisol excess redistributes fat to the trunk, producing central obesity and a rounder facial appearance, and it can interfere with the hypothalamic–pituitary–gonadal axis, causing irregular menses. In women, cortisol excess can also elevate adrenal androgens or increase follicle sensitivity, contributing to hirsutism. Taken together, central obesity with facial hair growth and irregular menses is a classic presentation of Cushing syndrome. Other conditions don’t typically produce this combination: gigantism involves excess growth hormone with tall stature rather than the described fat distribution and hair changes; Addison disease causes weight loss and low cortisol symptoms such as fatigue and hypotension; diabetes insipidus presents with polyuria and polydipsia, not obesity or hirsutism.