In the GYN clinic, I was handed a chart and was sent to evaluate a patient, Mrs. X.
Walking in, I could see that Mrs. X definitely had some problems. She had some balding and a slight moustache going on, but that wasn't what she was coming in about. She was coming in to complain about the size of a certain part of her nether female anatomy...it had started to grow increasingly larger and larger.
As I sat there taking a history from her, I thought it odd that she kept referring to Mexico, as if there was something there that might be important. I figured she kept going there to visit family...after all, the vast majority of patients that I see in the clinic or the hospital are from Mexico or South America and have family there. I didn't think much of it and kept asking questions on my list for the express purpose of figuring out just why she, a 50-something woman, was starting to look more and more like a man. She kept on mentioning Mexico. After awhile, I asked her what she was doing in Mexico. She was visiting family (big surprise...) and taking some medications. Medicine? From Mexico? Now, I try not to be jaded/prejudiced, but if I had a medical problem and needed medication, Mexico sure wouldn't top my list of places to aquire help.
Turns out she'd been bothered by hot flashes and a doctor in Mexico was giving her some medication to get rid of her symptoms. After a blood test, the answer was immediate. Her testosterone was elevated into the "Macho Man-Mr. Universe" level.
She also let it slip that she'd been very itchy "down there" lately, and no vaginal creams had worked so on a whim, she tried using her foot cream down there. To her surprise, it made her feel better.
Tx: We gave her prescriptions for Premarin and lotrimasone and told her to quit going to Mexico.