Which of the following is NOT a typical symptom of Cushing's syndrome?

Bilateral adrenal hyperplasia is not a symptom of Cushing's syndrome; rather, it is often considered a potential cause or underlying condition leading to the syndrome. Cushing's syndrome primarily refers to the clinical manifestations that result from prolonged exposure to elevated cortisol levels, which can sometimes arise from various sources, including pituitary adenomas, adrenal tumors, or ectopic ACTH (adrenocorticotropic hormone) production.

Typical symptoms of Cushing's syndrome include features such as a buffalo hump, which is the accumulation of fat at the upper back, truncal obesity characterized by weight gain mainly in the upper body while sparing the limbs, and abdominal striae—pink or purple stretch marks that may appear as the skin stretches under the influence of cortisol. These symptoms are directly linked to the changes in body composition and skin integrity associated with excess cortisol production and are very helpful in clinical diagnosis.