In women, an increase in the production of androgens, or male hormones, is called hyperandrogenism. Increased androgen production leads to increased sensitivity in the tissues affected by these hormones, resulting in hair growth and other physical changes, particularly on the face, chest, lower abdomen, back, and upper thighs.
Causes of Hyperandrogenism
- PCOS (polycystic ovary syndrome)
- Androgen-producing ovarian tumors
- Hyperectopic syndrome
- Cushing syndrome
- Congenital adrenal hyperplasia (CAH) (overactivity of the adrenal gland)
- Genetic factors
- Some medications
Symptoms of Hyperandrogenism
- Excessive hair growth in certain areas of the body (Hirsutism)
- Acne
- Oily skin
- Deepening of the voice
- Male body type
- Male pattern baldness
- Clitoral enlargement
- Virilization
How is hyperandrogenism (androgen excess) diagnosed?
Hyperandrogenism is diagnosed in two ways: through physical and pelvic examination, and through laboratory evaluation. Physical and pelvic examination reveals developments such as excessive hair growth, male-pattern baldness, deepening of the voice, clitoral enlargement, and decreased breast size, which are helpful in making the diagnosis. Laboratory evaluation measures serum or plasma testosterone and androstenedione levels. Sometimes hyperandrogenism manifests only with symptoms such as hirsutism and acne. Other times, it can present with problems such as amenorrhea (absence of menstruation) or infertility due to disruption of the ovulation cycle. In such cases, the patient should consult a doctor to determine the underlying cause and receive appropriate treatment. If the observed symptoms begin suddenly and progress rapidly, and testosterone levels are more than twice the normal level, tumor formation should be considered.
How is hyperandrogenism treated?
Treatment for hyperandrogenism depends on the cause of the condition and whether the patient wishes to become pregnant. If pregnancy is not desired, treatment aims to stop new hair growth and remove existing hair, thereby regulating the menstrual cycle. Treatment options include combined oral contraceptives, birth control pills, spironolactone, and flutamide.
If the patient desires pregnancy, ovulation induction treatments should be applied. These methods involve the use of oral clomiphene citrate or gonadotropins. Treatment methods include medications such as Clomiphene, clomiphene citrate, gonadotropins, and metformin.
Hyperandrogenism, especially in older adults, carries risks such as hypertension, cardiovascular diseases, diabetes, uterine cancer, and breast diseases. Therefore, when symptoms are noticed, a specialist doctor should be consulted to choose one of the appropriate treatment options.
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