Table of ContentsView AllTable of ContentsCausesSigns and SymptomsDiagnosisTreatmentManaging the EffectsComplications and Outlook
Table of ContentsView All
View All
Table of Contents
Causes
Signs and Symptoms
Diagnosis
Treatment
Managing the Effects
Complications and Outlook
Hyperandrogenismis a hormonal disturbance associated with high levels of androgens in the body. Androgens are sex hormones, with the most relevant one beingtestosterone.
Hyperandrogenism can occur in people of any sex, although it’s more common and noticeable in individuals assigned female at birth. Symptoms of hyperandrogenism vary depending on the underlying cause but may include acne, irregular menstrual periods, andhirsutism(excessive hair growth on the face and body).
This article will review what hyperandrogenism is, its potential causes, accompanying symptoms, and treatment.
rparobe / Getty Images
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
What Causes Hyperandrogenism?
Thepituitary gland, which sits just below the brain, produces hormones that influence the release of androgens from the above organs and glands. For example, the pituitary gland releasesadrenocorticotrophic hormone(ACTH), which controls adrenal gland androgen production.
Hyperandrogenism has several causes. While not a complete list, potential causes include:
Is Hyperandrogenism the Same as PCOS?Hyperandrogenism describes a state of androgen excess in the body, whereas PCOS is a medical condition. Nevertheless, hyperandrogenism is a hallmark feature of PCOS and the basis for the majority of the condition’s symptoms.
Is Hyperandrogenism the Same as PCOS?
Hyperandrogenism describes a state of androgen excess in the body, whereas PCOS is a medical condition. Nevertheless, hyperandrogenism is a hallmark feature of PCOS and the basis for the majority of the condition’s symptoms.
Who Does Hyperandrogenism Affect?
Depending on the underlying cause, hyperandrogenism can affect both children and adults. It can affect people of any sex, although it’s more common and noticeable in females of reproductive age.
Signs and Symptoms of Hyperandrogenism
Factors like sex, age, and the underlying cause affect the symptoms a person with hyperandrogenism may experience.
PCOS Symptoms
PCOSis the most common cause of hyperandrogenism, affecting around 6% to 15% of females in their childbearing years.
Symptoms of PCOSmost commonly include acne, hirsutism,male-pattern balding, and irregular, infrequent, or absent menstrual periods. They usually begin around puberty but can also develop in early adulthood.
HirsutismHirsutism describes excess body and facial hair in a distribution more typical for adults assigned male at birth, including thick, dark hair on the chest, stomach, upper arms, inner thighs, upper lip, and chin.
Hirsutism
Hirsutism describes excess body and facial hair in a distribution more typical for adults assigned male at birth, including thick, dark hair on the chest, stomach, upper arms, inner thighs, upper lip, and chin.
In addition to the above symptoms, many people with PCOS are overweight or have obesity. They are also vulnerable to developingtype 2 diabetes,fatty liver, and mood disorders like anxiety anddepression.
Cushing Disease Symptoms
Cushing diseasecan occur in people of any sex but is more common in females than males. It also usually affects adults, although it can develop in children.
Hyperandrogenism symptoms are prominent in females and include mild hirsutism on the face, scalp hair thinning, acne, and irregular menstrual periods. Males may also have acne.
Cushing syndrome is also associated with high cortisol levels, resulting in:
CAH Symptoms
Classic CAH is associated with androgen excess and a deficiency ofglucocorticoids(which regulate the immune system and metabolism) andmineralocorticoids(which control salt and water balance) in the body.
Females with classic CAH are usually diagnosed at birth due to ambiguous genitalia. The clitoris may be enlarged, resembling a penis, and the labia may be fused, resembling a scrotum.Males with CAH have typical-appearing genitalia.
Adrenal Crisis in Classic CAH
Non-classic CAH is a milder form of the disease and usually becomes evident in later childhood or adolescence. Symptoms can include:
Ovarian Hyperthecosis Symptoms
In addition to the above symptoms, nearly all people with this condition have obesity andinsulin resistance(the body does not respond to insulin as it should).
Androgen-Producing Tumor Symptoms
Androgen-producing tumorsof the adrenal gland, ovary, or testicleare infrequent causes of hyperandrogenism. They can develop in children or adults.They may occur due to an ovarian tumor in postmenopausal people.
Symptoms of androgen-producing adrenal and ovarian tumors tend to be severe and manifest rapidly.
In young children (before puberty), symptoms may include an enlarged clitoris or enlarged penis. Excessive and early hair growth in the pubic area and underarms may also be present.
In adult females, symptoms can include significant hirsutism, a receding hairline, severe acne, increased muscle mass, enlarged clitoris, irregular menstrual periods, and voice deepening.
Very rarely, a person with atesticular tumormay develop signs and symptoms of excess androgen. These include premature puberty in children, weight gain, body odor changes, and a decreased sex drive in adults.
Summary of Hyperandrogenism SymptomsPossible symptoms and signs of hyperandrogenism include:HirsutismIrregular or absent menstrual periodsAcne and oily skinMale-pattern baldingVoice deepeningIncreased muscularityEnlargement of the clitoris or penisFertility issuesPremature puberty
Summary of Hyperandrogenism Symptoms
Possible symptoms and signs of hyperandrogenism include:HirsutismIrregular or absent menstrual periodsAcne and oily skinMale-pattern baldingVoice deepeningIncreased muscularityEnlargement of the clitoris or penisFertility issuesPremature puberty
Possible symptoms and signs of hyperandrogenism include:
How Is Hyperandrogenism Diagnosed?
If you think you (or your child) have symptoms or signs of hyperandrogenism, it’s important to see a healthcare provider.
During the diagnostic process, a provider will:
Medical History and Physical Exam
When evaluating for possible hyperandrogenism, a provider will ask about menstruation and fertility issues (if applicable) and the timing and presence of potential androgen-related symptoms like acne and hirsutism.
They will also inquire about medications/supplements and obtain a family history of hormone conditions.
During the physical exam, the provider will check for symptoms and signs of elevated androgen levels, such as premature puberty in children and acne, thinning scalp hair, increased body/facial hair, and deepening of the voice in females.An external genital exam may also be performed.
Blood Tests
Several different blood tests may be ordered to help sort out whether hyperandrogenism exists and, if so, the underlying cause.
Examples of such blood tests include:
Imaging Tests
Imaging tests are also often a component of the diagnostic process for hyperandrogenism. They may include:
Treatment Options for Hyperandrogenism
The treatment of hyperandrogenism depends on the underlying cause and may involve medication, surgery, lifestyle behaviors, or some combination.
ManagingPCOScan be particularly complex, requiring an individualized approach. Therapies can include:
Surgery is generally the treatment of choice forCushing’s disease,ovarian hyperthecosis, andandrogen-secreting tumors.
If a medication is the hyperandrogenism culprit, stopping it under the guidance of a healthcare provider is advised.
Lastly, forclassic congenital adrenal hyperplasia, the treatment is taking “steroids” likehydrocortisoneandfludrocortisoneto replace the deficient adrenal gland hormones.
Steroids or birth control pills (in females) may also be taken in those withnon-classic congenital adrenal hyperplasiawho have symptoms or signs of hyperandrogenism.
Late-Onset Congenital Adrenal Hyperplasia Symptoms and Treatment
Managing the Effects of Hyperandrogenism
Some females experience symptoms of hyperandrogenism but have normal blood and imaging tests, indicating that their symptoms—often acneand hirsutism—are not due to a medical condition but rather due to their underlying genetic makeup or lifestyle factors like diet or stress.
The good news is that there are many cosmetic and medical strategies available to help manage symptoms of hyperandrogenism, even after optimizing treatment of the underlying cause (if one is present).
These might include:
Permanent Hair Removal for Women With PCOS
Complications and Long-Term Outlook
Potential complications and long-term outlook for hyperandrogenism depend on numerous factors, including cause and the promptness, extent, and quality of care provided.
As an example, complications of PCOS may include problems with fertility, issues with self-esteem and mood, and the development of future health problems like type 2 diabetes.
The best thing you can do is adopt a willing and proactive attitude in your (or your loved one’s) care. Find an experienced primary care physician, hormone specialist (endocrinologist), or surgeon (depending on the circumstance) with whom you are comfortable communicating.
Summary
Hyperandrogenism is a phenomenon of excess androgen sex hormones in the body. Symptoms vary based on factors like sex, age, and the degree of androgen excess but commonly include acne, excess hair growth, and irregular menstrual periods.
There are numerous potential causes of hyperandrogenism, including polycystic ovarian syndrome, genetic conditions like congenital adrenal hyperplasia, medications, and adrenal or ovarian tumors.
The diagnosis of hyperandrogenism requires a careful medical history, physical exam, blood tests (e.g., total testosterone), and imaging tests (e.g., pelvic ultrasound).
Treatment depends on the underlying cause and may involve medication like birth control pills to regulate menstrual cycles. Lifestyle and cosmetic strategies like weight loss and hair removal are also often implemented. Surgery is performed for rarer causes like androgen-producing tumors.
28 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma A, Welt CK.Practical approach to hyperandrogenism in women.Med Clin North Am. 2021;105(6):1099-1116. doi:10.1016/j.mcna.2021.06.008Alemany M.The roles of androgens in humans: biology, metabolic regulation and health.Int J Mol Sci. 2022;23(19):11952. doi:10.3390/ijms231911952Zaman A, Rothman MS.Postmenopausal hyperandrogenism: evaluation and treatment strategies.Endocrinol Metab Clin North Am. 2021;50(1):97-111. doi:10.1016/j.ecl.2020.12.002Wang K, Li Y, Chen Y.Androgen excess: a hallmark of polycystic ovary syndrome.Front Endocrinol (Lausanne). 2023;14:1273542. doi:10.3389/fendo.2023.1273542Cleveland Clinic.Hyperandrogenism.Witchel SF, Roumimper H, Oberfield S.Polycystic ovary syndrome in adolescents.Endocrinol Metab Clin North Am. 2016;45(2):329-44. doi: 10.1016/j.ecl.2016.01.004Azziz R.Polycystic ovary syndrome.Obstet Gynecol. 2018;132(2):321-336. doi:10.1097/AOG.0000000000002698National Institute of Diabetes and Digestive and Kidney Diseases.Cushing’s syndrome.Nieman LK.Epidemiology and clinical manifestations of Cushing syndrome. In: UpToDate, Lacroix A (Ed), Wolters Kluwer.Speiser PW, Arlt W, Auchus RJ, et al.Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2018;103(11):4043-4088. doi:10.1210/jc.2018-01865Witchel SF.Congenital adrenal hyperplasia.J Pediatr Adolesc Gynecol. 2017;30(5):520-534. doi:10.1016/j.jpag.2017.04.001Metzker LS, Ferreira LAC, Borges JCN, et al.Postmenopausal hyperandrogenism due to ovarian hyperthecosis.Case Rep Obstet Gynecol. 2023;2023:2783464. doi:10.1155/2023/2783464Columbia Surgery.Sex hormone producing tumor.American Cancer Society.Signs and symptoms of adrenal cancers.Kianian R, Eleswarapu SV, Donin NM.A middle-aged man with hyperandrogenic state.Urol Case Rep. 2023;47:102354. doi:10.1016/j.eucr.2023.102354Grossman AB.Virilization. InMerck Manual ConsumerVersion. Merck & Co., Inc.Yesiladali M, Yazici MGK, Attar E, Kelestimur F.Differentiating polycystic ovary syndrome from adrenal disorders.Diagnostics (Basel). 2022;12(9):2045. doi:10.3390/diagnostics12092045Christ JP, Cedars MI.Current guidelines for diagnosing PCOS.Diagnostics (Basel). 2023;13(6):1113. doi:10.3390/diagnostics13061113Goodarzi MO, Carmina E, Azziz R.DHEA, DHEAS and PCOS.J Steroid Biochem Mol Biol. 2015;145:213-225. doi:10.1016/j.jsbmb.2014.06.003American Cancer Society.Tests for adrenal cancer.MedlinePlus.17-hydroxprogesterone.MedlinePlus.Adrenocorticotropic hormone (ACTH).Hall JE.Evaluation and management of postmenopausal hyperandrogenism. In: UpToDate, Crowley WF, Barbieri RL(Eds), Wolters KluwerTeede HJ, Tay CT, Laven JJE, et al.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.J Clin Endocrinol Metab. 2023;108(10):2447-2469. doi:10.1210/clinem/dgad463Adriaansen BP, Schröder MA, Span PN, et al.Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.Front Endocrinol (Lausanne).2022:13:1064024. doi:10.3389/fendo.2022.1064024Carmina E, Dreno B, Lucky WA, et al.Female adult acne and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Endocr Soc. 2022;6(3):bvac003. doi:10.1210/jendso/bvac003. Erratum in:J Endocr Soc. 2023;7(3):bvad006. doi:10.1210/jendso/bvad006MedlinePlus.Excessive or unwanted hair in women.Palomba S, Santagni S, Falbo A, La Sala GB.Complications and challenges associated with polycystic ovary syndrome: current perspectives.Int J Womens Health. 2015;7:745-63. doi:10.2147/IJWH.S70314
28 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma A, Welt CK.Practical approach to hyperandrogenism in women.Med Clin North Am. 2021;105(6):1099-1116. doi:10.1016/j.mcna.2021.06.008Alemany M.The roles of androgens in humans: biology, metabolic regulation and health.Int J Mol Sci. 2022;23(19):11952. doi:10.3390/ijms231911952Zaman A, Rothman MS.Postmenopausal hyperandrogenism: evaluation and treatment strategies.Endocrinol Metab Clin North Am. 2021;50(1):97-111. doi:10.1016/j.ecl.2020.12.002Wang K, Li Y, Chen Y.Androgen excess: a hallmark of polycystic ovary syndrome.Front Endocrinol (Lausanne). 2023;14:1273542. doi:10.3389/fendo.2023.1273542Cleveland Clinic.Hyperandrogenism.Witchel SF, Roumimper H, Oberfield S.Polycystic ovary syndrome in adolescents.Endocrinol Metab Clin North Am. 2016;45(2):329-44. doi: 10.1016/j.ecl.2016.01.004Azziz R.Polycystic ovary syndrome.Obstet Gynecol. 2018;132(2):321-336. doi:10.1097/AOG.0000000000002698National Institute of Diabetes and Digestive and Kidney Diseases.Cushing’s syndrome.Nieman LK.Epidemiology and clinical manifestations of Cushing syndrome. In: UpToDate, Lacroix A (Ed), Wolters Kluwer.Speiser PW, Arlt W, Auchus RJ, et al.Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2018;103(11):4043-4088. doi:10.1210/jc.2018-01865Witchel SF.Congenital adrenal hyperplasia.J Pediatr Adolesc Gynecol. 2017;30(5):520-534. doi:10.1016/j.jpag.2017.04.001Metzker LS, Ferreira LAC, Borges JCN, et al.Postmenopausal hyperandrogenism due to ovarian hyperthecosis.Case Rep Obstet Gynecol. 2023;2023:2783464. doi:10.1155/2023/2783464Columbia Surgery.Sex hormone producing tumor.American Cancer Society.Signs and symptoms of adrenal cancers.Kianian R, Eleswarapu SV, Donin NM.A middle-aged man with hyperandrogenic state.Urol Case Rep. 2023;47:102354. doi:10.1016/j.eucr.2023.102354Grossman AB.Virilization. InMerck Manual ConsumerVersion. Merck & Co., Inc.Yesiladali M, Yazici MGK, Attar E, Kelestimur F.Differentiating polycystic ovary syndrome from adrenal disorders.Diagnostics (Basel). 2022;12(9):2045. doi:10.3390/diagnostics12092045Christ JP, Cedars MI.Current guidelines for diagnosing PCOS.Diagnostics (Basel). 2023;13(6):1113. doi:10.3390/diagnostics13061113Goodarzi MO, Carmina E, Azziz R.DHEA, DHEAS and PCOS.J Steroid Biochem Mol Biol. 2015;145:213-225. doi:10.1016/j.jsbmb.2014.06.003American Cancer Society.Tests for adrenal cancer.MedlinePlus.17-hydroxprogesterone.MedlinePlus.Adrenocorticotropic hormone (ACTH).Hall JE.Evaluation and management of postmenopausal hyperandrogenism. In: UpToDate, Crowley WF, Barbieri RL(Eds), Wolters KluwerTeede HJ, Tay CT, Laven JJE, et al.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.J Clin Endocrinol Metab. 2023;108(10):2447-2469. doi:10.1210/clinem/dgad463Adriaansen BP, Schröder MA, Span PN, et al.Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.Front Endocrinol (Lausanne).2022:13:1064024. doi:10.3389/fendo.2022.1064024Carmina E, Dreno B, Lucky WA, et al.Female adult acne and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Endocr Soc. 2022;6(3):bvac003. doi:10.1210/jendso/bvac003. Erratum in:J Endocr Soc. 2023;7(3):bvad006. doi:10.1210/jendso/bvad006MedlinePlus.Excessive or unwanted hair in women.Palomba S, Santagni S, Falbo A, La Sala GB.Complications and challenges associated with polycystic ovary syndrome: current perspectives.Int J Womens Health. 2015;7:745-63. doi:10.2147/IJWH.S70314
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sharma A, Welt CK.Practical approach to hyperandrogenism in women.Med Clin North Am. 2021;105(6):1099-1116. doi:10.1016/j.mcna.2021.06.008Alemany M.The roles of androgens in humans: biology, metabolic regulation and health.Int J Mol Sci. 2022;23(19):11952. doi:10.3390/ijms231911952Zaman A, Rothman MS.Postmenopausal hyperandrogenism: evaluation and treatment strategies.Endocrinol Metab Clin North Am. 2021;50(1):97-111. doi:10.1016/j.ecl.2020.12.002Wang K, Li Y, Chen Y.Androgen excess: a hallmark of polycystic ovary syndrome.Front Endocrinol (Lausanne). 2023;14:1273542. doi:10.3389/fendo.2023.1273542Cleveland Clinic.Hyperandrogenism.Witchel SF, Roumimper H, Oberfield S.Polycystic ovary syndrome in adolescents.Endocrinol Metab Clin North Am. 2016;45(2):329-44. doi: 10.1016/j.ecl.2016.01.004Azziz R.Polycystic ovary syndrome.Obstet Gynecol. 2018;132(2):321-336. doi:10.1097/AOG.0000000000002698National Institute of Diabetes and Digestive and Kidney Diseases.Cushing’s syndrome.Nieman LK.Epidemiology and clinical manifestations of Cushing syndrome. In: UpToDate, Lacroix A (Ed), Wolters Kluwer.Speiser PW, Arlt W, Auchus RJ, et al.Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2018;103(11):4043-4088. doi:10.1210/jc.2018-01865Witchel SF.Congenital adrenal hyperplasia.J Pediatr Adolesc Gynecol. 2017;30(5):520-534. doi:10.1016/j.jpag.2017.04.001Metzker LS, Ferreira LAC, Borges JCN, et al.Postmenopausal hyperandrogenism due to ovarian hyperthecosis.Case Rep Obstet Gynecol. 2023;2023:2783464. doi:10.1155/2023/2783464Columbia Surgery.Sex hormone producing tumor.American Cancer Society.Signs and symptoms of adrenal cancers.Kianian R, Eleswarapu SV, Donin NM.A middle-aged man with hyperandrogenic state.Urol Case Rep. 2023;47:102354. doi:10.1016/j.eucr.2023.102354Grossman AB.Virilization. InMerck Manual ConsumerVersion. Merck & Co., Inc.Yesiladali M, Yazici MGK, Attar E, Kelestimur F.Differentiating polycystic ovary syndrome from adrenal disorders.Diagnostics (Basel). 2022;12(9):2045. doi:10.3390/diagnostics12092045Christ JP, Cedars MI.Current guidelines for diagnosing PCOS.Diagnostics (Basel). 2023;13(6):1113. doi:10.3390/diagnostics13061113Goodarzi MO, Carmina E, Azziz R.DHEA, DHEAS and PCOS.J Steroid Biochem Mol Biol. 2015;145:213-225. doi:10.1016/j.jsbmb.2014.06.003American Cancer Society.Tests for adrenal cancer.MedlinePlus.17-hydroxprogesterone.MedlinePlus.Adrenocorticotropic hormone (ACTH).Hall JE.Evaluation and management of postmenopausal hyperandrogenism. In: UpToDate, Crowley WF, Barbieri RL(Eds), Wolters KluwerTeede HJ, Tay CT, Laven JJE, et al.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.J Clin Endocrinol Metab. 2023;108(10):2447-2469. doi:10.1210/clinem/dgad463Adriaansen BP, Schröder MA, Span PN, et al.Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.Front Endocrinol (Lausanne).2022:13:1064024. doi:10.3389/fendo.2022.1064024Carmina E, Dreno B, Lucky WA, et al.Female adult acne and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Endocr Soc. 2022;6(3):bvac003. doi:10.1210/jendso/bvac003. Erratum in:J Endocr Soc. 2023;7(3):bvad006. doi:10.1210/jendso/bvad006MedlinePlus.Excessive or unwanted hair in women.Palomba S, Santagni S, Falbo A, La Sala GB.Complications and challenges associated with polycystic ovary syndrome: current perspectives.Int J Womens Health. 2015;7:745-63. doi:10.2147/IJWH.S70314
Sharma A, Welt CK.Practical approach to hyperandrogenism in women.Med Clin North Am. 2021;105(6):1099-1116. doi:10.1016/j.mcna.2021.06.008
Alemany M.The roles of androgens in humans: biology, metabolic regulation and health.Int J Mol Sci. 2022;23(19):11952. doi:10.3390/ijms231911952
Zaman A, Rothman MS.Postmenopausal hyperandrogenism: evaluation and treatment strategies.Endocrinol Metab Clin North Am. 2021;50(1):97-111. doi:10.1016/j.ecl.2020.12.002
Wang K, Li Y, Chen Y.Androgen excess: a hallmark of polycystic ovary syndrome.Front Endocrinol (Lausanne). 2023;14:1273542. doi:10.3389/fendo.2023.1273542
Cleveland Clinic.Hyperandrogenism.
Witchel SF, Roumimper H, Oberfield S.Polycystic ovary syndrome in adolescents.Endocrinol Metab Clin North Am. 2016;45(2):329-44. doi: 10.1016/j.ecl.2016.01.004
Azziz R.Polycystic ovary syndrome.Obstet Gynecol. 2018;132(2):321-336. doi:10.1097/AOG.0000000000002698
National Institute of Diabetes and Digestive and Kidney Diseases.Cushing’s syndrome.
Nieman LK.Epidemiology and clinical manifestations of Cushing syndrome. In: UpToDate, Lacroix A (Ed), Wolters Kluwer.
Speiser PW, Arlt W, Auchus RJ, et al.Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2018;103(11):4043-4088. doi:10.1210/jc.2018-01865
Witchel SF.Congenital adrenal hyperplasia.J Pediatr Adolesc Gynecol. 2017;30(5):520-534. doi:10.1016/j.jpag.2017.04.001
Metzker LS, Ferreira LAC, Borges JCN, et al.Postmenopausal hyperandrogenism due to ovarian hyperthecosis.Case Rep Obstet Gynecol. 2023;2023:2783464. doi:10.1155/2023/2783464
Columbia Surgery.Sex hormone producing tumor.
American Cancer Society.Signs and symptoms of adrenal cancers.
Kianian R, Eleswarapu SV, Donin NM.A middle-aged man with hyperandrogenic state.Urol Case Rep. 2023;47:102354. doi:10.1016/j.eucr.2023.102354
Grossman AB.Virilization. InMerck Manual ConsumerVersion. Merck & Co., Inc.
Yesiladali M, Yazici MGK, Attar E, Kelestimur F.Differentiating polycystic ovary syndrome from adrenal disorders.Diagnostics (Basel). 2022;12(9):2045. doi:10.3390/diagnostics12092045
Christ JP, Cedars MI.Current guidelines for diagnosing PCOS.Diagnostics (Basel). 2023;13(6):1113. doi:10.3390/diagnostics13061113
Goodarzi MO, Carmina E, Azziz R.DHEA, DHEAS and PCOS.J Steroid Biochem Mol Biol. 2015;145:213-225. doi:10.1016/j.jsbmb.2014.06.003
American Cancer Society.Tests for adrenal cancer.
MedlinePlus.17-hydroxprogesterone.
MedlinePlus.Adrenocorticotropic hormone (ACTH).
Hall JE.Evaluation and management of postmenopausal hyperandrogenism. In: UpToDate, Crowley WF, Barbieri RL(Eds), Wolters Kluwer
Teede HJ, Tay CT, Laven JJE, et al.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.J Clin Endocrinol Metab. 2023;108(10):2447-2469. doi:10.1210/clinem/dgad463
Adriaansen BP, Schröder MA, Span PN, et al.Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.Front Endocrinol (Lausanne).2022:13:1064024. doi:10.3389/fendo.2022.1064024
Carmina E, Dreno B, Lucky WA, et al.Female adult acne and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Endocr Soc. 2022;6(3):bvac003. doi:10.1210/jendso/bvac003. Erratum in:J Endocr Soc. 2023;7(3):bvad006. doi:10.1210/jendso/bvad006
MedlinePlus.Excessive or unwanted hair in women.
Palomba S, Santagni S, Falbo A, La Sala GB.Complications and challenges associated with polycystic ovary syndrome: current perspectives.Int J Womens Health. 2015;7:745-63. doi:10.2147/IJWH.S70314
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