Table of ContentsView AllTable of ContentsWhat Are Androgens?HyperandrogenismSigns and SymptomsTestingOther CausesAssociated Health IssuesTreatmentWhen to See a Healthcare Provider
Table of ContentsView All
View All
Table of Contents
What Are Androgens?
Hyperandrogenism
Signs and Symptoms
Testing
Other Causes
Associated Health Issues
Treatment
When to See a Healthcare Provider
This is commonly due topolycystic ovary syndrome(PCOS), a hormonal disorder that impacts females and leads tocystsor small sacs found in theovaries, which are glands that produce eggs.Other causes of high androgens include certain tumors andCushing’s disease, with treatment (including medication and surgery) depending on the cause.
This article explains the signs and symptoms of high androgens in females, their causes, and how these levels can impact your overall health as well as treatment options.
Androgens are essential hormones that help with:
In females, the androgen hormones are created in fat cells and the ovaries. They are also made in theadrenal glands, which are located above the kidneys and are responsible for releasing various hormones.
Androgen hormones are steroid hormones, which are a group of hormones that include:
Testosterone, a commonly recognized androgen hormone, is associated with the development of sex characteristics, bone health, andsex drive.
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and gender are related concepts, but they are not the same.Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.Gender describes a person’s internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, 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 gender are related concepts, but they are not the same.Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.Gender describes a person’s internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Verywell Health acknowledges thatsex and gender are related concepts, but they are not the same.
Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
What Is Hyperandrogenism?
Hyperandrogenism occurs when androgens are higher than they should be.Hyperandrogenism is not the same as PCOS and can have a number of different causes. The most common one is PCOS.
There are two kinds of hyperandrogenism and both kinds can lead to a PCOS diagnosis:
By some estimates, hyperandrogenism occurs in about 20% of the female population. It is less common before puberty.
It is possible to have clinical signs of hyperandrogenism and for all blood work to come back normal. It is also possible to have labs indicate high androgen levels, with little to no clinical signs.
Symptoms of High Androgens
Signs and symptoms of hyperandrogenism may include abnormal hair growth, acne,male-pattern baldness, andvirilization, which is when females develop traits typically associated with males.
How to Know If You Have PCOS
Abnormal Hair Growth
Male-pattern hair growth, like facial hair or hair on the chest and back, in people of the female sex can be a sign of hyperandrogenism. The medical term for this ishirsutism. Hirsutism affects about 5% to 10% of females.
Hirsutism is a common symptom of PCOS. However, some people can have hirsutism without PCOS. Although not common, hirsutism can also occur in people with an adrenal gland problem or other disorders of male hormone overproduction.
Some individuals remove this type of hair growth and may not realize it’s a potential symptom of a medical condition. Be sure to tell your healthcare provider if you’re experiencing this.
Acne
How the Menstrual Cycle Affects Acne
Lack of Menstrual Periods
High levels of androgen may make your menstrual period stop, a condition known asamenorrhea. Amenorrhea has been seen in people with PCOS.Adrenal tumors can also cause menstruation to cease.
Male-Pattern Balding
Individuals may experiencehair lossas they get older. However, when females experience hair loss that looks similar to “male-pattern balding,” this may be a sign of hyperandrogenism.
Androgenic Alopecia in Polycystic Ovary Syndrome (PCOS)
Oily Skin
Androgens stimulate the activity of oil glands in the skin.When your oil glands are more active, they release moresebum, resulting in oily skin.
Having some sebum on your skin helps protect your skin and keeps it hydrated. However, the oiliness from too much sebum can block pores, leading to acne.
Virilization
Virilization occurs when females develop traits associated with males. Excess production of testosterone, specifically, may be what drives these changes in females.
Low levels of testosterone can cause male-pattern hair growth, oily skin, and irregular menstrual periods. Moderate levels can result in male-pattern baldness, loss of female fat distribution, and decreased breast size, whereas high levels can cause clitoris enlargement, deepening of the voice, and male muscle pattern.
How Are Androgen Levels Tested?
When diagnosing PCOS, healthcare providers want to test androgen levels. This is done through blood work. What is considered within the normal range for androgens will vary based on the specific lab, so be sure to discuss your results with your provider.
Normal Ranges of AndrogensTotal testosterone: This is the total amount of all thetestosteronein your bloodstream. Levels should be between 6.0 and 86 nanograms per deciliter (ng/dL) in females. In PCOS, total testosterone may be slightly elevated.Free testosterone: This testosterone is unattached to any proteins and is a small percentage of the total testosterone. Normal levels of free testosterone are between 0.7 and 3.6 picograms per milliliter (pg/mL). Free testosterone levels may be elevated in PCOS.Androstenedione: Normal levels in females are between 0.7 to 3.1 ng/mL. Elevated levels may indicate PCOS.DHEAS:For females in their 20s, a normal level is usually in the high 300s. Those in their 30s may have normal levels in the 200s.
Normal Ranges of Androgens
Total testosterone: This is the total amount of all thetestosteronein your bloodstream. Levels should be between 6.0 and 86 nanograms per deciliter (ng/dL) in females. In PCOS, total testosterone may be slightly elevated.Free testosterone: This testosterone is unattached to any proteins and is a small percentage of the total testosterone. Normal levels of free testosterone are between 0.7 and 3.6 picograms per milliliter (pg/mL). Free testosterone levels may be elevated in PCOS.Androstenedione: Normal levels in females are between 0.7 to 3.1 ng/mL. Elevated levels may indicate PCOS.DHEAS:For females in their 20s, a normal level is usually in the high 300s. Those in their 30s may have normal levels in the 200s.
Total testosterone: This is the total amount of all thetestosteronein your bloodstream. Levels should be between 6.0 and 86 nanograms per deciliter (ng/dL) in females. In PCOS, total testosterone may be slightly elevated.
Free testosterone: This testosterone is unattached to any proteins and is a small percentage of the total testosterone. Normal levels of free testosterone are between 0.7 and 3.6 picograms per milliliter (pg/mL). Free testosterone levels may be elevated in PCOS.
Androstenedione: Normal levels in females are between 0.7 to 3.1 ng/mL. Elevated levels may indicate PCOS.
DHEAS:For females in their 20s, a normal level is usually in the high 300s. Those in their 30s may have normal levels in the 200s.
Blood Tests for PCOS
How PCOS Is Diagnosed
If your healthcare provider has diagnosed you with PCOS, but your lab results show normal androgen levels, you may feel confused. Keep in mind that not everyone agrees on how to diagnose PCOS:
If you have infrequent periods that are more than 35 days apart and occur only four to nine times a year, you may receive a diagnosis of PCOS, even without high androgen levels or any visible signs of hyperandrogenism.
Other Causes of High Androgen Levels
The majority of females with hyperandrogenism have PCOS.That said, there are other possible causes of hyperandrogenism which can lead to symptoms similar to PCOS:
Differential Diagnosis of PCOS
In females, increased androgen levels can lead to irregular periods, facial hair growth, and difficulty becoming pregnant. These high levels are also responsible for some other risk factors that often accompany PCOS.
Fat Distribution
Androgens seem to play a role in where fat is stored in the body. Females with high androgen levels may start to accumulate more fat in the abdominal region.Body shape changes as a result, with more weight being carried around the belly.
Insulin Resistance
The risk ofinsulin resistanceis higher in females with excess androgens. Insulin resistance occurs when the body doesn’t respond to the hormone insulin like it should. Insulin helps keep blood sugar levels in check.
Insulin resistance is also associated with PCOS. However, not everyone with PCOS will develop insulin resistance. For people who do, antiandrogen therapy may be able to reverse insulin resistance.
Insulin resistance can cause high levels of blood sugar. Too much blood sugar can cause considerable damage. When you are resistant to insulin, you also have high levels of insulin in the blood. Too much insulin in the blood can set the stage forprediabetesand type 2 diabetes.
Cardiovascular Problems
Having abnormally high levels of androgens is associated with an increased risk ofheart problemsin females.
Scientists are still teasing out the nuances in how high androgen levels affect heart health. It seems that having high androgen levels alone doesn’t increase your risk of cardiovascular problems. When combined with irregularities in your period, however, hyperandrogenism may put you at increased risk of cardiovascular disease,coronary heart disease, and heart attack.
Difficulties With Pregnancy
It is known that PCOS can cause infertility in some people. Yet, many with PCOS can still get pregnant. If pregnancy does occur, there may be additional risks. High androgens affect the function of the ovaries and uterus, which could mean failure of the embryo to attach to the uterine wall,preeclampsia, and preterm birth. It can also increase the risk ofgestational diabetes.
Treatment for Hyperandrogenism
Treatment for hyperandrogenism will vary since PCOS and hyperandrogenism don’t always present the same way.
All treatments have their advantages and disadvantages, and medications may carry side effects and risks. Talk to your healthcare provider about which option may be best for you.
How Polycystic Ovary Syndrome (PCOS) Is Treated
Birth Control
For those who aren’t trying to get pregnant,hormonal birth controlpills may be used to reduce androgens and treat symptoms. Combinedestrogen-progesterone birth controlmay be tried first to treat PCOS symptoms. But, you may need to try a few options before finding the birth control that helps you feel best.
Not everyone does well on birth control and some prefer to avoid taking hormonal medications.
Antiandrogen Drugs
Another possible treatment is antiandrogen medication, which reduces the effects of excess androgens. Antiandrogen treatment can be started six months after starting birth control pills.
Antiandrogen drugs include the following:
Insulin Reducing Drugs
Metformin, which improves insulin sensitivity, may be used to treat PCOS-related androgen symptoms. Aside from reducing androgen levels, metformin has been shown to improve menstrual patterns, hirsutism, and body fat distribution in people with PCOS.
Metformin is considered safe to take if you’re trying to get pregnant. It may also be able to aid in ovulation and reduce miscarriage rates in people with PCOS.
Hair Removal
Some may choose to directlyremove unwanted hairgrowth, but keep in mind that most of these options will only work temporarily.
Electrolysis and laser therapy actually work really well. On the downside, they can be expensive and may require more than one session.
The following hair removal options are less expensive than electrolysis or laser therapy, but can irritate the skin:
Acne Treatments
There are a number ofover-the-counter acne treatments, but for those with PCOS-related acne, these may not make a significant difference. You may want to see adermatologist, a doctor who specializes in treating skin, hair, and nails. The dermatologist may prescribe you treatments that are more effective than over-the-counter options.
How to Naturally Decrease High AndrogensOne study found that drinking tea led to a significant decline of testosterone levels.Green teaproduced the strongest effect, but spearmint herbal tea and marjoram tea may also help.Eating nutritious foods and maintaining a healthy weight are also thought to help minimize PCOS symptoms.
How to Naturally Decrease High Androgens
One study found that drinking tea led to a significant decline of testosterone levels.Green teaproduced the strongest effect, but spearmint herbal tea and marjoram tea may also help.Eating nutritious foods and maintaining a healthy weight are also thought to help minimize PCOS symptoms.
If you have noticed any changes in your health that you think may be related to high androgen levels, contact a healthcare provider to get tested.
You may want to get checked out regularly if you know you have PCOS. PCOS can increase your risk of developing diabetes, high blood pressure, high cholesterol, obesity, anduterine cancer.
Taking a Testosterone Test to Know Your Levels
Summary
Hyperandrogenism occurs when androgens are higher than they should be. Excess androgens can have several causes, the most common being PCOS. Visible signs of hyperandrogenism and/or blood work that shows high levels of androgens can confirm a PCOS diagnosis.
Symptoms of hyperandrogenism may vary from person to person. High female levels of androgens can have negative health effects, including insulin resistance, body shape changes, and cardiovascular problems. Treatment may include various medications.
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