hyperandrogenism

What is Hyperandrogenism?

Hyperandrogenism refers to an excessive presence of male sex hormones, specifically androgens such as testosterone, in the body. This condition can affect individuals assigned female at birth (AFAB) and is characterized by high levels of these hormones.

Causes of Hyperandrogenism

The causes of hyperandrogenism are varied and can include:

• Abnormal adrenal or ovarian function [7]
• Peripheral formation of androgens [7]
• Polycystic ovary syndrome (PCOS), which affects approximately 60-76% of women with the condition, leading to hirsutism, acne, and alopecia [8][9]

Symptoms of Hyperandrogenism

The symptoms of hyperandrogenism may include:

• Excessive hair growth on the face, chest, back, or other areas
• Acne
• Alopecia (hair loss)
• Deepening voice
• Clitoral enlargement

These symptoms can vary in severity and are often associated with PCOS [8][9].

Definition

Hyperandrogenism is defined as an abnormally high production of androgens [10]. This condition requires medical attention to manage its symptoms and prevent long-term complications.

References:

[7] - Context result 7 [8] - Context result 8 [9] - Context result 9 [10] - Context result 10

Common Signs and Symptoms of Hyperandrogenism

Hyperandrogenism, also known as excess androgen syndrome, is a condition characterized by an overproduction of male hormones (androgens) in the body. The signs and symptoms of hyperandrogenism can vary from person to person but often include:

• Abnormal Hair Growth: Excessive hair growth on the face, chest, back, and other areas where women typically do not have much hair.
• Acne: Oily skin and acne are common symptoms of hyperandrogenism.
• Male-Pattern Baldness: Thinning or loss of hair at the front of the scalp, often in a pattern similar to male pattern baldness.
• Hirsutism: Excessive growth of coarse, dark hair on the face, particularly the beard and moustache area.
• Oily Skin (Seborrhoea): Excess oil production on the skin can lead to oily skin and acne.

According to various medical sources [1][2], these symptoms are often associated with an overproduction of androgens in the body. In some cases, hyperandrogenism can also cause other symptoms such as:

• Deepening of the Voice: A deeper voice is a common symptom of hyperandrogenism.
• Increase in Muscle Mass: Some individuals may experience an increase in muscle mass due to excess androgen production.

It's essential to note that these symptoms can vary in severity and may be accompanied by other health issues. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment [3][4].

References: [1] - Symptoms of High Androgens ... Signs and symptoms of hyperandrogenism may include abnormal hair growth, acne, male-pattern baldness, and ... [2] - What are the symptoms of hyperandrogenism? · Oily skin (seborrhoea) · Acne · Thick hair growth (hirsutism) - on the face particularly the beard and moustache ... [3] - Symptoms · Increase in the size of the clitoris · Deepening of the voice · Increase in muscle mass · Thinning hair and hair loss at the front of the ... [4] - What are the symptoms of hyperandrogenism? · Acne · Male-pattern baldness · Excess hair growth on the face and elsewhere on the body where women ...

Diagnostic Tests for Hyperandrogenism

Hyperandrogenism, also known as androgen excess, can be diagnosed through various blood tests that measure the levels of different hormones in the body.

• Total Testosterone: This test measures the total amount of testosterone in the bloodstream. Elevated levels are often seen in women with hyperandrogenism [1].
• Dehydroepiandrosterone Sulfate (DHEAS): This hormone is produced by the adrenal glands and can be elevated in women with hyperandrogenism [5].
• 17-Hydroxyprogesterone: This test is used to diagnose nonclassic congenital adrenal hyperplasia, a condition that can cause hyperandrogenism [6].
• Thyroid Function Tests: These tests are used to rule out thyroid disorders, which can sometimes present with symptoms similar to hyperandrogenism [7].

Other Diagnostic Tests

In addition to blood tests, other diagnostic tests may be used to diagnose hyperandrogenism. These include:

• Imaging Studies: Imaging studies such as ultrasound or MRI may be used to visualize the ovaries and adrenal glands.
• Physical Examination: A thorough physical examination is essential in diagnosing hyperandrogenism, particularly in assessing symptoms such as hirsutism and acne [13].

Diagnostic Criteria

The diagnostic criteria for hyperandrogenism can vary depending on the specific condition being diagnosed. For example, polycystic ovary syndrome (PCOS) has a set of diagnostic criteria that includes clinical symptoms and measurement of serum androgens [2]. However, there is no clear consensus guidelines on the diagnostic criteria for PCOS in adolescent girls within 2 years of menarche [3].

Prevalence

Hyperandrogenism or androgen excess is a common endocrine disorder of women of reproductive-age, with a prevalence of 5-10% [11]. The majority of patients with hyperandrogenism will have polycystic ovary syndrome (PCOS) [14].

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [5] Context result 5 [6] Context result 6 [7] Context result 7 [11] Context result 11 [13] Context result 13 [14] Context result 14

Treatment Options for Hyperandrogenism

Hyperandrogenism, also known as excess androgen levels, can be treated with various medications to alleviate symptoms such as hirsutism (excessive hair growth), acne, and male pattern baldness. Here are some common drug treatments:

• Oral Contraceptives: Combined oral contraceptives containing ethinyl estradiol (estrogen) and antiandrogenic agents can help regulate menstrual cycles and reduce androgen levels [1].
• Antiandrogens: Medications like cyproterone acetate, spironolactone, flutamide, or finasteride can block the effects of excess androgens on the body. These medications are often used to treat hirsutism in patients with polycystic ovary syndrome (PCOS) [2].
• Glucocorticoids: Low-dose glucocorticoid therapy with dexamethasone or prednisolone can be effective in treating adrenal hyperandrogenism [3].
• Birth Control Pills: Oral contraceptives are often used as a first-line treatment for hirsutism, particularly in patients with PCOS. They help regulate menstrual cycles and reduce androgen levels [4].
• Multimodal Therapy: A combination of lifestyle changes, physical hair removal, and medication is the most effective approach to treating hirsutism [5].

Specific Medications

Some specific medications used to treat hyperandrogenism include:

• Spironolactone: This antiandrogenic medication is often used to treat symptoms of PCOS, including hirsutism [6].
• Metformin: This medication is commonly used in combination with spironolactone to treat PCOS-related hirsutism [7].
• Cyproterone acetate: This medication is effective in treating hirsutism and other symptoms of hyperandrogenism [8].

References

[1] Medical treatment for hyperandrogenism · Oral contraceptive (birth control pill) containing ethinyl estradiol (estrogen) and antiandrogenic ...

[2] by D Lizneva · 2016 · Cited by 196 — Management of clinical hyperandrogenism involves primarily either androgen suppression, with a hormonal combination contraceptive, or androgen blockade, as with ...

[3] May 13, 2024 — Adrenal hyperandrogenism responds well to low-dose glucocorticoid therapy with dexamethasone or prednisolone. These agents are used with ...

[4] Antiandrogens: cyproterone acetate, spironolactone, flutamide or finasteride. Birth control; Oral steroids are used for patients with congenital adrenal ...

[5] Multimodal therapy is the most effective approach to the treatment of hirsutism; this includes lifestyle changes, physical hair removal, and androgen ...

[6] Jun 21, 2024 — Treatment depends on the underlying cause and may involve medication like birth control pills to regulate menstrual cycles. Lifestyle and ...

[7] by LEE RADOSH · 2009 · Cited by 172 — First-line agents for the treatment of hirsutism in patients with PCOS include spironolactone (Aldactone) and metformin (Glucophage), as well as ...

[8] by T Rabe · 1996 · Cited by 18 — The most important drugs for the treatment of symptoms of hyperandrogenism are cyproterone acetate, chlormadinone acetate, dienogest ...

Hyperandrogenism Differential Diagnoses

Hyperandrogenism, characterized by an excess amount of androgens in the body, can manifest as hirsutism, acne, and irregular periods in individuals [5]. The differential diagnosis for hyperandrogenism is crucial to identify the underlying cause of this condition. Here are some key differentials:

• Polycystic Ovarian Syndrome (PCOS): The most common symptom of hyperandrogenism in women is hirsutism, and PCOS is often considered the most prevalent cause [4].
• Ovarian Hyperthecosis: A rare disorder characterized by an excess of androgens due to a tumor on one ovary [3].
• Congenital Adrenal Hyperplasia (CAH): A genetic disorder that affects the adrenal glands, leading to excessive production of androgens [1][4].
• Cushing's Syndrome: A rare endocrine disorder caused by excess cortisol levels, which can lead to hyperandrogenism [3][8].
• Androgen-Producing Tumors: Rare tumors that produce excess androgens, such as ovarian or adrenal tumors [6][9].
• Idiopathic Hyperandrogenism: A condition where the cause of hyperandrogenism is unknown [6].

Key Points to Consider

• The differential diagnosis for hyperandrogenism should include physiologic hyperandrogenism of puberty and idiopathic hyperandrogenism in addition to pathological conditions [6].
• In patients with symptoms of androgen excess, it's essential to consider the differential diagnoses mentioned above to determine the underlying cause [7].

References

[1] by D Rachoń · 2012 · Cited by 78 [3] by CL Meek · 2013 · Cited by 30 [4] by A Sharma · 2021 · Cited by 41 [5] Jan 23, 2023 [6] In patients with symptoms of androgen excess, the differential diagnosis should include physiologic hyperandrogenism of puberty, idiopathic hyperandrogenism, ... [7] by LA Sanchez · 2001 · Cited by 12 [8] by JE Hall · Cited by 5 [9] by SA Kanbour · 2022 · Cited by 31