Androgen Excess

Higher-than-normal levels of male-type hormones

Table of Contents

Quick Facts

  • Type: Hormonal (endocrine) condition
  • What it is: Excess androgen hormones
  • Common cause: Polycystic ovary syndrome (PCOS)
  • Typical signs: Excess hair, acne, irregular periods

Overview

Androgens, such as testosterone, are hormones present in everyone but normally at higher levels in men. Androgen excess, also called hyperandrogenism, means the body has more of these hormones than usual. In women, this hormonal imbalance can produce visible effects on the skin, hair, and menstrual cycle.

Androgen excess is most often linked to polycystic ovary syndrome (PCOS), the most common cause in women of reproductive age. Less commonly, it results from adrenal gland conditions, certain medications, or, rarely, hormone-producing tumors. Identifying the cause guides treatment and helps address related health concerns.

Symptoms

Signs of androgen excess in women can include:

  • Excess hair growth in a male pattern, such as on the face, chest, or back (hirsutism)
  • Persistent acne, especially along the jaw and chin
  • Oily skin
  • Thinning hair or hair loss in a male pattern
  • Irregular or absent menstrual periods
  • In some cases, difficulty getting pregnant

Rapidly developing or severe symptoms, a deepening voice, or marked muscle changes are less common and warrant prompt evaluation to rule out an underlying cause that needs urgent attention.

Causes

Several conditions can lead to androgen excess:

  • Polycystic ovary syndrome (PCOS): By far the most common cause.
  • Adrenal conditions: Such as congenital adrenal hyperplasia or other adrenal gland disorders.
  • Medications or supplements: Including anabolic steroids and certain hormone products.
  • Hormone-producing tumors of the ovary or adrenal gland (rare).
  • Other endocrine conditions, such as those affecting cortisol or prolactin.

Risk Factors

  • Polycystic ovary syndrome
  • Family history of PCOS, hirsutism, or hormonal disorders
  • Insulin resistance and obesity
  • Use of anabolic steroids or certain hormone medications
  • Some inherited adrenal conditions

Diagnosis

Evaluation aims to confirm androgen excess and find its cause:

  • Medical history and exam: Reviewing menstrual patterns, hair and skin changes, and how quickly symptoms developed.
  • Blood tests: Measuring testosterone and other androgens and related hormones.
  • Additional hormone testing: To check adrenal and other glands when needed.
  • Ultrasound or imaging: Of the ovaries or adrenal glands if a structural cause or tumor is suspected.

Treatment

Treatment depends on the cause, the symptoms that bother the person most, and whether pregnancy is desired.

  • Treating the underlying condition, such as managing PCOS or an adrenal disorder.
  • Hormonal medications: Combined birth control pills can regulate periods and lower androgen effects; anti-androgen medicines may reduce excess hair and acne.
  • Skin and hair management: Acne treatments, and hair removal methods such as laser or electrolysis for unwanted hair.
  • Lifestyle measures: Weight management and addressing insulin resistance can help, particularly in PCOS.
  • Stopping triggering substances, such as anabolic steroids.

Results often take several months, and a clinician can tailor the plan to individual goals.

Prevention

Many causes of androgen excess cannot be prevented, but some steps may help. Maintaining a healthy weight and staying active can improve insulin resistance associated with PCOS. Avoiding non-prescribed anabolic steroids and using hormone-containing products only as directed reduces drug-related causes. Early evaluation of symptoms allows underlying conditions to be identified and managed sooner.

When to See a Doctor

See a doctor if you notice excess facial or body hair, persistent acne, scalp hair thinning, or irregular or missed periods, so the cause can be evaluated. Seek prompt care for rapidly worsening symptoms, a deepening voice, or marked muscle development, as these can occasionally signal a hormone-producing tumor or other condition that needs timely attention.

Related Topics

Polycystic Ovary Syndrome

The most common cause of androgen excess.

 Hirsutism

Excess hair growth from androgen excess.

 Congenital Adrenal Hyperplasia

An adrenal cause of high androgens.

 Unwanted Hair

A common sign of androgen excess.

Frequently Asked Questions

What is the most common cause of androgen excess in women?

Polycystic ovary syndrome (PCOS) is by far the most common cause in women of reproductive age. Less common causes include adrenal gland disorders, certain medications, and, rarely, hormone-producing tumors.

What symptoms does androgen excess cause?

In women it commonly causes excess hair growth in a male pattern, persistent acne, oily skin, scalp hair thinning, and irregular or absent periods. Some women also have difficulty getting pregnant.

How is androgen excess treated?

Treatment targets the cause and symptoms and may include hormonal birth control, anti-androgen medications, acne and hair treatments, and weight management for PCOS. If a medication or steroid is responsible, stopping it is part of treatment. Results usually take several months.

When should I be concerned about a serious cause?

Rapidly developing symptoms, a deepening voice, or marked muscle changes are less typical and should be evaluated promptly, as they can occasionally point to a hormone-producing tumor that needs timely care.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions about a medical condition.

References

  1. MedlinePlus, U.S. National Library of Medicine. Hirsutism.
  2. Mayo Clinic. Hirsutism — Symptoms and causes.
  3. Office on Women's Health, U.S. Department of Health and Human Services. Polycystic ovary syndrome.
  4. National Institute of Child Health and Human Development (NICHD). PCOS.