Are You Noticing Unusual Body Changes or Unwanted Hair Growth? Here is What You Need to Know About Hyperandrogenism

Have you been feeling worried about sudden changes in your body, your skin, or your hair growth patterns? Sometimes, these shifts happen because your body makes higher levels of male sex hormones called androgens than normal. Doctors call this medical condition hyperandrogenism. Do not let big medical words worry you, because we are going to break down everything you need to know in simple, clear everyday language.

Hyperandrogenism can affect both women and men, though it is most often diagnosed in women of childbearing age. Whether you are trying to understand your own lab test results or supporting a loved one, understanding what happens inside your body is the first step toward feeling better. Let us explore what causes this hormonal shift, what signs to look out for, and how your doctor can help you manage it safely.

What is Hyperandrogenism?

Simply put, hyperandrogenism means that your body has too much of a group of hormones called androgens. While androgens are often called male hormones, both women and men produce them naturally. They are very important for normal sexual development, reproductive health, and overall physical growth.

Hormones are chemical messengers made by your glands. They travel through your bloodstream to tell your organs, muscles, and other tissues what to do and when to do it. Everyone makes androgens, but men produce much larger amounts. In women, normal androgen levels are about twelve times lower than in men. Testosterone is the most well-known and powerful androgen hormone.

In men, androgens are made mostly in the testicles. In women, they are produced in the ovaries. Your adrenal glands, which sit right on top of your kidneys, also make androgens. Other tissues in your body, like your skin and fat tissue, help turn weaker androgens into stronger ones.

The signs and symptoms of hyperandrogenism vary depending on your age and sex. There are many different reasons why this happens, and safe medical treatments are available to help you regain balance.

Are Hyperandrogenism and PCOS the Same Thing?

Many people think that hyperandrogenism and Polycystic Ovary Syndrome (PCOS) are the exact same medical condition. While these two terms are closely connected, they do not mean the exact same thing.

Hyperandrogenism is actually one of the primary features or signs of PCOS. PCOS is a common hormonal disorder where the ovaries make excess male hormones, which mainly affects women. Therefore, while PCOS is the most frequent cause of hyperandrogenism, hyperandrogenism can also be caused by other medical issues.

also, PCOS involves other features beyond high androgen levels, such as irregular menstrual cycles and small fluid-filled sacs or cysts in the ovaries. Understanding this distinction helps your doctor find the exact root cause of your symptoms.

Who Does This Affect and How Common Is It?

Hyperandrogenism can potentially affect anyone at any stage of life, including young children and older adults. However, it is most commonly diagnosed in women of childbearing age.

Studies show that between 5% and 10% of women in their reproductive years experience hyperandrogenism. This means it is far more common than many people realize and is certainly not a rare condition. On the other hand, hyperandrogenism is much less common in young boys and adult men.

What Are the Signs and Symptoms?

The symptoms of hyperandrogenism depend heavily on your biological sex and whether you have reached puberty yet. It is important to know that you can have high androgen lab test levels without having many noticeable symptoms. Conversely, you might have certain physical symptoms even if your blood test results come back normal.

Crucial Warning: If you notice that your symptoms appear suddenly and get worse very rapidly, you must see a doctor right away. Rapidly developing signs can sometimes point to a more serious underlying cause, such as an androgen-producing tumor.

Let us look at how hyperandrogenism affects different groups of people:

Girls Before Puberty.

• An enlarged clitoris.
• Severe acne and very oily skin.
• Early or abnormal growth of body hair, known as hirsutism. This means thick, coarse, dark hair appears on the upper lip, chin, chest, stomach, or back instead of fine, light peach fuzz.

Boys Before Puberty.

• An enlarged penis.
• Early or rapid growth of pubic hair and underarm hair.
• A deepening voice at an unusually young age.

Adult Women.

• Persistent acne and oily skin.
• Unwanted coarse hair growth on the face and body (hirsutism).
• Irregular, missed, or unpredictable menstrual periods.
• Difficulty getting pregnant, also known as infertility.
• Hair thinning on the scalp in a male pattern (androgenic alopecia).

Adult Men.

When adult men experience excess androgens, the effects depend on whether the extra hormones come from the adrenal glands or from outside sources, such as taking illegal anabolic steroids. If extra androgens come from the adrenal glands, men usually do not notice big physical changes. However, it can sometimes lower sperm production and cause fertility challenges.

Why Does This Happen? What Are the Causes?

In women, androgens are made in the ovaries, adrenal glands, and fat cells. In men, they are made in the testicles and adrenal glands. Several other hormones help control how much androgen your body makes and releases.

For example, luteinizing hormone (LH) and adrenocorticotrophic hormone (ACTH) are two key hormones released by the pituitary gland in your brain. If any of these organs or hormones fail to work together properly, hyperandrogenism can develop.

There are several primary causes for high androgen levels:

• Polycystic Ovary Syndrome (PCOS), which is the most frequent cause.
• Congenital Adrenal Hyperplasia (CAH), a group of inherited genetic conditions.
• Cushing disease, caused by a pituitary gland issue.
• Androgen-secreting tumors in the glands or organs.
• Certain prescription medicines or substances.

Let us explore each of these causes in more detail.

Polycystic Ovary Syndrome (PCOS).

Among young and adult women, PCOS is by far the most common reason for ongoing hyperandrogenism after puberty. In fact, between 80% and 90% of women who have hyperandrogenism also have PCOS.

When you have PCOS, high levels of LH and insulin (known as hyperinsulinemia) stay in your system. This signals your ovaries to make extra androgen hormones. also, high insulin levels stop your liver from making a protective protein called Sex Hormone Binding Globulin (SHBG). Because there is less SHBG to hold onto them, the amount of active free testosterone floating in your blood goes up.

Congenital Adrenal Hyperplasia (CAH).

Congenital Adrenal Hyperplasia (CAH) refers to a group of inherited genetic conditions that affect your adrenal glands.

In people with CAH, genetic changes lead to a shortage of important enzymes, such as 21-hydroxylase, which your body needs to make vital hormones. Because these enzymes are missing, the adrenal glands make extra amounts of testosterone and other androgens instead.

The most common mild form related to hyperandrogenism is non-classical congenital adrenal hyperplasia. About 2% of women who experience hyperandrogenism have this specific genetic variation.

Cushing Disease.

Cushing disease is a specific type of Cushing syndrome. Cushing syndrome is a less common condition that happens when your body has too much of the stress hormone cortisol.

Cushing disease develops when a non-cancerous tumor forms in your pituitary gland. This tumor releases too much ACTH, which then drives your adrenal glands to produce excess cortisol. Because ACTH levels are high, your adrenal glands also pump out extra androgens, leading to hyperandrogenism.

Cushing syndrome also features other signs, such as:

• Purplish stretch marks across your belly and skin.
• Rapid weight gain centered around your face, neck, and abdomen.
• High blood pressure.

Emergency Red Flags: When to Seek Immediate Medical Help.

If you or a loved one experience sudden, severe physical changes—such as rapid virilization, deep voice changes in women, rapid weight gain with purple stretch marks, or sudden severe abdominal pain—go to the nearest Emergency Department (ER) or call 911 (US/Canada) or 999 (UK) right away. These rapid symptoms can indicate a fast-growing tumor that requires urgent medical evaluation.

Androgen-Secreting Tumors.

Rarely, tumors that develop in the adrenal glands, ovaries, or testicles can make and release large amounts of androgens. This causes your blood androgen levels to rise sharply. Hyperandrogenism caused by tumors is usually very severe and appears suddenly.

Tumors in the ovaries or adrenal glands are a rare cause of hyperandrogenism, affecting only about 0.2% of cases. Even though it is uncommon, you should always consult a doctor if your symptoms appear out of nowhere and progress quickly.

Certain medicines.

Some prescription drugs and substances can also cause hyperandrogenism. The most common medicines linked to this issue include:

• Anabolic-androgenic steroids, which are artificial versions of testosterone sometimes misused by athletes trying to boost muscle mass.
• Synthetic progestins found in certain hormone treatments.
• Certain antiepileptic medicines used to prevent seizures.

How Do Doctors Diagnose Hyperandrogenism?

If you are a woman and suspect you have hyperandrogenism, your doctor will start by performing a physical examination. They will check for physical signs like unwanted hair growth, acne, or skin changes. They will also ask about your detailed medical history, including:

• The age when your breasts first started developing.
• When you first noticed pubic hair growth.
• The exact age of your first menstrual period.
• Whether you remove body hair by shaving, waxing, or laser treatments.
• If you have ever used anabolic steroids or testosterone without a prescription.
• How often your periods happen, how many days they last, and how heavy they are.

If your doctor suspects hyperandrogenism, they will order specific blood tests to measure your hormone levels and confirm a diagnosis.

What Kinds of Tests Are Done?

Doctors typically order several key blood tests to evaluate hormone levels:

• Total testosterone: Measures the total amount of testosterone circulating in your blood. Women with PCOS often have mildly elevated levels, while extremely high levels can point toward an ovarian or adrenal tumor.
• Free testosterone: Measures the portion of testosterone that is not bound to any proteins. This is an active form of the hormone, and it is often elevated in women with PCOS.
• Androstenedione: A steroid hormone that acts as a stepping stone in your body as it makes testosterone and estrogen. High levels can suggest PCOS.
• Dehydroepiandrosterone sulfate (DHEAS): A sex hormone produced primarily by your adrenal glands. Testing DHEAS helps doctors evaluate whether your adrenal glands are making too many androgens.
• 17-hydroxyprogesterone: Measured in your blood to check for non-classical congenital adrenal hyperplasia, which is a common underlying cause of hyperandrogenism.

Because other conditions can mimic these symptoms, your doctor may order additional blood tests to rule out other health issues.

Your doctor may also use imaging tests to look for the root cause:

• A pelvic ultrasound to check your ovaries for cysts (a sign of PCOS) or other growths.
• A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to check your adrenal glands for tumors.

What Are the Treatment Options?

Treatments for hyperandrogenism depend entirely on what is causing the condition in your body. For example:

• Adrenal-related hyperandrogenism can often be managed effectively using low doses of prescription corticosteroids.
• If a tumor is found in your ovaries, testicles, or adrenal glands, surgeons may need to remove it. For perimenopausal or postmenopausal women with severe hyperandrogenism, doctors sometimes recommend a surgery to remove one or both ovaries, known as an oophorectomy.
• If a specific medicine is causing your high hormone levels, your doctor will guide you to safely stop or switch that drug.

Anti-androgen medicines are another common treatment. These prescription drugs work by blocking the effects of testosterone and other androgens on your tissues.

Common anti-androgen medicines include:

• Birth control pills (oral contraceptives) containing estrogen (like ethinyl estradiol) combined with an anti-androgenic progestin, such as cyproterone acetate, drospirenone, or dienogest. These help improve acne, slow unwanted hair growth, and regulate periods.
• Spironolactone, an anti-androgen medicine that helps clear hormone-related acne and reduces excess hair growth.
• Cyproterone, which helps treat PCOS symptoms, lowers testosterone levels, and cuts down skin oil production.

Treating Specific Symptoms.

If you have hyperandrogenism, you may also want targeted treatments for person symptoms:

• Acne treatments: Doctors may recommend medicated skin creams, oral antibiotics like tetracycline, hormone therapies including birth control pills, or strong oral retinoids like isotretinoin for severe cases.
• Hirsutism (unwanted hair growth): Many women use home methods like waxing, shaving, or professional laser hair removal alongside their prescription birth control pills to manage hair growth.
• Irregular periods: Hormonal birth control methods help regulate your menstrual cycle and protect your uterine lining.

When symptoms do not respond well to standard lifestyle care, your doctor can discuss more advanced anti-androgen treatments with you.

Can Hyperandrogenism Be Prevented?

Unfortunately, there is no known way to completely prevent hyperandrogenism from developing. also, there is no proven method to prevent PCOS, which is the most common underlying cause.

However, you can take positive steps to reduce your symptoms and improve your overall health. Eating a nutritious, balanced diet, exercising regularly, and keeping a healthy body weight can help lessen the impact of PCOS and hyperandrogenism on your daily life.

What is the Long-Term Outlook? (Prognosis).

Many of the underlying causes of hyperandrogenism require ongoing, long-term management. In some cases, women who have PCOS-related hyperandrogenism find that their symptoms improve greatly after losing a meaningful amount of weight. However, many people need ongoing care to keep their symptoms under control.

A Note on Mental Health: Living with the physical symptoms of hyperandrogenism can feel stressful and affect your self-esteem. If your symptoms cause you anxiety, stress, or feelings of depression, please do not hesitate to talk to a counselor, therapist, or mental health professional for support.

When Should You See a Doctor?

If you have been diagnosed with hyperandrogenism and take medicine, you will need to see your doctor regularly to make sure your treatment plan is working properly and your lab levels remain stable.

Most importantly, if your symptoms start affecting your emotional well-being or daily life, reaching out to a doctor or a mental health counselor is an essential part of your healing journey.

Sources & References:
1. Cleveland Clinic. Hyperandrogenism: Causes, Symptoms & Treatment. Available online: Cleveland Clinic Health Library.
2. Mayo Clinic. Polycystic Ovary Syndrome (PCOS) - Diagnosis and Treatment. Available online: Mayo Clinic Patient Care.
3. National Health Service (NHS UK). Overview - Polycystic ovary syndrome (PCOS). Available online: NHS Health Information.
4. Centers for Disease Control and Prevention (CDC). PCOS (Polycystic Ovary Syndrome) and Diabetes. Available online: CDC Reproductive Health.
5. NIH National Library of Medicine / StatPearls. Hyperandrogenism. PMID: 32119492. Available online: PubMed Central.

Tags: Hyperandrogenism, Androgen, Testosterone, PCOS, Hirsutism, Acne, Hormonal Imbalance, Women's Health, Patient Guide