Androgen Excess Disorder - An Overview

Introduction

Androgen excess disorder in females refers to a medical condition where an excessive amount of androgens (male hormones) are present in a woman's body. This hormonal imbalance can cause a variety of symptoms in women, such as hirsutism (excessive hair growth), acne, menstrual irregularities, and infertility. The underlying cause of androgen excess disorder can be due to various factors such as polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia, or certain adrenal or ovarian tumors.

What Is Androgen?

Androgens are a class of hormones responsible for initiating puberty and affecting reproductive health and physical development. Both males and females produce androgens. However, males produce higher levels of these hormones. Testosterone is the most well-known androgen. Males produce androgens in the testicles, while females produce it in the ovaries, and both genders also produce androgens in the adrenal glands above each kidney.

What Are the Reasons For Excessive Production of Androgens?

There are various illnesses or imbalances in hormones that can alter the hormone levels in women. The three most frequent causes of elevated testosterone levels in women are hirsutism, polycystic ovary syndrome, and congenital adrenal hyperplasia.

• Hirsutism- Hirsutism is a hormonal disorder experienced by women, which results in unwanted hair growth, particularly on the chest, back, and face. The extent of body hair growth is largely influenced by genetics, but the primary cause is an irregularity in the levels of androgen hormones.

• Polycystic Ovary Syndrome (PCOS) - It is a hormonal disorder that affects women and is caused by excessive androgen secretion. If someone has PCOS, they may experience infrequent or prolonged menstrual cycles, hirsutism, and enlarged ovaries that may not function properly. Some of the other typical consequences of PCOS include infertility, miscarriages, type 2 diabetes, obesity, and endometrial cancer.

• Congenital Adrenal Hyperplasia (CAH)- It is a condition that impacts the adrenal glands and the secretion of hormones in the body. In numerous instances of CAH, the body generates an excessive amount of androgens. The typical symptoms in women include infertility, masculine traits, premature growth of pubic hair, and severe acne.

What Are the Sign and Symptoms of Androgen Excess Disorder?

The symptoms of androgen excess disorder in women can vary based on the underlying cause. Still, they may include:

• Hirsutism (excessive hair growth).

• Acne

• Irregular or absent menstrual periods

• Infertility

• Deepening of the voice

• Enlarged clitoris

• Alopecia (hair loss)

• Obesity

• Mood swings or depression

• Decreased breast size

• Insulin resistance or type 2 diabetes.

How Does a Doctor Perform the Diagnostic Test for Androgen Excess?

The diagnosis of androgen excess disorder in women typically involves the following steps:

• Medical History and Physical Examination: The physician will conduct a comprehensive review of the medical history and a physical examination to evaluate the symptoms.

• Hormonal Tests: Blood tests will be performed to measure the levels of androgens and other hormones in the blood.

• Ultrasound: An ultrasound may be performed to evaluate the ovaries and adrenal glands.

• Other tests: Depending on the symptoms and medical history, the doctor may recommend additional tests such as a glucose tolerance test, a CT scan, or an MRI.

What Are the Treatment Options Available?

The treatment for high androgen levels depends on the underlying cause. A physician may suggest combining lifestyle modifications with medication. Some treatments may target the reduction of unwanted hair growth.

• Medications- Medications used to treat high testosterone levels, and related conditions can include:

1. Eflornithine cream: This slows the growth of new facial hair.

2. Glucocorticosteroids: These are a type of steroid hormone that reduces inflammation in the body.

3. Metformin: This is a treatment for type 2 diabetes and may also help lower blood sugar and insulin levels in people with PCOS.

4. Progestin: This hormone may regulate periods and improve fertility.

5. Spironolactone: This diuretic helps balance water and salt levels and reduces excessive female hair growth.

The combination of oral contraceptives, anti-androgens, and metformin may be most effective for treating hirsutism. Oral contraceptives may not be appropriate for those trying to conceive and can also cause side effects. The doctor will determine the best treatment option based on your specific case and needs.

• Hair Removal Treatment

Electrolysis and laser therapy can be used to manage unwanted hair growth, but they would not address the root cause of the hormonal imbalance.

1. Electrolysis: This procedure entails inserting a needle into each hair follicle and applying an electrical current to harm the follicle and impede new hair growth. Repeated sessions may be required.

2. Laser Therapy: This involves applying laser light to the hair follicles to damage them and prevent hair growth. Multiple treatments may be needed.

It is important to keep in mind that these hair removal procedures may have risks and may cause adverse effects. Hence, it is essential to consult the doctor before opting for these procedures.

Changes In Lifestyle

The following are some suggestions for reducing excess androgen levels in women and managing its symptoms:

1. Achieving and Maintaining a Healthy Weight: Losing just five to ten percent of the body weight has been shown to improve fertility and reduce symptoms in women with PCOS.

2. Balanced Diet: Adopting a healthy and well-balanced diet that is low in sugar, refined carbohydrates, and unhealthy fats may help improve symptoms of PCOS.

3. Managing Unwanted Hair Growth using methods such as plucking, shaving, waxing, or chemical depilation to manage unwanted hair growth. Some may opt to bleach their hair to make it less noticeable.

Conclusion

In conclusion, androgen excess disorder in females refers to a medical condition where there is an excessive amount of androgens present in a woman's body. This hormonal imbalance can cause a range of symptoms, such as hirsutism, acne, menstrual irregularities, and infertility. The underlying causes can be due to various factors such as PCOS, congenital adrenal hyperplasia, or certain adrenal or ovarian tumors. The diagnosis of androgen excess disorder involves taking a medical history, performing hormonal tests, and conducting an ultrasound. The treatment options available include a combination of lifestyle changes and medication such as Eflornithine cream, glucocorticosteroids, Metformin, and Spironolactone. Hair removal treatments such as electrolysis and laser therapy can be used to manage unwanted hair growth.