Understanding Hyperandrogenism

 

Hyperandrogenism is the condition of overproduction of a group of steroid hormones known as ‘Androgens’ (‘Andro’ meaning man in Greek) in women. The most prominent androgens responsible for excessive androgenic activities are ‘Testosterone’, and its biologically active metabolite ‘Dihydrotestosterone or DHT’. Excess amounts of above-mentioned androgens can pose a problem, resulting in such “virilizing effects” as acne, hirsutism (excess hair growth in “inappropriate” places, like the chin or upper lip) and thinning of hair on the head (balding).

What's Inside?

Underlying Causes

Polycystic Ovary Syndrome

The overall incidence of HA in women is approximately 5%–10%, with ‘polycystic ovarian syndrome (PCOS)’ accounting for approximately 80% of cases. This is a condition that affects a woman’s hormone levels – which gives rise to a presence of a multitude of cysts on the ovary. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.

Cushing Syndrome

Cushing syndrome occurs when your body is exposed to high levels of the hormone cortisol for a long time. Cushing syndrome, sometimes called hypercortisolism, may be caused by the use of oral corticosteroid medication. The condition can also occur when your body makes too much cortisol on its own.

Non-Classic Congenital Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. Non-Classic CAH. This form is milder and more common, and may not become evident until childhood or early adulthood.

Androgen-Secreting Tumors

Androgen secreting tumors of the ovaries or adrenal glands are rare causes of hyperandrogenism that often mimic PCOS. Women with these tumors tend to have sudden onset of symptoms, rapid progression of hyperandrogenism and early development of frank virilization. This condition is very rare.

Hypothyroidism

An underactive thyroid gland (hypothyroidism) is where your thyroid gland does not produce enough hormones. Often characterized by high levels of Thyroid Stimulating Hormone or TSH, hypothyroidism can often cause PCOS-like symptoms. Hypothyroidism can worsen PCOS and insulin resistance.

Severe Hyperprolactinemia

Prolactin is a hormone produced from the pituitary gland. It helps stimulate and maintain breast milk production. Hyperprolactinemia describes an excess of this hormone in a person’s body. Elevated prolactin levels might directly stimulate the adrenal cortex.

Drug-Induced Hyperandrogenism

Many drugs can induce hyperandrogenic symptoms. Anabolic-androgenic steroids, synthetic progestins, and antiepileptics are the most frequently implicated drugs in hyperandrogenism. The mechanisms of androgen excess are various. It should be remembered that it is always necessary to rule out other causes of androgen excess, especially an ovarian or adrenal tumor or PCOS, before attributing the symptom(s) to a drug.