Hyperandrogenism - What Does It Imply In Women?

Androgens or the male sex hormones are steroid hormones that mainly include Testosterone, Androstenedione, DHT (Dihydrotestosterone), DHEA (Dehydroepiandrosterone), DHEA-S (Dehydroepiandrosterone- Sulfate). These hormones are produced in both males and females, and androgen is responsible for the secondary sexual characteristics in men. Androgen is also responsible for the synthesis of estrogen (a precursor for estrogen synthesis) in females. The hormone is also known to regulate the activities of a host of body organs including the reproductive tract (both in males and females).

In females, androgens (testosterone, in particular) are, however, produced in lesser quantities by the ovaries. The problem arises when there is an elevated production of androgens in females, a condition termed as Hyperandrogenism. Mentioned below are some of the symptoms and complications indicative of Hyperandrogenism in women.

1. Hair loss and alopecia: This is common in women with Hyperandrogenism. When there is an increased production of androgen, especially testosterone, some of the testosterone gets converted into Dihydrotestosterone (DHT). A healthy hair growth cycle consists of three phases- Anagen (growth phase), Catagen (transitional hair growth phase), and Telogen (resting phase). The DHT produced get attached to the hair follicles, resulting in the hair follicles to enter into the Telogen phase prematurely with increased hair loss and alopecia.
2. PCOS: The elevated levels of androgen also result in the formation of cysts in one or both the ovaries. The ovarian cysts often interfere with the ovulation process as the condition either stall the maturation of the eggs or the release of the matured eggs from the ovary fail to take place.
3. Menstrual problems (irregular periods, heavy or scanty flow) and infertility are common in females with PCOS.
4. Menstrual problems and abnormalities: Research suggests that elevated plasma androgen levels can significantly affect the menstrual cycle in females. Incidences of Amenorrhea (a condition whereby a woman has missed three or more successive menstrual cycles) and Oligomenorrhea (a condition where the menstrual cycle is often lighter and less frequent) are relatively higher in women with Hyperandrogenism.
5. Hirsutism: Hirsutism is characterized by the presence of the excess body and facial hair in females (male pattern hair growth). Androgen plays a pivotal role in the regulation of the pilosebaceous unit along with the modulation of hair growth. The pilosebaceous unit (the unit mainly includes the sebaceous glands and the hair follicles) is involved in the production of the sebum.

In females with Hyperandrogenism, the elevated androgen level contributes significantly towards increased production of terminal body hair as seen in males (increased facial hair, hair on the chest, arms, legs) resulting in Hirsutism.

Probable complications and problems Hyperandrogenism can cause

1. Hyperandrogenism in females also triggers elevated sebum production, resulting in acne and related skin problems.
2. As already mentioned, androgen is responsible for secondary male sexual characteristics. Thus, females with Hyperandrogenism often exhibit Virilization or increased male characteristics.
3. With Increased incidences of menstrual abnormalities and PCOS, Hyperandrogenism can eventually make it difficult for a woman to conceive.
4. Females with Hyperandrogenism often suffer from obesity.