Hyperandrogenism: Causes and Treatments

Hyperandrogenism refers to the presence of elevated androgen levels in women. Androgens, such as testosterone, are typically considered male hormones, but they are also produced in small amounts in females. This hormonal imbalance can lead to a range of symptoms and health issues.

These hormones play a vital role in regulating various bodily functions, including the development of secondary sexual characteristics and reproductive health. However, an excess of androgens can disrupt these functions and lead to a variety of symptoms.

---

Causes of Hyperandrogenism

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is one of the most common causes of hyperandrogenism. PCOS is a hormonal disorder that affects the ovaries, leading to the overproduction of androgens. Women with PCOS often experience irregular menstrual cycles, ovarian cysts, and symptoms of hyperandrogenism.

Congenital Adrenal Hyperplasia (CAH)

Congenital Adrenal Hyperplasia (CAH) is a genetic disorder that affects the adrenal glands' ability to produce cortisol. As a result, the adrenal glands produce excess androgens. CAH can present at birth or develop later in life, leading to varying degrees of hyperandrogenism.

Androgen-Secreting Tumors

In rare cases, hyperandrogenism can be caused by androgen-secreting tumours in the ovaries or adrenal glands. These tumours can lead to a rapid increase in androgen levels and result in severe symptoms.

Medications

Certain medications, such as anabolic steroids and some antiepileptic drugs, can cause hyperandrogenism as a side effect. It is essential to review all medications with a healthcare provider if hyperandrogenism symptoms arise.

---

Symptoms of Hyperandrogenism

Hyperandrogenism manifests through a variety of symptoms, which can vary in severity. Common symptoms include:

---

Diagnosis of Hyperandrogenism

Diagnosing hyperandrogenism involves a comprehensive approach that includes a detailed medical history, physical examination, and laboratory tests.

Medical History and Physical Examination

A thorough medical history and physical examination are the first steps in diagnosing hyperandrogenism. The healthcare provider will inquire about menstrual history, symptom onset, and any family history of hormonal disorders. During the physical examination, signs of androgen excess, such as hirsutism and acne, will be assessed.

Laboratory Tests

Laboratory tests play a crucial role in confirming hyperandrogenism and identifying its underlying cause. Common tests include:

Imaging Studies

Imaging studies, such as ultrasound or MRI, may be necessary to identify ovarian or adrenal tumours or cysts that could be causing hyperandrogenism.

---

Treatment Options for Hyperandrogenism

Lifestyle Modifications

Lifestyle modifications are often the first line of treatment for hyperandrogenism, particularly in cases related to PCOS. These modifications may include:

Medications

Several medications can help manage hyperandrogenism symptoms and address the underlying cause:

Surgical Interventions

In cases where hyperandrogenism is caused by androgen-secreting tumours, surgical removal of the tumour may be necessary. Additionally, ovarian drilling, a minimally invasive surgical procedure, can be considered for women with PCOS who do not respond to other treatments.

---

Hyperandrogenism Guidelines and Best Practices

Adhering to established guidelines and best practices is essential for effectively managing hyperandrogenism. Key guidelines include:

Individualized Treatment Plans

Treatment should be tailored to the individual, taking into account the underlying cause, severity of symptoms, and the patient's overall health and preferences.

Regular Monitoring

Regular monitoring of hormone levels and symptoms is crucial to assess the effectiveness of treatment and make necessary adjustments.

Multidisciplinary Approach

A multidisciplinary approach involving endocrinologists, gynaecologists, dermatologists, and nutritionists can provide comprehensive care for women with hyperandrogenism.