Hyperandrogenemia describes a dysfunction of the ovaries and/or the adrenal glands, which can be triggered by various causes and occurs in different forms. The disease results from an excessive release of male sex hormones (androgens). Without treatment, hyperandrogenemia often leads to infertility and the resulting unfulfilled desire to have children.
What is hyperandrogenemia?
Hyperandrogenemia is an excess of male sex hormones in women. These are produced by men, but also by women, just as men also produce female sex hormones in some organs. The disease is therefore one of the hormonal disorders.
Androgens are substances that promote the development and formation of male sexual characteristics. Ultimately, the balance between the male and female sex hormones always plays a decisive role. An unfavorable balance leads to the corresponding clinical symptoms.
In women, male sex hormones are mainly produced in the ovaries, but the adrenal glands and adipose tissue also produce male hormones. Hyperandrogenemia can be triggered by various underlying diseases or functional disorders. If there is a suspicion, the main place of formation of the hormones must be determined in the first place.
There are many possible causes of hyperandrogenemia. It is not uncommon for various diseases to trigger the excess of male hormones, for example a tumor in the adrenal gland, pituitary gland or ovary, which produces androgens but can usually be surgically removed depending on the location.
Many sufferers suffer from a hormonal imbalance such as polycystic ovary syndrome. This metabolic disease causes too many male hormones to be produced in the ovaries. The reasons for this have not yet been fully clarified. Obesity and diabetes are also said to favor the development of the disease.
Symptoms, Ailments & Signs
Hyperandrogenemia is manifested by various symptoms, which can vary in severity depending on the extent. The typical symptoms of hyperandrogenemia in women include increased growth of body hair, loss of body hair, balding (receding hairline) and an impure complexion up to acne.
Affected women take on a generally more masculine appearance with a deeper voice, and develop excess fat on the epidermis due to increased sebum secretion. There is an increase in libido, at the same time menstrual disorders occur, such as a missed period. Infertility can occur.
In severe cases it is even possible that the voice deepens and the clitoris enlarges. However, these are rather rare symptoms. Further clarification is required here. This is especially true if symptoms develop very quickly.
Then it should be checked that there is no tumor in the ovary or in the adrenal gland, which produces the large amounts of male hormones and thus causes these unusual symptoms. However, hyperandrogenemia usually only manifests itself through slight signs, so that the disease is often recognized late or not at all.
Diagnosis & disease progression
If there is a suspicion of hyperandrogenemia, the doctor can easily determine this. First of all, he arranges for a blood test. This tests the concentration of male hormones in the blood. If there is an excess, the causes are then investigated.
This means that it is determined which organ is suitable as the main educational institution. The appropriate treatment is then initiated on the basis of this. In addition, the so-called ACTH stimulation test is available, with which the function of the adrenal cortex can be checked.
Hyperandrogenemia cannot be cured, but there are now various effective treatment methods that enable the affected patient to lead a symptom-free life and also to fulfill their desire to have children.
As a rule, hyperandrogenemia leads to a masculinization of the affected person. This mainly leads to aesthetic problems, since most patients no longer feel comfortable with their bodies. It is not uncommon for depression and other psychological complaints to develop, which can have a very negative effect on the patient’s everyday life.
Infertility also occurs. In most cases, the affected person can no longer fulfill their desire to have children if the hyperandrogenemia is not treated. The unfulfilled desire to have children can lead to significant psychological problems not only in the patient himself but also in the partner, which usually have to be examined and treated by a psychologist.
Menstrual cycle disorders continue to occur and the patient’s hair falls out. The complexion becomes very impure and acne often occurs. Due to the reduced aesthetics, inferiority complexes or general dissatisfaction and irritability often develop.
The treatment of hyperandrogenemia is always causal and depends on the underlying disease. In the case of a tumour, further complications can occur, although these depend on the type and severity of the tumour. In most cases, however, life expectancy is not affected by hyperandrogenemia.
When should you go to the doctor?
Disorders of the female menstrual cycle should always be clarified by a doctor as soon as they occur over a period of several months. If menstrual bleeding stops, the bleeding phase is shortened or bleeding is heavy, it is advisable to consult a doctor. Women who are not using hormonal birth control should be more vigilant if they do not ovulate. If there is no ovulation for several months in a row, a doctor’s visit is advisable.
If there is a desire to become pregnant that remains unfulfilled despite all efforts, a doctor should be consulted. People with diabetes or women who are very overweight should consult a doctor as soon as they develop a feeling of inconsistency. Changes in weight, blemishes, or hair loss are considered unusual and should be investigated. In many cases, these are warning signals from the body that require treatment.
If you suddenly develop greasy skin, develop acne on your face or experience mood swings, you should consult a doctor. A doctor is required for behavioral problems, a depressive or hyperactive appearance as well as melancholic behavior traits. A particularly euphoric mood, sudden aggressiveness, increased irritability and a permanent change of mind need to be discussed with a doctor. In rare cases, there is a change in pitch. If you have this symptom, you should see a doctor as soon as possible.
Treatment & Therapy
The treatment of hyperandrogenemia depends on two factors: the extent of the disease and the cause. Therefore, it is important to adequately identify the trigger. If hyperandrogenemia occurs as a result of a metabolic disease, such as polycystic ovary syndrome, the birth control pill is usually used because it balances the woman’s hormone balance.
This treatment is also used for those affected who wish to have children and lasts until the hormone balance has normalized again. As a result, the excess of androgens gradually returns to normal. The dosage of the hormones by the pill depends on the extent of the hyperandrogenemia.
It must therefore be individually tailored to the woman. The contraceptive pill is discontinued in women who want to have children after the androgen balance has normalized. It is then replaced with Clomifien, an active ingredient that triggers ovulation and thus forms the basis for a healthy pregnancy.
If there is an increased formation of male hormones due to an overactive adrenal gland, the administration of low doses of glucocorticoids, including cortisone, can slow down the formation of the hormones. In rare cases, hyperandrogenemia is also caused by a hormone-producing tumor that should be surgically removed.
Outlook & Forecast
The prognosis is based on the cause of the disease and the progression of the disease. The sooner a diagnosis is made and therapy is started, the better the chances of recovery are normally. In the case of an existing metabolic disease, hormone preparations are usually administered. These bring the hormonal balance back into balance and the symptoms are relieved. Long-term therapy is initiated because a relapse is to be expected if the drug is discontinued. If there are naturally caused hormonal changes later in the development process, freedom from symptoms is often documented and the treatment is ended.
Although medication can provide relief, side effects and sequelae can occur. In addition to a change in libido, behavioral changes also occur. The consequences are not always desirable or pleasant for those affected.
In the case of an existing tumor disease, the prognosis of hyperandrogenemia depends on the prospect of curing the cancer. If the tumor can be completely removed and the follow-up treatment is successfully completed, there is a good chance that the hyperandrogenemia will be cured. Otherwise, symptomatic treatment to relieve pain will come to the fore.
If there is a disease of the kidney or adrenal gland, drug treatment is also initiated. Depending on the severity of the kidney damage, the chances of recovery are individual.
Hyperandrogenemia can only be prevented to a limited extent. We recommend giving up nicotine, learning stress management techniques and, ultimately, consistent treatment of diseases that contribute to impairing the hormonal balance.
Since adipose tissue can also form male sex hormones, weight reduction and a low-fat diet are very important for overweight women. Physical activity can therefore also help to avoid hyperandrogenemia.
In the case of hyperandrogenemia, follow-up care proves to be relatively difficult and the options available to those affected are usually very limited. First and foremost, rapid and, above all, early detection and treatment of this disease must be carried out so that further complications or symptoms can be prevented. The earlier the hyperandrogenemia is recognized, the better the further course of this disease is usually.
A doctor should be consulted as soon as the first symptoms and symptoms appear. However, the disease cannot always be treated, so another method must be used to fulfill the desire to have children. In some cases, psychological treatment is also necessary in order to reduce or avoid depression or mental upsets. The support of one’s own family or friends is also very important.
The treatment itself can be carried out by taking medication, whereby the person concerned must ensure that the correct dosage is taken regularly. In the event of interactions or side effects, a doctor should also be contacted first. In the case of a tumor, it must first be removed. After such an operative intervention, the patient should rest and take care of his body.
You can do that yourself
Hyperandrogenemia is a hormonal disorder that the patient cannot treat herself. A precise diagnosis is necessary so that the doctor can create an individually tailored therapy and treatment plan. The cooperation of the patient can have a very positive effect here if she answers all questions honestly and shares her observations. Once the diagnostics have been completed and the therapy plan drawn up, the patient can contribute a lot to his recovery by adhering to the therapy plan and going to the doctor for regular check-ups. A trusting relationship with the doctor allows questions or joint adjustments to the therapy plan.
Hyperandrogenemia causes increased and severe acne formation in many patients. Although this is not dangerous for those affected, it is usually perceived as a major deficiency from a cosmetic point of view and leads to further discomfort. The patient can do a lot to improve the acne symptoms with intensive and correct skin care and get advice and guidance from a beautician. A regular visit to the cosmetics department supports the good course of acne.
If physical symptoms such as aggressiveness or restlessness occur as a result of hyperandrogenemia, the patient can seek help in a sports and exercise program that is appropriate to her abilities. Endurance sport helps healthy patients to better control their mood swings.