androgen excess disorders

Causes of Androgen Excess Disorders

• Polycystic Ovary Syndrome (PCOS): A common hormone disorder in women of reproductive age, leading to increased androgen production.
• Congenital Adrenal Hyperplasia (CAH): A genetic condition affecting adrenal gland function and resulting in excessive androgen production.
• Anabolic Steroid Use: Use of artificially synthesized hormones can lead to symptoms of androgen excess.
• Tumors: Androgen-producing tumors such as adrenal or ovarian tumors can cause androgen excess.

Symptoms of Androgen Excess Disorders

• Hirsutism: Excessive hair growth in areas where men typically grow hair.
• Acne: Persistent or severe acne as a result of increased androgens.
• Irregular Menstrual Cycles: Particularly common in women with PCOS.
• Infertility: Androgens affect reproductive functions, possibly leading to fertility issues.
• Voice Deepening: Often occurs with significant androgen excess.

Diagnosis of Androgen Excess Disorders

Diagnosing androgen excess disorders typically involves a combination of medical history review, physical examination, and laboratory tests. Doctors may assess the following:

• Blood Tests: To measure levels of testosterone, DHEAS, and other related hormones.
• Ultrasound: For identifying polycystic ovaries, a common indication of PCOS.
• CT Scan/MRI: Used when there's a suspicion of tumors in adrenal glands or ovaries.

Management and Treatment of Androgen Excess Disorders

The treatment for androgen excess disorders focuses on addressing the underlying cause and managing symptoms.

Polycystic Ovary Syndrome and Androgen Excess

Polycystic Ovary Syndrome (PCOS) is one of the most common causes of androgen excess in women. This condition affects the ovaries, causing multiple small cysts and a hormonal imbalance that leads to an overproduction of androgens.

Symptoms of PCOS Related to Androgen Excess

PCOS manifests with a range of symptoms due to increased androgen levels. These may include:

• Irregular Menstrual Cycles: One of the hallmark symptoms caused by hormonal imbalance.
• Hirsutism: Excessive hair growth in areas like the face, chest, and back.
• Acne and Oily Skin: Commonly seen in individuals with elevated androgens.
• Thinning Hair: On the scalp, resembling male-pattern baldness.
• Weight Gain: Often seen in the abdominal area and related to insulin resistance associated with PCOS.

Diagnosis of PCOS

To diagnose PCOS, doctors typically look for a combination of symptoms and may use several diagnostic tools. Here’s what may be involved:

• Medical History Review: Discussing menstrual history, weight changes, and symptom onset.
• Physical Examination: Checking for signs of hirsutism, acne, and obesity.
• Blood Tests: Measuring levels of hormones such as testosterone and LH.
• Ultrasound: Imaging the ovaries to check for cysts.

Congenital Adrenal Hyperplasia and Androgen Excess

Congenital Adrenal Hyperplasia (CAH) is a genetic disorder affecting the adrenal glands, which results in the production of excessive androgens. This overproduction can impact the development of sexual characteristics and overall hormonal balance.

Causes and Genetics of CAH

CAH is primarily caused by deficiencies in specific enzymes needed for hormone production in the adrenal glands. The most common form is due to 21-hydroxylase deficiency. These enzyme deficiencies affect the adrenal glands' ability to produce cortisol and aldosterone. As a result, adrenals produce more androgens, leading to various symptoms.

Symptoms of CAH Related to Androgen Excess

The symptoms of CAH due to elevated androgens may include:

• Virilization: Development of male physical characteristics in females.
• Early Puberty: Accelerated skeletal growth and premature fusion of growth plates.
• Increased Body Hair: In both males and females resulting from androgen exposure.
• Severe Acne: Often persistent and difficult to treat.

Androgen Excess Disorders in Women

Androgen excess disorders in women are conditions where there's an increased level of androgens, male hormones, leading to various health challenges. These disorders can affect physical appearance, reproductive health, and overall well-being. Understanding symptoms, causes, and treatment options is crucial for effective management.

Symptoms of Androgen Excess Disorders

• Hirsutism: Unwanted hair growth on the face and body in a male pattern.
• Acne: Persistent and often severe, primarily affecting the face, chest, and back.
• Alopecia: Thinning or loss of hair on the scalp, similar to male-pattern baldness.
• Menstrual Irregularities: Such as oligomenorrhea (infrequent menstrual periods) or amenorrhea (absence of menstrual periods).
• Deepening of the Voice: A less common symptom but can occur with significant androgen excess.

Causes of Androgen Excess Disorders

Androgen excess disorders can arise from multiple underlying conditions:

• Polycystic Ovary Syndrome (PCOS): Most common and characterized by irregular menstrual cycles and multiple cysts on the ovaries.
• Congenital Adrenal Hyperplasia (CAH): An inherited disorder affecting adrenal gland function, leading to excess androgen production.
• Androgen-secreting Tumors: Rare ovarian or adrenal tumors that elevate androgen levels.
• Anabolic Steroid Use: Use of synthetic substances related to male hormones can mimic or exacerbate androgen excess.
• Medication Side Effects: Some drugs may inadvertently increase androgen levels.

Treatment Options for Androgen Excess Disorders

Treatment largely depends on the underlying cause and severity of symptoms:

• Lifestyle Changes: Dietary modifications and exercise, especially in cases related to PCOS, can help balance hormones.
• Medications: Birth control pills and anti-androgen medications can regulate menstrual cycles and reduce testosterone levels.
• Spironolactone: Often prescribed to reduce symptoms such as hirsutism and acne.
• Surgical Options: In cases of tumors causing excess androgen production, surgical intervention could be necessary.
• Insulin-Sensitizing Agents: Metformin is commonly used to improve insulin resistance, particularly in PCOS-related androgen excess.