Hyperandrogenism
What is Hyperandrogenism?
Hyperandrogenism happens when your body produces too much androgen hormones. Androgens include testosterone and dihydrotestosterone, also called DHT. These are often thought of as male hormones, but women produce them too in smaller amounts.
When androgen levels get too high in women, it causes noticeable changes in the body. You might see excess hair growth on the face, chest, or back. Some women also experience acne, scalp hair loss, or changes in their menstrual cycle. This condition affects roughly 5 to 10 percent of women of reproductive age.
Hyperandrogenism is not a disease itself but a hormone imbalance that points to an underlying cause. It often appears alongside polycystic ovary syndrome, or PCOS. Understanding your androgen levels through blood testing helps identify the root cause so you can address it effectively.
Symptoms
- Excess hair growth on face, chest, back, or abdomen, also called hirsutism
- Acne that appears suddenly or does not respond to typical treatments
- Scalp hair thinning or male pattern baldness
- Irregular or absent menstrual periods
- Deepening of the voice
- Increased muscle mass
- Enlarged clitoris in severe cases
- Oily skin
- Difficulty getting pregnant
Some women with mildly elevated androgen levels may have few or no obvious symptoms at first. Others experience distressing changes that affect their quality of life and self-image.
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Causes and risk factors
Polycystic ovary syndrome causes most cases of hyperandrogenism in women. PCOS disrupts normal ovulation and leads to cysts on the ovaries. Insulin resistance often drives this process. When cells become resistant to insulin, the body produces more insulin. High insulin levels signal the ovaries to make extra androgens.
Other causes include adrenal gland disorders, androgen-secreting tumors, and certain medications. Congenital adrenal hyperplasia is a genetic condition that affects hormone production. Cushing syndrome and thyroid disorders can also contribute. Obesity worsens hyperandrogenism because fat tissue produces hormones that increase androgen levels. Family history raises your risk, especially for PCOS. Some women develop the condition after stopping birth control pills that previously masked the hormone imbalance.
How it's diagnosed
Doctors diagnose hyperandrogenism through a combination of physical examination and blood tests. Your doctor will look for visible signs like excess hair growth and acne patterns. Blood tests measure androgen levels, including testosterone and dihydrotestosterone. DHT testing uses a specialized method called LC/MS/MS, which provides accurate measurement of this potent androgen.
Rite Aid offers dihydrotestosterone testing through our convenient Quest Diagnostics network. You can add this test to your annual blood panel to check your androgen levels. Your doctor may also order imaging tests like pelvic ultrasound to look at your ovaries. Additional hormone tests help rule out adrenal or pituitary problems. Early detection matters because untreated hyperandrogenism increases risk for diabetes, heart disease, and fertility problems.
Treatment options
- Weight loss through balanced nutrition and regular physical activity, which reduces insulin resistance
- Anti-androgen medications like spironolactone that block androgen effects on the body
- Birth control pills that regulate hormones and reduce androgen production
- Metformin to improve insulin sensitivity, especially if you have PCOS or prediabetes
- Topical creams like eflornithine to slow facial hair growth
- Hair removal methods including laser therapy, electrolysis, or waxing for cosmetic concerns
- Dietary changes focusing on low-glycemic foods to stabilize blood sugar
- Stress management through mindfulness or yoga, as stress affects hormone balance
- Treatment of underlying conditions like thyroid disorders or adrenal problems
Need testing for Hyperandrogenism? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Testosterone is the primary androgen hormone your body produces. DHT, or dihydrotestosterone, is made from testosterone and is actually three times more potent. DHT binds more strongly to androgen receptors in your skin and hair follicles. This is why even small increases in DHT can cause significant symptoms like excess hair growth and acne.
Hyperandrogenism rarely resolves without treatment or lifestyle changes. If obesity or insulin resistance causes your elevated androgens, weight loss may improve your hormone levels naturally. However, genetic conditions like congenital adrenal hyperplasia require lifelong management. Working with your doctor to address the root cause gives you the best chance of improving your symptoms.
Most women notice improvements within 3 to 6 months of starting treatment. Hair growth slows down first, but existing hair takes time to stop growing. Skin improvements like reduced acne often appear within 2 to 3 months. Menstrual cycle regularity may take 3 to 4 cycles to normalize. Be patient and consistent with your treatment plan for best results.
Not necessarily, though PCOS causes about 70 to 80 percent of hyperandrogenism cases. Other conditions can raise androgen levels too, including adrenal disorders and rare tumors. Your doctor will use blood tests, physical examination, and imaging to determine the specific cause. Getting the right diagnosis ensures you receive appropriate treatment for your situation.
Yes, weight loss often significantly improves hyperandrogenism, especially if insulin resistance contributes to your condition. Losing just 5 to 10 percent of your body weight can lower androgen levels and restore regular periods. Fat tissue produces hormones that worsen androgen excess. A combination of nutrition changes and regular exercise works best for sustainable results.
Many women with hyperandrogenism can get pregnant with proper treatment. High androgen levels often disrupt ovulation, making conception difficult. Treating the underlying cause and lowering androgen levels usually restores fertility. Your doctor may prescribe medications like metformin or letrozole to help you ovulate. Some women benefit from fertility treatments if lifestyle changes and medications do not work.
Untreated hyperandrogenism increases your risk for several health problems. You have higher chances of developing type 2 diabetes, high blood pressure, and heart disease. The condition also raises risk for endometrial cancer because of irregular periods. Getting tested and treating hyperandrogenism early helps protect your long-term health and prevents these complications.
Focus on avoiding foods that spike blood sugar and worsen insulin resistance. Limit refined carbohydrates like white bread, pastries, and sugary drinks. Reduce dairy intake, as some studies suggest it may increase androgen levels. Choose whole grains, lean proteins, vegetables, and healthy fats instead. An anti-inflammatory diet with plenty of fiber helps balance hormones naturally.
Most doctors recommend testing every 3 to 6 months when starting treatment for hyperandrogenism. Once your levels stabilize, annual testing is usually sufficient to monitor your condition. More frequent testing helps if you change medications or experience new symptoms. Regular monitoring ensures your treatment plan works and catches any changes early.
Yes, chronic stress can worsen hyperandrogenism by affecting your hormone balance. Stress increases cortisol production, which can disrupt other hormones including androgens. High cortisol also worsens insulin resistance, creating a cycle that elevates androgen levels further. Managing stress through regular exercise, adequate sleep, and relaxation techniques supports your hormone health.