Androgen excess

Androgen excess is an endocrine disorder present in women that can cause acne, virilisation, hirsutism. The endocrine glands secrete 5 types of androgens : dehydroepiandrosterone sulfate (DHEAS), testosterone, ehydroepiandrosterone (DHEA), androstenedione, and androstenediol, from which testosterone and dihydrotestosterone are the only with direct androgenic activity.

Androgens are responsible for the transformation of vellus hair to terminal hair.

This is a normal process that starts at puberty and slows down during the life. However excess androgen production will bring excess of unwanted hair, called hirsutism. This condition is due to the sensitivity of hair follicles to androgen excess, the non sexual skyn (eyebrow) are less sensitive. Parts of the body like the lower pubic triangle or axillary parts are very sensitive. Hirsutism is very often a manifestation of other diseases. For instance if hirsutism comes with oligomenorrhea or amenorrhea is more than enough to diagnose PCOS. But a regular period does not mean that there is not an androgen excess.

Another problem caused by the androgen excess is the “Acne vulgaris”. It occurs on the face, neck, fore head, chest, upper arm because of the increased sebaceous gland activity. The interaction between bacteria and excess sebum accumulation turns into pustules and nodules of acne. This can go along with hirsutism. Another syndrome that couples with hirsutism is virilization. Virilization is the abnormal development of male sexual features in a female. Prenatal virilization of a female fetus occurs when androgen in excess is present in maternal blood or is produced by fetal adrenal glands.

complete masculinization of a genetically female fetus can occur and then the result will be a baby boy without testicles. also Undervirilization can occur and this can produce ambiguous genital parts. Example of undervirilization is androgen insensitivity syndrome. Virilization on a woman can also manifest as clitoral enlargement and deepening of the voice .

Some of the possible causes of virilization in women are: Congenital adrenal hyperplasia due to 21-hydroxylase deficiency , hormone replacement therapy (female-to-male), androgen-producing tumors of the pituitary gland, adrenal glands and ovaries .

Androgen-secreting tumors are rare and more 30% of them are malignant. Generally androgen excess is not associated with mortality but there are some conditions that go along with this problem and that untreated can become very serious. For instance type 2 diabetes affect 40% women with androgen excess. It is also associated with Impaired glucose tolerance.

Androgen excess is not related with race , but it is with some family history .

PCOS presents with familial clustering but it is unclear if this is only due to the genetic factor or there are other factors to.

Androgen excess

 

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