Androgens are hormones that masculinize the body. In women, this can manifest as features such as an uncommonly large amount of body hair. It is important to understand the effect of androgens on the body in order to spot the symptoms of excess androgens, identify a cause and implement proper treatment.
Androgens
Androgens are masculinizing hormones. The most active androgen naturally produced by the body is testosterone from the testes. The adrenal gland also produces less active androgens. The ovaries also produce weak androgens which serve as precursors to estrogen. In males, testosterone or its more potent metabolites cause penile and scrotal growth; growth of pubic, facial and underarm hair; and increased activity of the skin's oil glands. Testosterone also causes growth of vocal cords, making the voice deeper. Androgen also maintains libido and increases muscle mass. Excess androgens in women can cause masculinization, including increased hair growth.
Androgens and Hair Growth in Females
Excess hair growth in females is most commonly due to excess androgens and occurs in a male pattern. Excess hair can be found on the upper lip, chin, chest, abdomen, pelvis, underarms, thighs and back.
Causes of Excess Androgens
The most common causes of excess androgens in females are polycystic ovarian syndrome, in which the ovaries overproduce androgens; congenital adrenal hyperplasia, in which the adrenal glands overproduce androgens starting at birth; and Cushing's syndrome, in which the adrenal glands overproduce androgens due to overstimulation from the brain.
Other Symptoms of Androgen Excess
Other symptoms of androgen excess in females include acne, menstrual irregularities and deep voice. Polycystic ovarian syndrome can specifically present signs of insulin resistance, such as dark leathery skin on the back of the neck or in skin folds, in addition to the other characteristics of hyperandrogenism.
Treatment
Treatment of excess hair growth due to hyperandrogenism is aimed at the specific cause of the high androgen levels. Various treatment types include oral contraceptives, analogs of GnRH, androgen receptor blockers and corticosteroids. Oral contraceptives and GnRH analogs inhibit the ovary from producing androgens, androgen receptor blockers inhibit the action of the androgens at the receptors in the hair follicles, and corticosteroids are aimed at inhibiting excess androgen production by the adrenal glands.
References
- "Current Diagnosis & Treatment: Obstetrics & Gynecology" (Ch. 57); Marsha K. Guess, D. Ellene Andrew, Carol L. Gagliardi and Adelina M. Emmi; 2007
- "Greenspan's Basic and Clinical Endocrinology" (Ch. 14); Mitchell P. Rosen and Marcelle I. Cedars; 2007
- "Endocrine Physiology" (Ch. 8); Patricia E. Molina; 2010
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