Testosterone is a hormone produced by the testes in men and by the adrenal gland in men and women. It gives people characteristically male features, and it is typically not produced in excess in women. Two diseases in which is is produced in excess in women are congeintal adrenal hyperplasia and polycystic ovarian syndrome. The treatment for the former is generally medical therapy, while the treatment for the latter is lifestyle change.
About testosterone
According to Glenn D. Braunstein in "Greenspan's Basic and Clinical Endocrinology," testosterone is one of the three major sex steroids, the others being dihydrotestosterone, which is a more powerful form of testosterone, and estradiol, which is a form of estrogen. It is secreted by the testes, is converted to dihydrotestosterone in the circulation and causes individuals to acquire male characteristics, such as a deeper voice and facial hair.
Symptoms of Excess Testosterone in Women
According to John C. Achermann and J. Larry Jameson in "Harrison's Principles of Internal Medicine," excess testosterone in women causes reproductive dysfunction marked by infrequent ovulatory cycles and may cause infertility. It can also lead to male-pattern hair growth, known as hirsutism, and can cause acne. In female children exposed to exposed to excess testosterone in the uterus, sexually ambiguous genitalia may develop instead of characteristically female genitalia.
Diseases
Several diseases may result in excess testosterone in women. According to "Harrison's," a classic example of one such disease is congenital adrenal hyperplasia, or CAH. The adrenal glands usually take cholesterol and turn it into testosterone via one pathway, and into cortisol or aldosterone, which are two other adrenal hormones, via another. In CAH, one of the enzymes responsible for producing cortisol is deficient, and as a result, excess precursor molecules are shunted into the testosterone-production pathway, resulting in excess testosterone production.
CAH Treatment
According to Christopher J. Kane in "Smith's General Urology," the mainstay of treatment for CAH is administration of cortisol. As noted above, cortisol production is insufficient in CAH; this insufficiency, via a complicated set of feedback loops, signals the adrenal gland to continue to try to produce cortisol, and as it cannot do this, it only winds up making more testosterone. When cortisol is given from an external source, it relieves the adrenal gland of its drive to make its own cortisol, thereby decreasing the production of testosterone.
Polycystic Ovarian Syndrome
According to H. Trent MacKay in "Current Medical Diagnosis and Treatment," another cause of excessive testosterone in women is polycystic ovarian syndrome, or PCOS. This disease typically occurs in overweight women experiencing decreased reproductive capacity; its cause is multifactorial, but it is characterized by excessive circulating levels of testosterone. In contrast to CAH, in which the best treatment is medical therapy, the best treatment for PCOS is weight loss.
References
- "Greenspan's Basic & Clinical Endocrinology"; David G. Gardner and Dolores Shoback (editors); 2007
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci, Eugene Braunwald, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Joseph Loscalzo (editors); 2008
- "Smith's General Urology"; Emil A. Tanagho and Jack W. McAninch (editors); 2008
- "Current Medical Diagnosis and Treatment"; Stephen J. McPhee and Maxine A. Papadakis (editors); 2009
