About service
What is hyperandrogenism?
In women, the ovaries and adrenal glands naturally produce testosterone, but only in small quantities—normally between 0.3 and 3 nanomoles per liter of blood, compared with 8.2 to 34.6 nmol/L in men.
Hyperandrogenism is diagnosed when the level of this hormone exceeds the normal range. This can lead to signs of virilization (male traits in women): facial and body hair in a male pattern, acne, alopecia, muscle hypertrophy, and others.
Beyond the aesthetic impact, hyperandrogenism can have psychological and social consequences. Moreover, overproduction of testosterone may cause infertility and metabolic disturbances.
Causes
This phenomenon can be explained by various causes, the most common of which are as follows:
Ovarian dystrophy.
It leads to polycystic ovary syndrome (PCOS), which affects approximately one in ten women. The disorder is often discovered during adolescence when the patient seeks medical advice for excessive hair growth or severe acne, or later when facing infertility.
Excess ovarian testosterone disrupts follicular development, preventing proper ovulation. This manifests as menstrual irregularities or even amenorrhea.
Congenital adrenal hyperplasia.
This rare genetic disorder results in dysregulation of the adrenal glands, causing hypersecretion of male hormones and insufficient production of cortisol—a hormone essential for carbohydrate, lipid, and protein metabolism. In this case, hyperandrogenism is associated with fatigue, hypoglycemia, and hypotension. The condition usually appears at birth but can manifest later in adulthood in milder forms.
Adrenal tumor.
Rarely, an adrenal tumor may cause excessive secretion of androgens and cortisol. Hyperandrogenism then occurs alongside hypercortisolism or Cushing’s syndrome, which leads to arterial hypertension.
Ovarian tumor secreting male hormones.
This is the rarest cause.
Menopause.
During this period, the production of female hormones decreases significantly, allowing male hormones to express themselves more freely. Only a clinical examination combined with hormonal assessment and androgen evaluation can confirm the diagnosis.
Symptoms
Clinical signs of hyperandrogenism include:
• Hirsutism (excessive hair growth): hair appears on atypical areas for women (face, chest, abdomen, lower back, buttocks, inner thighs).
• Acne and seborrhea (oily skin).
• Male-pattern alopecia, with pronounced hair loss on the crown or forehead.
These symptoms may also be accompanied by:
• Menstrual irregularities such as amenorrhea or prolonged and irregular cycles (spaniomenorrhea).
• Clitoral enlargement (clitoromegaly) and increased libido.
Other signs of virilization include deepening of the voice and muscle hypertrophy resembling male morphology.
Complications
Severe hyperandrogenism can lead to long-term complications:
• Metabolic complications: androgen overproduction promotes weight gain and insulin resistance, increasing the risk of obesity, diabetes, and cardiovascular disease.
• Gynecological complications: including infertility and an increased risk of endometrial carcinoma.
For these reasons, hyperandrogenism should not be considered solely from an aesthetic perspective—it requires medical management.
Diagnosis
A physician may diagnose hyperandrogenism through the following examinations:
Hormonal assays.
When clinical suspicion arises, the physician orders a blood test for androgenic hormones: total testosterone, free testosterone, delta-4 androstenedione, 17-hydroxyprogesterone, and DHEA, measured early in the morning.
• Elevated testosterone with normal DHEA suggests ovarian overproduction.
• Elevated testosterone with moderately increased DHEA suggests an adrenal origin of hirsutism.
Imaging studies.
Pelvic ultrasound and/or CT or MRI of the abdomen and pelvis should be performed to rule out ovarian or adrenal tumors, particularly if:
• Total testosterone >150 ng/dL (5.2 nmol/L) or >100 ng/dL (3.5 nmol/L) in postmenopausal women,
• DHEA >700 µg/dL (19 µmol/L) or >400 µg/dL (10.8 µmol/L) in postmenopausal women.
Hirsutism must be distinguished from hypertrichosis, which is generalized or localized excessive hair growth in normal female distribution areas and may be congenital or acquired.
Treatment
Treatment depends on the underlying cause.
• Pharmacological treatment: main therapeutic options include antiandrogens and oral contraceptives.
• Congenital adrenal hyperplasia is managed with oral corticosteroids.
• In cases of obesity, lifestyle modification (Mediterranean diet, regular physical activity) is essential. Weight loss of about 10% can reduce hyperandrogenism and its complications.
• Laser hair removal is useful for hirsutism.
• Surgical resection may be indicated for tumors.
Prevention
Unfortunately, hyperandrogenism is difficult to prevent in most cases.
If it results from congenital adrenal hyperplasia, genetic counseling should be offered before conception to prevent transmission to offspring.
When obesity is a contributing factor, symptoms can be managed through healthy lifestyle habits.
In women, the ovaries and adrenal glands naturally produce testosterone, but only in small quantities—normally between 0.3 and 3 nanomoles per liter of blood, compared with 8.2 to 34.6 nmol/L in men.
Hyperandrogenism is diagnosed when the level of this hormone exceeds the normal range. This can lead to signs of virilization (male traits in women): facial and body hair in a male pattern, acne, alopecia, muscle hypertrophy, and others.
Beyond the aesthetic impact, hyperandrogenism can have psychological and social consequences. Moreover, overproduction of testosterone may cause infertility and metabolic disturbances.
Causes
This phenomenon can be explained by various causes, the most common of which are as follows:
Ovarian dystrophy.
It leads to polycystic ovary syndrome (PCOS), which affects approximately one in ten women. The disorder is often discovered during adolescence when the patient seeks medical advice for excessive hair growth or severe acne, or later when facing infertility.
Excess ovarian testosterone disrupts follicular development, preventing proper ovulation. This manifests as menstrual irregularities or even amenorrhea.
Congenital adrenal hyperplasia.
This rare genetic disorder results in dysregulation of the adrenal glands, causing hypersecretion of male hormones and insufficient production of cortisol—a hormone essential for carbohydrate, lipid, and protein metabolism. In this case, hyperandrogenism is associated with fatigue, hypoglycemia, and hypotension. The condition usually appears at birth but can manifest later in adulthood in milder forms.
Adrenal tumor.
Rarely, an adrenal tumor may cause excessive secretion of androgens and cortisol. Hyperandrogenism then occurs alongside hypercortisolism or Cushing’s syndrome, which leads to arterial hypertension.
Ovarian tumor secreting male hormones.
This is the rarest cause.
Menopause.
During this period, the production of female hormones decreases significantly, allowing male hormones to express themselves more freely. Only a clinical examination combined with hormonal assessment and androgen evaluation can confirm the diagnosis.
Symptoms
Clinical signs of hyperandrogenism include:
• Hirsutism (excessive hair growth): hair appears on atypical areas for women (face, chest, abdomen, lower back, buttocks, inner thighs).
• Acne and seborrhea (oily skin).
• Male-pattern alopecia, with pronounced hair loss on the crown or forehead.
These symptoms may also be accompanied by:
• Menstrual irregularities such as amenorrhea or prolonged and irregular cycles (spaniomenorrhea).
• Clitoral enlargement (clitoromegaly) and increased libido.
Other signs of virilization include deepening of the voice and muscle hypertrophy resembling male morphology.
Complications
Severe hyperandrogenism can lead to long-term complications:
• Metabolic complications: androgen overproduction promotes weight gain and insulin resistance, increasing the risk of obesity, diabetes, and cardiovascular disease.
• Gynecological complications: including infertility and an increased risk of endometrial carcinoma.
For these reasons, hyperandrogenism should not be considered solely from an aesthetic perspective—it requires medical management.
Diagnosis
A physician may diagnose hyperandrogenism through the following examinations:
Hormonal assays.
When clinical suspicion arises, the physician orders a blood test for androgenic hormones: total testosterone, free testosterone, delta-4 androstenedione, 17-hydroxyprogesterone, and DHEA, measured early in the morning.
• Elevated testosterone with normal DHEA suggests ovarian overproduction.
• Elevated testosterone with moderately increased DHEA suggests an adrenal origin of hirsutism.
Imaging studies.
Pelvic ultrasound and/or CT or MRI of the abdomen and pelvis should be performed to rule out ovarian or adrenal tumors, particularly if:
• Total testosterone >150 ng/dL (5.2 nmol/L) or >100 ng/dL (3.5 nmol/L) in postmenopausal women,
• DHEA >700 µg/dL (19 µmol/L) or >400 µg/dL (10.8 µmol/L) in postmenopausal women.
Hirsutism must be distinguished from hypertrichosis, which is generalized or localized excessive hair growth in normal female distribution areas and may be congenital or acquired.
Treatment
Treatment depends on the underlying cause.
• Pharmacological treatment: main therapeutic options include antiandrogens and oral contraceptives.
• Congenital adrenal hyperplasia is managed with oral corticosteroids.
• In cases of obesity, lifestyle modification (Mediterranean diet, regular physical activity) is essential. Weight loss of about 10% can reduce hyperandrogenism and its complications.
• Laser hair removal is useful for hirsutism.
• Surgical resection may be indicated for tumors.
Prevention
Unfortunately, hyperandrogenism is difficult to prevent in most cases.
If it results from congenital adrenal hyperplasia, genetic counseling should be offered before conception to prevent transmission to offspring.
When obesity is a contributing factor, symptoms can be managed through healthy lifestyle habits.
+7 (495) 154-21-44 
admin@expertclinics.ru 
Moscow, Starovolynskaya st., 12 bld. 1