What are the implications of hyperandrogenism (elevated testosterone) in females?

From the Guidelines

Elevated testosterone in women, also known as hyperandrogenism, can have significant implications on their health, including irregular periods, acne, excessive hair growth, male-pattern baldness, and mood changes, and should be managed through lifestyle changes, medications, and addressing underlying causes, with the goal of improving morbidity, mortality, and quality of life. The management of hyperandrogenism in women is crucial to prevent long-term complications such as infertility, metabolic syndrome, and cardiovascular disease.

• Lifestyle changes, including weight loss, regular exercise, and a balanced diet low in refined carbohydrates, can help alleviate symptoms of hyperandrogenism, as noted in the study by 1.
• Medical treatments, such as combined oral contraceptives containing ethinyl estradiol with drospirenone or cyproterone acetate, can suppress testosterone production and improve symptoms, as discussed in the study by 1.
• Anti-androgens like spironolactone (50-200mg daily) or finasteride (2.5-5mg daily) may be prescribed to block testosterone effects, as mentioned in the study by 1.
• For women with polycystic ovary syndrome (PCOS), metformin (500-2000mg daily) can improve insulin sensitivity and reduce testosterone levels, as noted in the study by 1. The diagnosis of hyperandrogenism is critical, and the study by 1 found that total testosterone (TT) and calculated free testosterone (cFT) are the most accurate androgen measurements for assessing biochemical hyperandrogenism in PCOS diagnosis.
• The study by 1 also recommended using liquid chromatography with tandem mass spectrometry (LC-MS/MS) for androgen measurement due to its high accuracy.
• Regular monitoring through blood tests is essential to track progress and adjust treatment as needed, as emphasized in the study by 1. Overall, the management of hyperandrogenism in women requires a comprehensive approach that includes lifestyle changes, medical treatments, and regular monitoring to improve symptoms and prevent long-term complications, with the goal of improving morbidity, mortality, and quality of life.

From the Research

Implications of Hyperandrogenism in Females

The implications of hyperandrogenism, or elevated testosterone levels, in females can be significant and varied. Some of the key effects include:

• Menstrual irregularities and infertility, as seen in polycystic ovary syndrome (PCOS) 2, 3, 4
• Virilization, including excess hair growth, acne, and deepening of the voice 2, 5
• Insulin resistance and an increased risk of metabolic syndrome and type 2 diabetes 3, 4
• Changes in body composition, including an increase in abdominal fat and a decrease in lean mass 3
• Potential negative effects on cardiovascular health and an increased risk of certain types of cancer 4, 6

Effects on Reproductive Health

Hyperandrogenism can have significant effects on reproductive health, including:

• Suppression of ovulation and menstruation 2
• Infertility and an increased risk of pregnancy complications 2, 3
• An increased risk of miscarriage and other pregnancy-related problems 3

Treatment Options

Treatment options for hyperandrogenism in females may include:

• Hormonal therapies, such as birth control pills or anti-androgen medications 3, 5
• Medications to improve insulin sensitivity and reduce the risk of metabolic syndrome and type 2 diabetes 3, 4
• Lifestyle changes, such as weight loss and exercise, to improve overall health and reduce the risk of complications 3, 4

Safety Concerns

There are also safety concerns to consider when treating hyperandrogenism in females, including:

• The potential for masculinization and other androgen-related side effects 6
• The risk of cardiovascular problems and certain types of cancer 4, 6
• The need for careful monitoring and individualized treatment plans to minimize the risk of adverse effects 6