Hyperandrogenism in women: symptoms and treatment
You, probably, paid attention to the women having man's lines in the shape. This may be a low voice, the appearance of vegetation on the face and body, the typical body structure for men, and the like.
Excess secretion of androgens or their increased effect on the woman's body most often leads to this situation. In medicine, this pathology is defined as hyperandrogenism.
Symptoms, causes and ways of dealing with it, we consider in this article.
What triggers hyperandrogenism?
The described disease is the most common endocrine disruption in women. As a result of research, it was established that 20% of the weaker sex have a diagnosis of hyperandrogenism.
In women, this condition is usually caused not only by the excess amount of male sex hormones produced by the ovaries or adrenal glands. The pathology is also provoked by an increase in the conversion of androgen precursors into their even more active form (for example, testosterone becomes dihydrotestosterone,2.5 times more active). The situation is aggravated by the increase in androgen utilization, prompted by the increased sensitivity of the organ (for example, the skin) to this hormone.
Some features of the development of hyperandrogenism
Thus, hyperandrogenism in women, the symptoms of which manifest, in particular, acne (acne), develops with an increase in androgen sensitivity in the sebaceous glands. Note that while the level of male sex hormones in the patient's blood remains normal!
In addition, a decrease in the amount of globulin that binds sex hormones (normally it prevents free testosterone from entering the blood cell and interacting with androgenic receptors) also affects the development of hyperandrogenism.
Globulin synthesis occurs in the liver, so dysfunctions of this organ can provoke the onset of hyperandrogenism or spur its development. The same effect has a decrease in the level of estrogen produced by the thyroid gland.
Symptoms of hyperandrogenism in women
Hyperandrogenism can be manifested by virilization, that is, the appearance of male symptoms in a woman.As a rule, this is expressed in the hairiness of the chest area, midline of the abdomen, inner side of the thighs and increased growth of hair on the face. But in the hair on the head at this time may appear bald patches (so-called alopecia). In addition, the pathology is often accompanied by cosmetic defects: acne (acne), peeling and inflammation of the skin on the face (seborrhea), as well as atrophy of the abdominal muscles and limbs.
For women with hyperandrogenism, menstrual disorders or amenorrhea (absence of menstruation), obesity, hypertension, myocardial hypertrophy and infertility are characteristic.
In addition to all the above, women suffering from the described pathology usually have an increased susceptibility to various types of infections, a tendency to depression, and also increased fatigue.
By the way, remember that this pathology has no age. Hyperandrogenism in womenmay occur at any time in life, from birth.
How is hyperandrogenism diagnosed?
The described diagnosis can not be made only on the basis of external signs available to the patient. Even in the case when they seem very eloquent.It is necessary to conduct a series of tests and ultrasound of the internal organs. A key method for diagnosing this pathology is a blood test for the number of steroids.
Please note that the patient’s condition can also be manifested by the presence of diabetes mellitus, Cushing’s syndrome (which is outwardly expressed by obesity, moon-like face and limb thinning), polycystic ovaries, adrenal tumors, etc.
As you can see, all this involves a variety of methods by which hyperandrogeny will be diagnosed in women.
How to distinguish between hirsutism and hypertrichosis?
As mentioned above, one of the earliest and most persistent symptoms of this pathology in women is excessive hair growth on the face and body (hirsutism).
But such a sign should not be confused with hypertrichosis, a condition in which hair growth occurs on any part of the body, including where hair growth does not depend on the action of androgens.
A hyperandrogenic syndrome in women provokes the appearance of hair in precisely such places, that is, by the male type: on the face (beard and mustache), on the chest, on the inner side of the thighs, on the stomach and lower back, and between the buttocks.
The patient with hirsutism, as a rule, is offered treatment in which cosmetic measures (epilation) and hormonal correction are included.
The effect of androgens on hair growth in women
How does hair growth interrelate with the production of androgens in a woman's body? The fact is that the amount of this hormone determines how and where the hair will grow on the body of a woman. So, during the onset of sexual development, it is under the influence of androgens that a small amount of hairs appear in the armpit and pubic area.
But if the level of hormones begins to exceed the norm, then hair growth will appear on the face, chest and abdomen. And a very high level of androgens causes, in addition, a decrease in hair growth on the head, which causes balding of hairs above the forehead.
Moreover, note that this hormone has no effect on the growth of downy hair, eyelashes and eyebrows.
How does ovarian hyperandrogenism develop?
In medicine, three forms of the described disease are distinguished: ovarian, adrenal, and mixed.
The development of the first form of pathology is caused by a deficiency of enzymes contained in the ovaries (as a rule, this is a hereditary pathology).This prevents the conversion of androgens into female sex hormones - estrogens and, accordingly, causes their accumulation. As a result, a woman develops ovarian hyperandrogenism.
By the way, what kind of androgens (testosterone, DEA sulfate or androstenedione) will prevail in the patient’s blood depends directly on what enzymes are missing in her body.
How is the functioning of the ovaries disrupted?
The ovarian form of the disease is most often characterized by polycystic and hypertecosis (bilateral enlargement) of the organ. By the way, girls involved in power sports have a high risk of acquiring this pathology.
This is due to the fact that an excessive level of androgens suspends the growth of the follicles that make up the ovaries, eventually leading to their overgrowth (so-called follicular atresia). In addition, it stimulates the development of the pathological formation of fibrous connective tissue (fibrosis) and causes polycystic.
According to the feedback principle, this hyperandrogenism syndrome in women leads to a failure in the central regulation of the level of androgens (at the level of the pituitary and hypothalamus), which, in turn, greatly changes the hormonal background.
Now let's talk about adrenal hyperandrogenism. You probably know that the adrenal glands are a pair of small endocrine glands, which are located above the kidneys. They, by the way, produce 95% of the androgen called DEA sulfate.
A feature of the pathology of this organ is that adrenal hyperandrogeny in women is most often congenital. It occurs as a result of androgenital syndrome.
This syndrome causes the absence of enzymes that contribute to the production of glucocorticoid hormones, which are normally produced by the adrenal cortex. This leads to the fact that their predecessors (progesterone, pregnenolone, etc.) accumulate in the blood, forcing the body to use them for excessive production of androgens.
Less common is hyperandrogenism caused by adrenal tumors that secrete androgens (this pathology is called Cushing's disease).
Periodically occurs and mixed hyperandrogenism in women. The causes of its origin lie in the simultaneous dysfunction of the ovaries and adrenal glands.
Due to an increase in the level of adrenal androgens, their formation in the ovaries is enhanced, and the increased content in the blood of the latter stimulates the pituitary gland, forcing it to increase the production of luteinizing hormone, which causes the formation of hyperandrogenic syndrome.
Mixed form also occurs as a result of trauma, pituitary tumors or brain intoxication in a woman.
What is dangerous hyperandrogenism during pregnancy?
In addition to the problems listed above, the pathology described is dangerous for women who want to conceive and bear a child. For example, hyperandrogenism during pregnancy is responsible for between 20 and 40% of miscarriages or fetal deaths that occur in the early stages.
And note that this state of affairs is sad already because the abortion itself exacerbates hormonal disorders. And in this case, against the background of the existing hormonal changes, this completely leads to the fact that pregnancy in the future becomes impossible.
Prediction of pregnancy with hyperandrogenism
If a woman turns to a specialist with specific complaints that have been listed above, then she will definitely be prescribed an examination to exclude the pathology described.
With proper diagnosis and adequate treatment of hyperandrogenism during pregnancydoes not prevent the patient to successfully carry and give birth to a child. This is helped by drugs that reduce the level of androgens in the blood. Their patient must be taken regularly throughout the duration of the pregnancy.
How is hyperandrogenism treated?
Before starting treatment for hyperandrogenism in women, a detailed examination is required to identify the type of disease and the reasons that provoked its development.
If a woman does not plan to have a baby, the doctor selects oral contraceptives for the patient, which have an anti-androgenic effect. In the opposite case, drugs that stimulate the release of the egg are prescribed, and wedge-shaped excision of the ovary is sometimes used to help the egg come out of it.
If a high level of androgens is detected that the body cannot utilize, patients are usually prescribed the drugs Dexamethasone and Metipret, which increase the amount of female hormones in the body.
If the disease is triggered by the presence of a tumor, the patient is indicated surgery.This also forces specialists and polycystic ovary. As a rule, most of it is removed.
In the adrenal form of the disease, hormone therapy is applied, including glucocorticoid hormones (for example, Dexamethasone). By the way, it is prescribed in a maintenance dose and during pregnancy.
Drugs used to treat hyperandrogenism
To improve the condition of the skin in the described disease, the drug “Diane-35” is used, which suppresses the production of androgens by the adrenal glands and ovaries, as well as the release of pituitary into the blood of a woman with luteinizing hormone. At the same time, cyproterone acetate, which is part of the drug, blocks androgen receptors sensitive to androgens, preventing them from contacting them.
As a rule, to increase the effectiveness of this drug is prescribed in combination with the tool "Androkur". These drugs help women with severe acne. But their action can be assessed only 3 months after the start of treatment.
The therapy with the anti-androgenic drugs “Yanina” and “Jeanine” is also very effective. Treatment of hyperandrogenism in women with the help of these agents.lasts at least six months. It does not cause an increase in body weight and contributes to the normalization of the menstrual cycle.
Are there any folk remedies to help with hyperandrogenism?
A fairly wide range of medicinal herbs is known, which are included in the metabolic processes of the female body and have a positive effect on the regulation of the balance of hormones.
Of course, with such a disease as hyperandrogeny, treatment with folk remedies is not a panacea at all, but, for example, a remedy such as tsimifuga (or, in a different way, klopogon) can help in cases of hormonal imbalance. No less effective and prutniak sacred, on the basis of which the drug is produced "Cyclodinone".
However, you can list a whole list of representatives of the flora, which, along with the drugs prescribed by a specialist, will help regulate hormonal balance: licorice root, mint, dagil, evading peony, etc. Ready-made collections of such plants are sold in the pharmacy chain and are always ready to alleviate the condition of the woman.
A few words in the end
Do not try to treat the pathology yourself! If you are diagnosed with hyperandrogeny, reviews of friends or relatives about any "magic" means will not help solve the problem.
Improper treatment can have very serious consequences for a woman. Therefore, if a disease is suspected, first of all, it is necessary to consult a gynecologist and an endocrinologist. Their joint efforts and your patience and perseverance will help stop the development of pathology and prevent irreversible consequences.