Hyperandrogenism in women is external signs. Symptoms of hyperandrogenism in adolescents

Date: 03.04.2019

Hyperandrogenism is called endocrine disease, in which there is an excessive secretion of male sex hormones in women. The manifestations of this pathology include violations menstrual cycle and reproductive activity in general. Often women complain of seborrhea, hirsutism, acne and alopecia. Before understanding how to lower androgen levels and whether hyperandrogenism in women can be cured, it is important to correctly determine the causes of the disease.

To make the correct diagnosis, a routine examination is not enough, the doctor prescribes hormonal screening, ultrasound diagnostics ovaries, as well as computed tomography of the pituitary and adrenal glands. Based on the results of the examination, special preparations, mainly hormonal. If the results of the examination showed that the woman has a tumor of any nature, then only surgical treatment is prescribed.

A few words about ovarian and mixed hyperandrogenism

Surgical treatment of polycystic ovary disease can be carried out in several ways, these are:

wedge resection;
demedulation of the ovaries, in which an incision of follicular formations can be made;
thermocauterization;
electrocautery.

The latter two methods are considered alternatives to ovarian resection. In such situations, the laparoscopic method is used.

The most difficult thing is to cure mixed hyperandrogenism, especially in cases in which a woman plans to have offspring in the future. Usually, after the examination, the doctor will prescribe a small dose of dexamethasone, which must be taken over one year. This drug is able to stop the production of male sex hormones in the adrenal glands. When taking this drug, cortisol levels in the blood are monitored. Normally, it should not exceed the 5mkg% mark. After a year of taking this medicinal product the hormonal background of the patient is examined. If it is revealed that most of the androgens are not produced by the adrenal glands, but, for example, by the ovaries, then the course of therapy will be changed. In such situations, the doctor prescribes the intake of small doses of oral contraceptives.

The treatment regimen may be different, it can also change, depending on the established form of pathology and the source of its origin.

The use of drugs for the treatment of hyperandrogenism

The hormonal background of a woman influences many processes, in particular, it concerns her reproductive function. As for men, a disruption in their hormonal levels leads to sexual dysfunctions, it can be a simple decrease in sex drive or impotence.

Symptoms of hyperandrogenism in women include:

profuse growth of hair on the body and face;
baldness of certain areas of the head;
reduction of the mammary glands;
changing the timbre of the voice;
disruptions of the menstrual cycle and others.

To suppress the production of androgens in the female body, the doctor prescribes antiandrogen drugs, which are presented in the form of oral contraceptives. To improve their action, drugs may be prescribed vegetable origin, only they are selected individually, taking into account all the characteristics of the body and susceptibility to components.

Older women probably know what a Tsimifuga is. This component is included in most drugs for plant based... It is designed to eliminate unpleasant symptoms, which are often found in women in menopause.

With an imbalance in the hormonal system, the doctor may prescribe Cyclodinone. The composition of this preparation includes such a plant as the sacred twig.

Who cured hyperandrogenism claim that many plants have healing property, they have a positive effect on metabolic processes female body, while being able to regulate hormonal levels. Particularly popular are licorice root, angelica, mint, duck peony and other plants, which are freely sold in a processed form in a pharmacy. The ready-made collection is dispensed without a prescription, and you can prepare a medicine from it yourself, following the instructions. Given this possibility, home treatment should not be abused, since without correct diagnosis and drug intervention will not effectively cure hyperandrogenism.

It must be remembered that timely diagnosis of the disease increases the chances of successful treatment of this pathology. In addition, you should be aware that even minor symptoms may indicate the presence of some form of hyperandrogenism. The complexity of the treatment of this disease lies in the fact that the symptoms and signs may not appear immediately, so it is extremely difficult to recognize the alarm bell.

In medicine, such a problem is known as hyperandrogenism in women. The causes, symptoms, treatment for such a diagnosis require assessment and participation. qualified doctors... And although this ailment is extremely difficult to overcome completely, it is better to contact the doctors without delay.

The essence of the disease

When it comes to a disease such as hyperandrogenism in women, the causes of the symptoms, treatment and preventive measures always associated with such a problem as the effect of androgens on the body. This process leads to the appearance of masculine features in the female appearance and other not very pleasant changes. In more detail, we are talking about such manifestations as the appearance of hair on the face and body, a low voice, as well as changes in some elements of the figure.

It is worth noting the fact that this pathology female endocrine system occurs often, and can not only lead to unpleasant external changes, but also cause infertility. Therefore, when the first symptoms of hyperandrogenism appear, you need to immediately plan a visit to the doctor.

Why pathology develops

The topic "hyperandrogenism in women: causes, symptoms, treatment" is very important for the fairer sex, because it manifests itself this problem in about 20% of patients. Therefore, it makes sense to pay attention to those factors and processes that lead to the development of this disease.

AGS can be defined as the main reason - adrenogenital syndrome... The bottom line is that the adrenal glands are capable of producing many other hormones besides androgens, such as glucocorticoids. The latter appear under the influence of a certain enzyme. Accumulated androgens are the basis for their occurrence. Sometimes women already have an enzyme defect at birth, as a result of which male hormones are not converted, but accumulate on an ongoing basis, causing unpleasant changes in the female body.

There is another process due to which hyperandrogenism of adrenal genesis develops. These are adrenal tumors. They are also formed against the background of an increase in the concentration of androgens.

The risk of developing the above pathology also appears in the case when male hormones are produced in a woman's ovaries. Moreover, cells that produce androgens can cause tumors to form in the ovarian region.

The syndrome of hyperandrogenism is sometimes a consequence of the effects of the pathologies of other endocrine organs such as the pituitary gland.

Signs of excess androgens

If we talk about clinical symptoms increased concentration male hormone, they can be described as follows:

acne;
hair loss and receding hairline in the forehead area (androgenic alopecia);

the sebaceous glands begin to produce an excessive amount of secretion, as a result of which the oily skin increases;
baryphony, which means lowering the timbre of the voice;
hair appears on the belly and chest.

It is worth noting the fact that hirsutism - excess growth terminal hair on the female body, is diagnosed in 80% of patients with a problem such as hyperandrogenism syndrome.

With such a disease, some of the fairer sex may have menstrual irregularities, complete absence of menstruation, as well as obesity, infertility and hypertension.

The concentration of male hormones can increase the susceptibility of the female body to various types of infections. Fatigue and depression are also possible.

Acne and sebaceous glands

To clearly understand what to do with a problem such as hyperandrogenism in women, the causes, symptoms, treatment and diagnosis should be considered thoroughly. Since the factors that determine the development of the disease were considered above, it makes sense to study the features of the symptoms.

If we talk about such a problem as acne, then it is worth noting that they are the result of keratinization of the follicle walls and increased production of sebum, which is stimulated by the concentration of androgens, including in plasma. With such symptoms, as a rule, COCs or antiandrogens are prescribed, which can significantly improve the patient's condition.

Also, under the influence of male hormones in androgen-dependent zones, pigmented, thick, coarse hair appears instead of vellus hair. This usually occurs during puberty. At the same time, the effect of androgen on the area of eyebrows, eyelashes, temporal and occipital parts remains minimal.

Adrenal hyperandrogenism

It is worth recalling that the adrenal glands are two endocrine glands that are located directly above the kidneys themselves.

They are the source of 95% of the produced androgen (DEA sulfate). The complexity of hyperandrogenism associated with these glands boils down to the fact that the pathology is congenital in nature and makes itself felt against the background of androgenital syndrome. It leads to a critical decrease in the female body in the level of enzymes necessary for the production of hormones such as glucocorticoids.

Hyperandrogenism of adrenal genesis is caused by this deficiency, which leads to an increase in the concentration of other hormones - pregnenolone, progesterone, etc. Such changes culminate in an increased production of androgen in the female body.

Sometimes a pathology is diagnosed that was caused by tumors of the adrenal glands that secrete a male hormone. According to statistics, such a form of the disease as adrenal hyperandrogenism is recorded in 30-50% of women who have problems with androgen.

Effects on the ovaries

High concentrations of male hormones can also affect the functioning of the ovaries. In most cases, this problem makes itself felt through two forms: hypertecosis and polycystic. It is important to pay attention to the fact that the risk of developing this pathology in women increases with regular strength sports.

Ovarian hyperandrogenism is a consequence of the retardation of follicular growth under the influence of androgens. Since the ovaries are composed of them, the result of such processes is the infection of the latter. The medical name for this problem is follicular atresia.

But these are not all the difficulties that accompany ovarian hyperandrogenism of genesis. The bottom line is that the male hormone plays the role of a factor against which the pathological formation of fibrous connective tissue leading to polycystic disease. In this situation, the good news is that only 5% of women face this problem.

It is also worth noting that this form of hyperandrogenism in the fairer sex is the reason for the failure of the central regulation of the level of androgens. This process takes place at the level of the hypothalamus and pituitary gland. As a result, the hormonal background changes significantly.

Signs to watch out for

There are a number of symptoms that indicate the problem described above. The fact that there is such a pathology as ovarian hyperandrogenism of genesis can be found out by the following manifestations:

osteoporosis;
seborrhea;
on the face, in addition to acne, peeling and inflammation appear, which are difficult to neutralize with the usual cosmetic methods;
amyotrophy;
excess weight;
changing the proportions of the female body - masculinization;
coarsening of the voice (baryphony);
hair growth all over the body, even on the face;
the formation of bald patches on the head.

Apart from this, there are many more secondary symptoms such as an increase in blood glucose levels, arterial hypertension, decreased immunity, etc.

Excess weight

Obesity in women can cause the ovarian hyperandrogenism described above.In this form of pathology, an increase in the level of estradiol is often recorded.

A study was conducted by doctors, according to which the following information was confirmed: both the high level of the male hormone and the estrogens that form under its influence have the most direct effect on the development of obesity corresponding to the male type.

Such processes are the reason for the increase in insulin dependence and the subsequent increase in the concentration of the male hormone in the body of women suffering from the pathology described above. In some cases, androgens are not influenced by a woman's weight through the central nervous system.

Mixed form

Doctors with a certain frequency have to deal with the manifestation of several forms of hyperandrogenism. This situation is explained by the fact that a violation of the ovaries occurs at the same time.

The possibility of such a complication is important to consider when studying what is dangerous for hyperandrogenism in women. In essence, this is what happens: adrenal androgens concentrate in the adrenal glands, thereby increasing the level of the male hormone in the ovaries. This process also occurs in the blood, which leads to increased production of luteinizing hormone. The latter, in turn, provokes the appearance of a hyperandrogenic syndrome.

The onset of a mixed form of pathology can be caused by severe trauma, brain intoxication, or

Diagnostics

Initially, the doctor must separate hyperandrogenism from other diseases against which it develops (acromegaly, liver disease, etc.). The next step is to determine the hormonal level. This procedure should be performed on an empty stomach in the morning. Such an analysis must be performed three times, since at a high concentration of androgen it is constantly changing.

Attention is drawn to the level of dehydroepiandrosterone, a high content of which will indicate adrenal hyperandrogenism. The level of ketosteroids in the urine is also important. If its content is outside the norm, then it makes sense to suspect the development of pathology.

Treatment methods

Hyperandrogenism is too much serious problem to ignore the help of trained medical professionals. And if we analyze the entire course of treatment, then we can conclude that it is aimed at achieving 4 key goals:

elimination of manifestations on the skin;
normalization of the menstrual cycle;
treatment of infertility that was caused by anovulation;
elimination and prevention metabolic disorders associated with the underlying disease.

A diet for hyperandrogenism in women is prescribed in case of significant weight gain. In this case, it is important to adhere exactly to all the doctor's recommendations, only if this condition is met, you can get the desired result.

For those patients who intend to have a child, in most cases hormone therapy is prescribed, which can ensure full ovulation.

Women who are not planning a pregnancy are treated with oral contraceptives and, in some cases, wedge-shaped ovarian excision.

Drugs for the treatment of hyperandrogenism in women are also actively used if the body is not able to neutralize high androgen levels on its own. We are talking about such funds as "Metipred", "Dexamethasone" and others. Surgical intervention can be prescribed if the pathology is provoked by a tumor.

Outcomes

A high concentration of the male hormone in the female body is more than a serious problem that often develops against a background of at least dangerous diseases... Therefore, when the first symptoms appear, diagnosis and treatment should be carried out in mandatory.

Hyperandrogenism is caused by increased secretion of male sex hormones in a woman's body. Androgens are produced by the ovaries and the adrenal cortex. Depending on the primary cause pathologies may differ clinical symptoms.

Hyperandrogenism in women causes increased secretion in the pituitary gland, which blocks the release of follicle-stimulating hormone and estradiol. As a result, the process of follicle maturation is disrupted, the release of the egg does not occur (anovulation). High androgen levels contribute to the formation of multiple cysts in the ovaries (polycystic ovary syndrome).

Male hormones reduce the susceptibility of peripheral tissues to, this leads to an increase in blood glucose levels, impaired glucose tolerance, carbohydrate metabolism and the development of diabetes mellitus 2 types.

Classify true and idiopathic hyperandrogenism. In the first case, the level of androgens in the woman's blood is increased, and in the second, the sensitivity of peripheral tissue receptors to male hormones is increased.

Causes of pathology

What is hyperandrogenism and why does it occur? The main causes of the disease are:

tumors, metastases of the adrenal glands;
violation of the hypothalamic-pituitary regulation caused by trauma, tumors, inflammatory diseases brain;
ovarian tumors: luteoma, tekoma;
androgenital syndrome is a congenital abnormality of the adrenal cortex, in which there is an increased production of testosterone.

In women, the causes of hyperandrogenism cause hormonal imbalance, functioning reproductive system, metabolic processes in the body.

Symptoms of ovarian hyperandrogenism

The disease is of ovarian and adrenal genesis - depending on the organ, which begins to intensively produce androgens. Ovarian hyperandrogenism in most cases develops against the background of polycystic ovary syndrome, less often hormone-producing tumors cause pathology.

PCOS is characterized by menstrual irregularities, infertility, and increased levels of androgens in the blood. The girl's figure changes according to the masculine type, hair on the face and body begins to grow, the volume of the waist and chest increases, the fatty layer is deposited in the lower abdomen. The work of the sebaceous glands is disrupted, seborrhea appears, acne, which does not respond to treatment. Stretch marks appear on the skin of the thighs, buttocks. Sleep apnea(holding your breath) leads to insomnia.

In the photo is a woman with characteristic features hirsutism.

The characteristic symptoms of PCOS hyperandrogenism are the appearance premenstrual syndrome... Women become irritable, their mood often changes, migraine worries, intense pains in the lower abdomen, swelling, soreness of the mammary glands.

The ovaries increase in size 2-3 times, their capsule thickens. Inside the organ, multiple cystic formations... Hormonal imbalance causes thickening and hyperplasia of the endometrium of the uterus, menstruation becomes longer, more abundant, with the release of blood clots.

Symptoms of adrenal hyperandrogenism

This type of virilization develops against the background of androgenital syndrome. it hereditary disease, which causes increased secretion of androgens in the adrenal cortex. A congenital deficiency of organ enzymes up to a certain point is compensated by the body, but under the influence of a number of factors, hormonal imbalance occurs. Pregnancy can provoke such a condition, severe stress, the beginning of sexual activity.

The cause of adrenal hyperandrogenism can be hormone-producing tumors. Cancer cells in the reticular cortex produce "weak" androgens. In the process of metabolism, male hormones are converted into more active form and change the general hormonal background of a woman. contributes to the acceleration of these processes.

Adrenal hyperandrogenism causes cyclic disturbances in the ovaries due to an increase in the level of estrogen, the growth and maturation of the follicle is suppressed, the menstrual cycle is disrupted, and menstruation may stop altogether. The process of ovulation does not occur, a woman cannot become pregnant and bear a child.

Symptoms of adrenal hyperandrogenism in girls:

deformation of the external genitalia at birth, it is difficult to determine the gender of a child (female hermaphroditism);
delayed sexual development, menarche begins at the age of 15-16, the menstrual cycle is irregular, accompanied by profuse blood loss;
in adolescent girls, signs of hirsutism are observed: hair grows on the face and body like in men;
acne, seborrhea, skin pigmentation;
partial atrophy of the mammary glands;
an increase in the size of the clitoris;
alopecia - hair loss on the head;
the figure changes: narrow hips, broad shoulders, short stature;
rough voice.

Among women reproductive age adrenal hyperandrogenism leads to early termination of pregnancy. It is caused by the cessation of growth of the uterus due to the formation of a defective corpus luteum... Most girls have completely disrupted menstrual and childbearing function, infertility develops, and sexual desire increases. Hirsutism is poorly expressed, the physique does not change, metabolic processes are not disturbed.

Mixed type of hyperandrogenism

Hyperandrogenism mixed genesis manifested by symptoms of the ovarian and adrenal forms of the disease. Women have polycystic ovary disease and signs of androgenital syndrome.

Manifestations mixed type diseases:

acne;
striae;
increased blood pressure;
violation of the menstrual cycle;
cysts in the ovaries;
infertility, early termination of pregnancy;
impaired glucose tolerance or high blood sugar;
increased content of low density lipoproteins.

Hyperandrogenism can cause systemic diseases that affect the adrenal cortex, ovaries, or brain disrupt metabolism. These are anorexia nervosa, schizophrenia, type 2 diabetes mellitus, acromegaly, prolactinoma.

Peripheral and central hyperandroegnia

With the defeat of the central nervous system, inflammatory, infectious diseases or intoxication of the body, the secretion of gonadotropic hormones of the pituitary gland, which are responsible for the production of luteinizing and follicle-stimulating hormones, can be suppressed. As a result, the process of maturation of the follicle in the ovary and the synthesis of sex hormones are disrupted, and the production of androgens is increased.

In women, symptoms, ovarian dysfunction, menstrual disorders, skin rashes, PMS are found.

Peripheral hyperandrogenism is caused by an increase in the activity of the skin enzyme, the sebaceous glands 5-α-reductase, which converts testosterone into the more active androgen. This leads to varying degrees of severity, the appearance of acne vulgaris.

Hyperandrogenism during pregnancy

In pregnant women, an increase in androgen levels is the cause of spontaneous abortion. The most dangerous periods are the first 7-8 and 28-30 weeks. In 40% of patients, intrauterine fetal hypoxia is observed, most often in the third trimester. Another complication is late toxicosis, while kidney function worsens, blood pressure rises, and body edema appears.

Hyperandrogenism during pregnancy can lead to premature discharge of amniotic fluid, complicated labor. Changes in the hormonal background negatively affect the development of the child, in infants it can be disrupted cerebral circulation, there are signs of intrauterine malnutrition.

Hyperandrogenism and pregnancy are reasons for urgent hormone therapy to prevent abortion and other complications. Women who have previously had miscarriages, miscarriage, increased levels of male hormones, it is necessary to conduct a thorough examination at the stage of planning pregnancy.

Diagnosis of the disease

Diagnosis - hyperandrogenism is established according to the results of laboratory tests on the level of hormones. With polycystic ovary syndrome, the level of testosterone, a luteinizing hormone, rises in a woman's blood. The concentration of FSH in the blood and 17-KS in the urine remains within the normal range. The LH / FSH ratio increased 3-4 times. With hormone-dependent ovarian tumors, testosterone and prolactin levels are significantly increased in the blood.

The mixed form of the disease is characterized by slight increase the level of testosterone, LH, DHEA-S in the blood and 17-KS in the urine. The concentration of prolactin is normal, and FSH is reduced. The LH / FSH ratio is 3.2.

To determine the primary cause of hyperandrogenism, tests are performed with Dexamethasone and. A positive HCG test result confirms polycystic ovarian disease, which is causing hormonal imbalances. A negative answer indicates the adrenal nature of hyperandrogenism.

Abraham's test allows you to identify a disease of adrenal genesis, with the introduction of synthetic glucocorticoids, synthesis in the anterior lobe of the pituitary gland is suppressed, which stops stimulation of the adrenal cortex. If the result is positive, it is adrenal hyperandrogenism, a negative response may be a sign of a cortical tumor.

Additionally, an ultrasound scan of the ovaries is performed to identify cysts, changes in the size and structure of the organ. Electroencephalography, MRI, CT of the brain are indicated if the pituitary gland is suspected.

Treatment methods

The therapy is prescribed individually for each patient. Androgen receptor blockers reduce the effect of male hormones on the skin, ovaries (Flutamide, Spironolactone). Androgen secretion inhibitors inhibit the production of testosterone by the endocrine glands (Cyproterone acetate). These funds restore the balance of hormones, eliminate the symptoms of pathology.

Adrenal hyperandrogenism is compensated by glucocorticoids, which suppress excess androgens. Women are prescribed Dexamethasone, Prednisolone, and they are taken during pregnancy if the expectant mother has an increased testosterone level. It is especially important to timely treat girls who have close relatives with congenital androgenital syndrome. The dosage and duration of the medication is prescribed by the doctor.

Hormonal treatment of hyperandrogenism is carried out with glucocorticosteroids, combined oral contraceptives(Diane-35), GnRH agonists. These drugs are used to treat mild ovarian hyperandrogenism, PCOS.

Drug-free treatment

To restore hormonal balance, women are advised to regularly exercise in moderate physical activity, give up bad habits, lead healthy image life. It is important to adhere to a diet, make a balanced diet that excludes coffee, alcohol, carbohydrates, animal fats. It is useful to eat fresh fruits, vegetables, dairy products, dietary meats and fish. To replenish the deficiency of vitamins, pharmaceutical preparations are taken.

Treatment folk remedies can only be carried out in conjunction with the main therapy. You should first consult a doctor.

Hyperandrogenism causes disturbances in the work of many organs and systems, leads to the development of adrenal and ovarian insufficiency, infertility, type 2 diabetes mellitus. To prevent the onset of symptoms of hirsutism, skin rashes, hormone therapy is shown.

Bibliography

Kozlova V.I., Puchner A.F. Viral, chlamydial and mycoplasma diseases of the genitals. A guide for doctors. Saint Petersburg 2000.-574 p.
Miscarriage, infection, innate immunity; Makarov O.V., Bakhareva I.V. (Gankovskaya L.V., Gankovskaya O.A., Kovalchuk L.V.) - "GEOTAR - Media." - Moscow. - 73 p. - 2007.

The syndrome of hyperandrogenism in women is a common disorder that affects the endocrine system. The disease is accompanied by an increase in the amount of male sex hormones. This negatively affects both the body as a whole and the functioning of the reproductive system. This condition occurs in 5% of women, which is sufficient high rate... The opposite situation is called hypoandrogenism - this is when men have a lack of male sex hormones.

Hyperandrogenic syndrome is a condition that is accompanied by an increased production of androgens (male sex hormones) by the body. Sometimes their normal concentration is observed, which can still have a negative effect on the body. The excess of androgens in the female part of the population is manifested by the appearance of masculine traits. Also, the patient has problems with reproductive function. This syndrome also occurs in men. In them, it manifests itself (enlargement of the mammary glands as in women). Also, such men often suffer from impotence and other problems.

Androgens are a group produced by the human body. They are produced by the testes in men or by the ovaries in women. Also, these hormones are produced by the adrenal cortex. Their list includes:

other.

Androgen synthesis is controlled by substances that are produced by the pituitary gland. These include adenocorticotropic hormone. Androgen formation begins with the conversion of cholesterol to pregnenolone. This process observed in all tissues that are steroid-producing. Subsequently, the synthesis continues in completely different organs. Most often they have nothing to do with steroidogenesis.

At the exit, different hormones are formed, depending on the organ that is involved in the process. The ovaries produce testosterone, estrone,. The adrenal glands produce,. This organ also produces testosterone. In the process of androgen production, not only organs are involved, but also tissues of the periphery, for example, subcutaneous adipose tissue.

Symptoms of hyperandrogenism in women

Signs of hyperandrogenism in women are:

... It is characterized by increased male pattern hair. In this case, there is a hairline uncharacteristic for women. It can be localized on the abdomen, back, face, chest. In the presence of increased hair growth, the diagnosis of hyperandrogenism should be distinguished from. The latter condition has the same symptoms, but does not appear due to elevated androgens. Increased hair growth can develop due to the characteristics of the woman's body, which is the norm. A striking example is representatives from Central Asian countries;

acne. It is characterized by the formation of acne on the skin (most often on the face). It is accompanied by damage to the hair follicles and sebaceous glands, blockage of the excretory ducts. This problem often worries adolescents, which does not indicate the presence of this syndrome. After 20 years, more than half of women who have acne are diagnosed with an excess of male sex hormones;
seborrhea. It is characterized by increased secretion of the sebaceous glands. This process is observed on the head, face, neck and other parts of the body. Often seborrhea causes acne or other skin problems among women;
alopecia. Hair follicles are very sensitive to an increase in the level of androgens in the blood. Most of all, this phenomenon is observed in the frontal, temporal and parietal regions. Under the influence of male hormones in these areas, the hair changes, becomes much thinner, and eventually falls out altogether. As a result, bald patches are formed. Androgenic alopecia is often seen in women who have significantly elevated levels of male hormones;

virilization. It is characterized by the appearance of pronounced masculine features in women. This symptom is present in patients with serious pathologies in whom androgens are produced in large quantities;
violation of the menstrual cycle. Women are given different diagnoses depending on the nature of the disorder. Often there is opsooligomenorrhea (the presence of too large or short interval between periods), amenorrhea (complete absence of menstruation for a long period);
... It can be observed in the presence of pathologies of the adrenal glands or ovaries;
amyotrophy;

decreased immunity as a result;
impaired glucose tolerance;
the presence of genital organs of the intermediate type. Such a woman may experience fusion of the labia, hypertrophy of the clitoris, and other defects. These problems are congenital in nature and appear due to hyperplasia of the adrenal cortex. Such a person can be called androgyne, which means the union of a man and a woman in one body;
chronic depression, drowsiness, loss of energy and other signs of hyperandrogenism.

The reasons for the development of the problem

The development of the syndrome of hyperandrogenism is observed due to the following reasons:

hereditary factors. Androgenism in women can be passed from mother to daughter. If this problem is identified in the family, there is a high probability that it will be inherited;
violation normal work the brain, in particular, or. These departments are involved in the formation of hormones of the genital area;

dysfunction of the adrenal cortex. It is a congenital pathology characterized by an increase in the production of some hormones and the suppression of others. In 95% of cases, a decrease in the concentration of aldosterone is observed, which leads to an abnormal formation of the external genital organs of a woman;
the formation of tumors of the ovaries or adrenal glands, which disrupt the normal process of hormone production. They are also called androgen-secreting. When localized on the ovaries, testosterone production increases, on the adrenal glands -;
polycystic ovary syndrome. This is a disease characterized by the absence of tumors, but affecting the increase in the production of male hormones in women. Multiple cysts form in the ovaries, which causes. The increased level of androgens, which is observed in PCOS, leads to infertility, obesity, and increased hair growth. During the diagnosis of a sick woman, a chronic absence of ovulation is revealed;

adrenogenital syndrome. It is characterized by excessive formation of male sex hormones by the adrenal glands;
... It is accompanied by an increase in hormones produced by the adrenal cortex - glucocorticoids. In a sick woman, it is observed where fat is mainly deposited on the face, neck, trunk. Other symptoms of the disease are menstrual irregularities, infertility, muscle atrophy (mainly on the limbs), osteoporosis, lack of glucose tolerance, osteoporosis, chronic depression. In men, there is an increase in mammary glands, impotence;
prolactinoma. A tumor localized in the pituitary gland. This formation affects the production, which is responsible for the growth of the breast, the formation of milk;

ovarian hyperthecosis and stromal hyperplasia. An unnatural proliferation of their tissues is observed. Most often found in mature age after 60 years. In the study of patients, an increase in the level of estradiol and estrone is determined. The violation is accompanied by obesity, the development of arterial hypertension, impaired glucose tolerance, uterine cancer;
high activity of 5-alpha-reductase, which is involved in the production of steroid hormones;
long and uncontrolled intake different types(including oral contraceptives);
disruption of work thyroid gland;
chronic liver disease.

Increased androgen production in pregnant women

An excess of androgens in women who are carrying a fetus is dangerous condition... In 20-40% of all cases, pregnancy ends with a spontaneous abortion at early date... This happens due to a non-developing fetus or anembryony (the absence of an embryo in the fruit egg).

This problem can be chronic. Each subsequent pregnancy ends in miscarriage, which leads to such a condition as recurrent miscarriage. Secondary infertility develops, and hormonal disorders become more pronounced.

The most critical moments that a woman experiences are the periods when the fetus begins to additionally produce male sex hormones. This happens naturally and is observed:

from 12 to 13 weeks of pregnancy;
from 23 to 24;
from 27 to 28.

If a high level of androgens in women was detected before pregnancy, treatment occurs at all stages - both before and during gestation. The doctor determines the risk for the woman and the child and prescribes the appropriate medications to normalize the hormonal levels.

Diagnosis of the disease

Symptoms and treatment for this problem depend on the cause. To determine them, an analysis of the patient's condition is carried out. The attending physician takes into account when characteristic symptoms hyperandrogenism - in childhood, adolescence or adulthood. Such an analysis will determine the direction of further diagnostics. It should be aimed at elevated exploration certain organs - ovaries, adrenal glands, etc.

Diagnosis of hyperandrogenism includes:

blood and urine analysis. A study is being conducted to determine the level of androgens and their metabolic products;
Ultrasound of the small pelvis. Often, both conventional and transvaginal are prescribed;
Ultrasound of the adrenal glands;
tomography.

Treatment

If a high level of androgens was detected in women, the treatment of this condition occurs using different methods. It all depends on the reason, which must be determined without fail. Basically appointed:

taking glucocorticosteroids;
taking antiandrogens. They suppress the production of male sex hormones;
taking estrogen-progestin drugs. They contain female sex hormones;
use of gonadotropin-releasing hormone agonists. Drugs of this type act on the pituitary gland, which helps to normalize the hormonal background;
surgical treatment for detecting tumors;
normalization of weight, adherence to the principles healthy eating, physical activity.

Prophylaxis

The increased growth of androgens in women is treated with adherence certain rules, which prevent the further development of the disease. These include:

balanced diet. It is important to eat healthy food, give up fatty, salty, smoked, fried foods, limit the use of sweets;
normalization of weight. Excess weight directly affects the increase in the production of male sex hormones;
moderate physical activity. You can sign up for the pool or gym. Physical activity should be daily, but excessive exercise should be avoided;
prevention of stress. The increased psychoemotional load also negatively affects hormonal background women;
giving up bad habits - smoking, alcohol abuse;
regular visits to the gynecologist;
it is necessary to promptly treat diseases of the thyroid gland, adrenal glands, liver and other organs.

Complications

If the treatment of hyperandrogenism in women was absent or did not give a positive result, the following complications develop:

diabetes;
habitual miscarriage;
infertility;

Also, sick women complain of cosmetic defects - oily and problem skin, increased hair growth and others.

Bibliography

Emergency care for extragenital pathology in pregnant women. 2008, 2nd edition, revised and supplemented, Moscow, "Triada-X".
Savicheva A.M., Bashmakova M.A. Urogenital chlamydia in women and its consequences. Ed. E.K. Ailamazyan - N. Novgorod: Publishing House of the NGMA, 1998.-182 p.
Zaporozhan V.M., Tsegelskiy M.R. Obstetrics and gynecology. - K .: Zdorov'ya, 1996.-240 p.
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Diseases of the cervix, vagina and vulva / Ed. V.N. Prilep-

Graduated from the Kirov State medical academy in 2006.In 2007 she worked in the Tikhvin Central district hospital on the base therapeutic department... From 2007 to 2008 - employee of the hospital of a mining company in the Republic of Guinea ( West africa). From 2009 to the present, he has been working in the field of information marketing medical services... We work with many popular portals such as Sterilno.net, Med.ru, website

Hyperandrogenism in women is a condition caused by a malfunction of the endocrine system, in which too many male sex hormones are produced in the female body.

Sometimes the amount of androgens is within the normal range, but the body's sensitivity to their action increases. The causes, symptoms, treatment are varied. Therapy is prescribed by a doctor and is carried out strictly under his control and supervision.

The peculiarities of this pathology are that it is manifested by violations reproductive functions, metabolism, androgenic changes in appearance, while all these phenomena are due to common cause - high level male hormones and the high sensitivity of the body to their effects.

Medical statistics claim that from 4 to 7.5% of adolescent girls and from 10 to 20% of female adults suffer from hyperandrogenism to one degree or another.

Male hormones in the fair sex are produced by the ovaries, adrenal cortex, and subcutaneous fatty structures. Androgens are precursors of estrogens and are responsible for the formation of sexual behavior. During puberty, male hormones play an important role in growth processes. Under their influence, the bones of the skeleton mature, the growth zones are closed in time, but the oversaturation of the body with androgens triggers a chain of pathologies that affect the health of a woman.

Signs of hyperandrogenism in women:

cause the formation of aesthetic problems of appearance (alopecia, acne and others);
are the cause of metabolic disorders, which often ends in obesity;
lead to malfunctions of the reproductive system (menstrual irregularities, lack of ovulation, infertility).

If a woman does not receive drug treatment, then all together this can provoke development oncological processes, diabetes mellitus and disorders of the cardiovascular system.

Causes

Gynecologists subdivide hyperandrogenism into 3 types, depending on the causes of occurrence:

ovarian (ovarian);
adrenal (adrenal);
mixed character.

It can be hereditary or acquired, as well as:

absolute (when there is an excess of androgens in the blood);
relative (when the pathology is due to the excessive susceptibility of the female body to the action of male hormones).

Excessive synthesis of androgens occurs during tumor processes in the ovaries, hypothyroidism, genetically determined adrenal hyperplasia and other body dysfunctions, and can also be the result of taking medications that simulate the activity of male sex hormones.

Hyperandrogenic syndrome and its symptoms

Clinical manifestations of hyperandrogenism in women depend on the causes and extent of the lesion. Sometimes symptoms can build up over many years.

The initial manifestations usually occur during puberty:

oily seborrhea appears on the skin;
the face becomes covered with vulgar acne, acne;
the duration of the menstrual cycle changes, regulations may be absent for a long time;
"extra" hair appears on the face, arms and legs.

In the future, cystic changes in the ovaries are formed. Ovulation does not occur, the long-awaited pregnancy does not occur. If conception occurs, there is a high risk of miscarriage during the first weeks. This is due to a deficiency in progesterone, which is called the pregnancy hormone. With hyperandrogenism, the female body is not able to produce a sufficient amount of it. In rare cases of full bearing of pregnancy, it is difficult and proceeds with a high risk of complications. Labor activity is characterized by weakness, and amniotic fluid depart much earlier than the due date.

Often hyperandrogenism is manifested by causeless drowsiness, rapid fatigue, and the appearance of depressive conditions. This is due to a malfunction of the secretion of glucocorticoids in the adrenal cortex.

In menopause, hair loss occurs on the temples and in the parietal region, which causes many women to develop neuroses and the appearance of depressive conditions.

At severe forms hyperandrogenism, changes in the female genital organs, coarsening of the voice, the formation of muscles and fat deposits on the body according to the male type can be observed.

If the secretion of androgens occurs against the background of the development of tumor processes in the adrenal glands and ovaries, the growth of neoplasms is accelerated.

Diagnostics

Diagnosis of hyperandrogenism in women is made:

based on careful collection and study of anamnesis;
by physical examination and assessment of sexual development;
according to the results of a blood test for testosterone and other indicators.

The revealed excess of androgens requires clarification of the cause of the pathology. For this, CT, MRI and ultrasound methods are used. Radioiodine scintigraphy is sometimes done. The area of the adrenal glands and the pelvic organs are examined. Produced laboratory research urine samples.

Often there is a need to examine and consult women with hyperandrogenism by other specialists: a geneticist, endocrinologist and dermatologist.

Treatment

Treatment of hyperandrogenism in women is a long process that requires a versatile approach. As the main means of therapy, medicinal estrogen-progestational drugs are used that suppress the production and action of male sex hormones.

They block the synthesis of androgens and the sensitivity of the female body's receptors to them. In severe cases, hormone replacement therapy is carried out for a year or more. In severe dermatopathies, peripheral blockade of receptors that respond to androgens is used. In parallel, the correction of conditions associated with the manifestation of subclinical hypothyroidism and other deviations is carried out.

With excessive production of insulin, signs of obesity, along with pharmaceutical preparations, they give a good effect additional measures for weight correction - special diet and complex physical exercise... If there are tumor processes in the body, they are most often benign.

Removal of neoplasms is performed surgically, while the likelihood of re-growth is practically excluded. Women suffering from hyperandrogenism need long-term dispensary observation so that in the future they can plan a pregnancy and carry it out successfully.

Is it possible to somehow prevent the development of hyperandrogenism? Currently, there are no preventive measures that would fully guarantee protection against such a pathology.

Nevertheless, you can significantly reduce the risks if:

lead a healthy lifestyle;
eat properly, balanced and regularly;
give up addictions;
daily perform a set of simple physical exercises, without getting carried away with excessive sports training, as they can provoke the development of hyperandrogenism, especially if there is a intake of steroid medications.

It is important to timely treat pathologies that arise in the body, and not to neglect regular preventive examinations.

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