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High androgen levels in women can affect more than just hair growth. Common symptoms include persistent acne, oily skin, irregular periods, increased abdominal fat, and mental health challenges like anxiety or depression. Often linked to Polycystic Ovary Syndrome (PCOS), high androgens can also lead to serious health risks like diabetes, heart disease, and infertility.
Key Symptoms of High Androgens:
- Skin issues: Acne, oily skin.
- Hair changes: Excess facial/body hair, scalp hair thinning.
- Menstrual irregularities: Missed or irregular periods, fertility problems.
- Weight gain: Especially around the abdomen, linked to insulin resistance.
- Mental health: Anxiety, depression, and low self-esteem.
Quick Facts:
- Prevalence: Affects 5–10% of women of reproductive age; PCOS is the leading cause.
- Health Risks: 3x higher risk of diabetes, 2.5x higher risk of heart attack.
- Treatment Options: Medications (e.g., Spironolactone, Metformin), lifestyle changes (diet, exercise).
Early diagnosis and tailored treatment are essential. Combining medical care with lifestyle adjustments can help manage symptoms, improve quality of life, and reduce long-term risks.
Androgen Excess in Women with Dr. Lara Briden episode #38
Main Symptoms of High Androgen Levels
High androgen levels can cause a range of changes, many of which affect the skin, hair, menstrual cycle, and overall health. While the experience varies from person to person, being aware of these symptoms can help you identify patterns and seek the right care.
Skin Issues: Acne and Oily Skin
One of the most noticeable signs of elevated androgens is acne, particularly when combined with other hormonal symptoms. Androgens increase oil gland activity, leading to more sebum production. This excess oil can clog pores and result in acne, often appearing on the face, chest, and back.
"Hyperandrogenism happens when you have high levels of androgens (a group of sex hormones) in your body. It most commonly affects women and can cause hirsutism, acne and irregular periods." – Cleveland Clinic
Among women with PCOS, the most common cause of high androgen levels, 42% experience acne compared to just 17% of women without the condition. Beyond acne, the increased oil production can leave skin feeling persistently greasy, making oil-free skincare routines essential.
Androgens also influence hair follicles, causing noticeable changes in hair growth and texture.
Hair Changes: Excess Growth and Hair Thinning
High androgen levels can lead to unwanted hair growth in areas like the face, chest, or back, while also contributing to hair thinning on the scalp. Androgens regulate hair follicles, turning fine vellus hairs into thicker, pigmented terminal hairs. This explains why you might notice coarse, dark hair in certain areas while dealing with thinning hair on your head.
For scalp hair loss, dihydrotestosterone (DHT) plays a major role. In women with androgenetic alopecia, DHT causes hair follicles to shrink, leading to thinner, weaker hair. This condition affects approximately 30 million women and 50 million men in the U.S., with noticeable hair loss affecting about half of all individuals by age 50.
Irregular Periods and Fertility Challenges
Hormonal imbalances caused by high androgen levels can disrupt menstrual cycles, often leading to irregular or missed periods. These disruptions interfere with ovulation, making it harder to conceive. For women trying to get pregnant, this can be a particularly frustrating symptom.
Weight Gain and Fat Distribution
High androgen levels can also affect how your body stores fat, often leading to weight gain around the abdomen. This pattern of fat distribution increases the risk of heart disease and type 2 diabetes, especially when combined with insulin resistance. Studies show that 38% to 88% of women with PCOS are overweight or obese. Insulin resistance, commonly linked to abdominal fat, can progress to prediabetes or type 2 diabetes.
Less Obvious Symptoms
Beyond the more visible signs, elevated androgens can bring about subtle changes that are easy to overlook. These might include mood swings, trouble concentrating, lower energy levels, or shifts in sex drive. Some women also notice signs of insulin resistance, such as acanthosis nigricans - dark, velvety patches of skin in body folds.
In severe cases, high androgen levels can cause more pronounced changes, such as increased muscle mass, a deeper voice, or clitoral enlargement. Recognizing these symptoms early is key to managing hormone imbalances effectively. Treatments like spironolactone for unwanted hair or topical spironolactone for hair loss can target specific symptoms while you work on restoring hormonal balance.
What Causes High Androgen Levels
High androgen levels can result from various conditions, with Polycystic Ovary Syndrome (PCOS) being the most common. Pinpointing the cause of elevated androgens is key to addressing symptoms and finding an effective treatment.
Polycystic Ovary Syndrome (PCOS)
PCOS is the leading cause of high androgen levels, affecting between 6% and 20% of women of reproductive age worldwide.
In PCOS, a combination of hormonal imbalances contributes to the increase in androgens. Chronically high levels of luteinizing hormone and insulin stimulate the ovaries to produce more androgens. At the same time, insulin resistance - present in about 75% of individuals with PCOS - reduces levels of sex hormone-binding globulin (SHBG), which leads to higher amounts of free testosterone circulating in the body. This combination of increased androgen production and lower SHBG levels amplifies the symptoms of PCOS, such as irregular periods, acne, and excess hair growth.
However, not all cases of high androgens follow the typical PCOS pattern. Other underlying conditions may be at play.
Less Common Causes: Tumors and Other Disorders
When symptoms appear suddenly or don’t align with PCOS, other causes should be explored. While PCOS is the most frequent culprit, there are other conditions that can lead to elevated androgen levels.
- Congenital Adrenal Hyperplasia (CAH): This genetic condition, which affects about 2% of females with hyperandrogenism, can sometimes be mistaken for PCOS when it presents later in life.
- Cushing's Disease: Often misdiagnosed as PCOS, this disorder can also contribute to increased androgen levels.
- Androgen-Secreting Tumors: Though rare, these tumors - found in the ovaries or adrenal glands - account for only 0.2% of hyperandrogenism cases. They can cause a rapid increase in androgen levels, and sudden symptoms should be evaluated immediately.
Additionally, certain medications, such as anabolic-androgenic steroids, synthetic progestins, and some antiepileptics, can lead to elevated androgen levels.
Understanding the root cause is essential for effective treatment. For instance, PCOS often requires long-term strategies to manage hormone levels and improve insulin sensitivity. In contrast, androgen-secreting tumors may need surgical removal, and medication-induced hyperandrogenism might resolve with a change in prescription. A thorough diagnosis ensures treatment is tailored to the specific condition, providing the best chance for symptom relief.
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Health Risks of Untreated High Androgens
Leaving high androgen levels unmanaged can lead to serious health complications, affecting various systems in the body and increasing the risk of chronic conditions.
Diabetes and Heart Disease Risk
High androgen levels are closely linked to an increased risk of both cardiovascular disease and type 2 diabetes - two of the leading causes of death among women in the U.S. Elevated androgens encourage the accumulation of abdominal fat and contribute to insulin resistance, setting off a chain reaction that disrupts metabolism and harms heart health.
Women with elevated androgens are nearly three times more likely to develop type 2 diabetes compared to those with balanced hormone levels. The cardiovascular risks are just as alarming. Women with PCOS experience a 5–7 times higher risk of cardiovascular disease and are more than twice as likely to face coronary heart disease and stroke. For perspective, high androgen levels increase the risk of a heart attack by 2.5 times and the risk of stroke by 71%.
| Health Risk | Increased Risk |
|---|---|
| Type 2 Diabetes | 2.87 times higher |
| Heart Attack | 2.50 times higher |
| Stroke | 1.71 times higher |
| High Blood Pressure | 1.70 times higher |
| Metabolic Syndrome | 3.35 times higher |
"Women worry about infertility, acne and weight gain but might not be thinking of high blood pressure and type 2 diabetes. It's important to know that they're at an increased risk and how important diet and exercise is", says Dr. Erin Michos, M.D..
But the impact of untreated high androgens isn't limited to physical health - it also takes a toll on mental well-being.
Mental Health Effects
The psychological effects of high androgen levels are often overlooked, but they are significant. Over 60% of women with PCOS are diagnosed with at least one psychiatric condition, such as anxiety, depression, or an eating disorder. Women aged 20 to 29 are particularly vulnerable, with a higher likelihood of developing mental health disorders during this stage of life.
High androgen levels can disrupt brain chemistry, leading to neurodegeneration, reduced brain-derived neurotrophic factors, and increased inflammation in the brain. These changes can affect mood, cognitive function, and emotional stability.
Research highlights that 38.6% of anxiety cases in women with high androgens are tied to infertility and hair loss, while 25.7% of depression cases stem from persistent acne issues. Alarmingly, suicide rates are significantly higher in women with PCOS compared to those without the condition.
These mental health challenges can further complicate reproductive health, which is already strained by hormonal imbalances.
Pregnancy and Fertility Problems
In addition to disrupting ovulation, untreated high androgen levels can pose serious risks during pregnancy. Women with elevated androgens face a higher likelihood of miscarriage and are more prone to complications like gestational diabetes and preeclampsia.
Labor and delivery can also be riskier. These women are at greater risk for heart-related issues and blood clots during delivery - both of which can be life-threatening.
Proven Treatment Options
Managing high androgen levels effectively often requires a combination of medical treatments and lifestyle adjustments. The goal is to reduce androgen production, lower free androgen levels, and block their effects on the body. A tailored approach that combines prescription medications with practical lifestyle changes often yields the best results.
Prescription Medications
There are several FDA-approved medications that can help manage the symptoms of high androgen levels. Your healthcare provider will recommend the best option - or a combination of treatments - based on your specific needs.
Spironolactone works by blocking androgen receptors, helping to reduce acne and unwanted hair growth. Research shows it outperforms finasteride for hirsutism and can be particularly effective when oral contraceptives alone don’t provide sufficient relief after six months. Generic spironolactone costs approximately $61 per month. However, it’s important to use reliable contraception while on this medication.
Eflornithine (Vaniqa) is a prescription cream designed to slow the growth of new facial hair. While it doesn’t remove existing hair, it can be a helpful addition to your treatment plan. Some users may experience mild side effects like stinging, redness, or burning at the application site.
Metformin is especially beneficial for women with PCOS, as it lowers both insulin and androgen levels. Studies, including a Cochrane review, suggest it’s as effective as oral contraceptives in treating hirsutism related to PCOS. However, gastrointestinal discomfort is a common side effect. Generic metformin costs about $73 per month.
For hair loss, oral minoxidil has become a popular option. Unlike its topical counterpart, the oral form is often more convenient and effective for female pattern hair loss. Oana Health offers oral minoxidil starting at $25 per month, making it an accessible choice for many women.
| Medication | Primary Uses | Monthly Cost | Key Benefits |
|---|---|---|---|
| Spironolactone | Hirsutism, acne, irregular periods | $61 (generic) | Blocks androgen receptors |
| Eflornithine | Facial hair growth | $46 | Slows new hair growth |
| Metformin | Insulin resistance, hirsutism | $73 (generic) | Reduces insulin and androgens |
| Oral Minoxidil | Hair loss | $25 | Promotes hair regrowth |
Oral contraceptives are another cornerstone treatment, especially for women who also need birth control. They work by reducing ovarian androgen production and increasing sex hormone-binding globulin (SHBG), which lowers free testosterone levels. Side effects may include nausea, headaches, and spotting.
While these medications address hormonal imbalances, combining them with sustainable lifestyle changes can further improve outcomes.
Diet and Lifestyle Changes
Lifestyle modifications play a critical role in managing high androgen levels. Even small changes can make a big difference - losing as little as 5% of body weight can help lower androgen levels and restore ovulation.
Dietary adjustments should focus on managing insulin levels, as insulin resistance affects 50% to 75% of individuals with PCOS. A diet similar to one recommended for type 2 diabetes - high in fiber, low in refined carbohydrates, and free of trans and saturated fats - can be particularly effective. Incorporating omega-3 and omega-9 fatty acids is also beneficial. The Mediterranean diet, which emphasizes whole, unprocessed foods and limits saturated fats, processed meats, and refined sugars, is another excellent option.
Simple dietary tips include:
- Limiting added sugar to no more than 24 grams per day.
- Eating balanced meals with protein, healthy fats, and fiber-rich carbs.
- Adding natural remedies like two cups of spearmint tea or 30 grams of ground flaxseeds daily, which some women find helpful.
Regular exercise is equally important for reducing insulin resistance and androgen levels. Aim for at least 150 minutes of moderate activity each week, including strength training two to three times weekly. Activities like high-intensity interval training (HIIT), yoga, Pilates, or tai chi can also be effective.
Managing stress is another crucial component, as chronic stress can worsen insulin resistance and elevate androgen levels. Practices such as yoga, meditation, and other self-care techniques can support hormone balance.
"If you are diagnosed with polycystic ovary syndrome, it doesn't mean that you are destined to have poor health. There is a lot you can do to take charge, minimize symptoms and keep yourself healthy", says Amanda Stathos, M.S., R.D., L.D.N.
Telehealth services, such as those offered by Oana Health, provide a convenient way to integrate these treatments and lifestyle strategies. Through online consultations with licensed professionals specializing in hormonal care, you can access personalized, science-backed treatments like Eflornithine, Spironolactone, and topical Spironolactone.
The best outcomes often come from working with knowledgeable healthcare providers who can design a personalized plan that combines the right medications with practical, sustainable lifestyle changes.
Conclusion: Getting the Right Treatment
High androgen levels impact 5–10% of women of reproductive age, with 80–90% of these cases linked to PCOS. Early detection and tailored treatment are critical. As noted by medical experts:
"Timely diagnosis and appropriate therapy are important because symptoms and signs related to excessive androgen production are prevalent in adolescents and young adults, with added metabolic complications occurring in adult women".
Putting off treatment can lead to lasting changes and make symptoms harder to manage. This underscores the importance of accessible and effective treatment options.
The goal of medical treatment is to lower androgen production, decrease free androgen levels, and block androgen activity. Combining medications like spironolactone with lifestyle adjustments has shown to be the most effective approach.
Telehealth has emerged as a convenient way to ensure timely care. In just a quick 5‑minute online consultation, specialists can review your medical history and design a treatment plan tailored to your needs. These services are not only convenient but also affordable, with treatments starting at $22–$25 per month.
Victoria A., a patient, shared her positive experience:
"Oana's telehealth service is fantastic! It's helped manage my insulin levels and reduce excess hair growth I was experiencing due to PCOS. I'm recommending this to all my friends with PCOS".
If you're dealing with symptoms of high androgen levels, don’t wait to seek help. Addressing hormonal imbalances early can lead to better outcomes. With Oana Health, you can begin your journey toward symptom management through an online consultation. From unwanted hair to hair loss and hormonal balance, you can access effective treatments from the comfort of your home. By combining medical care with lifestyle changes, you can take control of your symptoms and improve your overall quality of life.
FAQs
What are some effective lifestyle changes to manage high androgen levels in women?
Managing high androgen levels in women often begins with prioritizing healthy lifestyle choices. Keeping a balanced weight by combining regular physical activity with a nutrient-rich diet can make a big difference. Activities like vigorous aerobic workouts and resistance training are especially helpful as they boost insulin sensitivity, which may, in turn, lower androgen levels.
Incorporating a low-glycemic or low-carb eating plan, such as the Mediterranean or DASH diet, can also help regulate insulin levels. This may ease symptoms like acne, hair thinning, or excessive hair growth. Sticking to these habits consistently is key to managing hyperandrogenism and enhancing overall health.
How do high androgen levels affect mental health in women, and what can be done to manage these effects?
High androgen levels in women can have a significant impact on mental health, potentially leading to issues like depression, anxiety, mood swings, and even heightened aggression. These hormonal shifts can throw off emotional balance, creating feelings of stress or frustration.
Managing these challenges often involves treatments aimed at reducing androgen levels. Options like antiandrogen medications - such as spironolactone or finasteride - may help improve mood and overall mental health. Tackling underlying conditions, like PCOS, through hormonal therapy, weight management, or lifestyle adjustments can also play a crucial role in supporting emotional well-being. Additionally, supplements like melatonin might offer some benefits in certain cases. It's essential to work closely with a healthcare provider to determine the best course of action tailored to your needs.
What health risks can arise from untreated high androgen levels in women, and why is early detection important?
Untreated high levels of androgens in women can lead to a range of serious health concerns, including insulin resistance, type 2 diabetes, high cholesterol, high blood pressure, and a greater risk of heart disease. These conditions, if left unchecked, can have a lasting impact on overall health and may even lead to life-threatening complications.
Catching the problem early is crucial to avoiding severe symptoms such as virilization (the development of male physical traits), infertility, and metabolic disorders. Addressing elevated androgen levels promptly allows for targeted treatment, helping to minimize long-term risks and improve overall well-being.
