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Androgens are a group of sex hormones that include testosterone, dihydrotestosterone, androstenedione, and dehydroepiandrostenedione (DHEA). In men, they are produced by Leydig cells in the testes. Dihydroepiandrostenedione (DHEA) is additionally produced in the reticular layer of the adrenal glands. In women, the main source of androgens is from the adrenal glands, and to a small extent from the ovaries.
Androgens in women and men
Androgens are a group of hormones that include:
- testosterone;
- androstendion;
- dihydrotestosterone;
- dehydroepiandrostendion.
In women, androgens are produced mainly in the adrenal glands, and to a lesser extent by the ovaries (most often androstenedione and testosterone). The androgens produced in the ovaries are converted into estrogens. They are responsible for the initiation of the maturation process, and the appearance of the skin also depends on them (high blood concentration makes the skin smooth and healthy). The presence of these hormones also affects women’s sex drive, adds energy and promotes well-being.
A drop in testosterone causes a worsening of well-being and self-esteem. Libido is very low. On the other hand, in women, too much androgens are most often associated with PCOS (polycystic ovary syndrome) and affect menstrual disorders, infertility and unsightly excess hair, which causes great discomfort and shame.
Some women, as a result of hyperandrogenism, also have to deal with acne and a male voice.
In men, androgens are secreted by cells in the testes (Leydig cells). Additionally, one of the hormones, more precisely dihydroepiandrostenedione, is produced in the adrenal glands. In men, androgens are responsible for such features as body structure, shaping of the sexual organs, hairiness, libido and voice timbre. In addition, the right amount of androgens affects the sex drive and adds vitality and energy.
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The excess of androgens in the body leads to hyperandrogenism. The cause of the ailments is too much androgen production in the ovaries, testes and adrenal glands. In men with adrenal hyperplasia, hyperandrogenism will be manifested by decreased libido, infertility and lack of male features. Medicines such as anticonvulsants, anabolic steroids or drugs that lower blood pressure can be another possible cause of excess androgen production.
The causes of hyperandrogenism in women
The causes of the adrenal glands usually include:
- lumps of the adrenal glands that produce hormones
- congenital adrenal hyperplasia.
In turn, ovarian causes include:
- PCOS (polycystic ovary syndrome),
- hypertecosis (ovarian cell hyperplasia),
- hormone-producing nodules
- functional ovarian hyperandrogenization,
- menopause,
- hyperprolactinemia.
We should also mention the preparations taken in the treatment of endometriosis, e.g. Danazol.
When do we perform androgen testing?
The most common indications for an androgen test.
1. Hypogonadism in men (decreased libido, infertility, lack of male features).
2. Tumors of the testicles.
3. Menstrual disorders, infertility, hirsutism in women – suspected virilizing tumor of the adrenal glands or ovary (additional symptoms of excess androgens in women are acne, seborrhea, male voice, poor development of secondary and tertiary sexual characteristics).
4. Suspicion of polycystic ovary syndrome.
Study details:
Material for the study of androgens: serum.
Preparation for the test: on an empty stomach (at least 8 hours).
The course of the study: a single blood sampling from a vein in the arm (usually in the left forearm or in the area of the left elbow).
Time to wait for the result: 1 Day.
Androgen testing is almost always performed in conjunction with other determinations. Fasting is not entirely necessary, it is more important that blood is drawn in the morning. In women, it is recommended to conduct the test from the 4th to the 10th day of the cycle, not later than a week before the expected menstruation.
Before performing the test, inform your doctor about any medications you are taking that may affect the test result. This is especially true for glucocorticosteroids and, in women, for oral contraceptives.
Does the test cause complications?
As with other tests requiring venous blood donation, prolonged bleeding and the formation of subcutaneous hematomas may occur due to abnormal venipuncture.
Androgens – Standards for Testing
- Testosterone: 0,69-2,77 nmol / L (0,2-0,8 ng / ml) in women, 7,6-34 nmol / L (2,2-9,8 ng / ml) in men.
- Dihydrotestosterone: 0,7-3,5 nmol / L (0,2-1,0 ng / ml) in men.
- Androstenedione: 2,7-5,8 nmol / L (0,8-1,6 ng / ml) in women, 2,7-5,8 nmol / L (0,8-1,6 ng / ml) in men.
- Dihydroepiandrostenedione: 5,2-25,3 nmol / L (1,5-7,3 ng / ml) in women, 13,8-27,7 nmol / L (4,0-8,0 ng / ml) in men.
Treatment of excess androgens
Treatment of excess androgens depends on the cause. Hormone therapy is most often prescribed in women suffering from polycystic ovary syndrome. However, when the cause is adrenal hyperplasia, preparations from the group of glucocorticosteroids are used.
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Women struggling with too much hair can go to a laser treatment that will reduce it, e.g. laser hair removal.