All about Androgens — and how its highs and lows can affect your health

High androgen levels, or hyperandrogenism, is caused by multiple reasons, the most common being polycystic ovary syndrome (PCOS).

Androgens are hormones that have an impact on the reproductive health of both men and women. Produced in the ovaries and adrenal glands, androgens contribute to muscle development and cognitive function. However, one needs to maintain healthy androgen levels. High levels of androgen, or hyperandrogenism, can often lead to excessive acne, excessive hair growth, as well as irregular or absent periods. An imbalance in androgen levels usually happens due to hormonal disorder Polycystic Ovary Syndrome (PCOS). It may also occur because of the prevalence of some tumours. Here is your guide on how to lower androgen levels.

What are androgen levels?

Androgens are hormones that are responsible for the male traits in the body. They are present in men and women. “Androgen levels are measured through blood tests such as testosterone levels, dihydrotestosterone (DHT), and androstenedione,” explains gynaecologist and obstetrician Dr Rohan Palshetkar. Androgen levels go up around puberty and impact muscle growth, bone density, as well as sexual function. According to research by the National Institutes of Health, DHT is the most potent and pure hormone among the androgens. This hormone is involved in sexual differentiation. While it is important in male physiology, it does not play a significant role when it comes to females. However, an imbalance of DHT can have minor effects on female physiology.

What do androgens do in the body?

Androgens are helpful in the development of male reproductive organs, and the development of secondary sexual characteristics like facial hair, deepening of voice and muscle growth in males. They also affect the libido of men as well as women. “In women, androgens are precursors to the hormone estrogen and the development of oocytes, which are cells in the ovaries,” says Dr Palashetkar

How do you know your androgen levels are off balance?

In men, low androgen levels can lead to decreased sex drive, erectile dysfunction, fatigue, depression, loss of muscles, and reduced hair growth. An increased androgen level can lead to acne, aggressive behaviour and sleep apnea, among other things. In women, low androgen levels can lead to reduced sex drive, lack of energy, infertility, and osteoporosis, states this study, published in Clinical Endocrinology. This is because androgens are also converted into estradiol, a type of estrogen that impacts menstruation, pregnancy as well as pubic and armpit hair.

All about Androgens — and how its highs and lows can affect your health
Hair fall is one of the common symptoms of high androgen levels. Image courtesy: Freepik

Why do androgen levels go high?

There can be many reasons for high androgen levels in women

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1. PCOS

High androgen levels are usually seen in PCOS patients. The symptoms of high androgen levels include irregular cycles, excessive hair growth, acne, as well as baldness. It can also cause ovulation and fertility issues. A study, published in Medical Clinics of North America, states that 65-75 percent women have hyperandrogenism, with hirsutism, or excessive hair around the mouth and chin area, being the most common symptom.

2. Genetic conditions

Congenital adrenal hyperplasia (CAH) consists of genetic conditions that can result in high levels of androgens. There is an enzyme shortage in the body due to these conditions, which leads to an overproduction of certain hormones such as androgens, states this study, published in the Journal of Clinical Medicine.

3. Cushing syndrome

Cushing syndrome, a syndrome caused by too much cortisol in the body, happens due to a benign tumour in the pituitary gland that releases an excess of ACTH (adrenocorticotropic hormone), states this study, published in Endocrine Abstracts. This turns into cortisol and causes the syndrome. When there is an excess of ACTH, the adrenal glands produce an excess of androgens. This leads to high blood pressure, rapid weight gain as well as purple stretch marks.

4. Androgen-secreting tumours

Certain adrenal tumours result in an overproduction of androgens. While this is rare, this can happen suddenly. A study, published in Frontiers in Endocrinology, observed that among 1205 patients with high levels of androgen, 1.7 per cent or 20 patients had androgen-secreting tumours.

5. Breast cancer

A history of breast cancer can also lead to an excess of androgen levels. Androgen therapy is used as a tumour-suppressor, and this can also result in high levels of the hormone, states this study, published in Nature Medicine.

6. Other reasons

The other reasons for high androgen levels include hyperprolactinemia, a condition caused by high levels of prolactin in the body, stress, insulin resistance, and epilepsy medications.

How to diagnose high androgen levels?

A physical exam is performed by your doctor to determine your androgen levels. Symptoms of hyperandrogenism, such as excessive facial hair or acne, will be observed. Your medical history regarding your menstrual cycle, the development of breasts, and pubic hair will also be assessed. Then, blood tests are ordered to confirm the diagnosis.

Some blood tests can determine androgen levels in the body. These are Total testosterone, where the total amount of testosterone is measured in the body, Free testosterone, where the testosterone that is not attached to proteins is measured, Androstenedione, which is a steroid hormone, and high levels can hint at PCOS; and finally, Dehydroepiandrosterone sulfate (DHEAS), that is a sex hormone released by adrenal glands. 17-hydroxyprogesterone is also measured as this can detect non-classic congenital adrenal hyperplasia, a condition that can cause high levels of androgen.

How to lower androgen levels with treatment?

There are a few ways to lower androgen levels, and some of these techniques are also used in PCOS treatment. Hormonal birth control pills and antiandrogen medication might be prescribed by your doctor. Insulin-reducing drugs can also help reduce androgen levels.

A woman holding a pad and a calendar
PCOS is one of the most common signs of high androgen levels in females. Image courtesy: Freepik

How to lower androgen levels naturally?

There are other ways where androgen levels can be lowered naturally. These are as follows:

  • Lifestyle modification by incorporating a balanced diet, exercise and stress management can help reduce androgen levels and insulin resistance.
  • Eating high-fiber foods can help. These have been shown to reduce androgen levels and improve insulin sensitivity.
  • Low glycemic index foods also help reduce insulin resistance, and this helps reduce androgen levels.
  • Adequate sleep of 7-8 hours of sleep helps maintain the hormone levels.
  • Tracking symptoms is very important as levels may increase suddenly in some cases.

Summary

High androgen levels can result in an inability to get pregnant, menstrual cycle irregularity, facial hair and acne in women. Women with PCOS have a high probability of increased androgen levels and regular check up is a must. The symptoms of high levels of androgens vary from person to person.