Hyperandrogenism in women: causes, symptoms, treatment
Hyperandrogenism - an increase in the amount of male sex hormones in women above the normal level. This endocrine disorder is diagnosed in 5% of women. It occurs either from increased production of male hormones, or from excessive sensitivity of tissues and organs to those.
In the body of every woman, male sex hormones are produced - androgens. They are produced by the ovaries - the female sex glands, and the adrenal glands - the endocrine organs located above the kidneys. Hyperandrogenism is diagnosed with excess production of androgens by these two glands.
Symptoms of developing hyperandrogenism in women
A high level of androgens often leads to the formation of small cysts and the formation of such a dense capsule around the ovary. Also, the violation leads to anovulation, which leads to infertility.
If pregnancy does occur, there is a very high probability of its premature termination at the initial stage. The risk of miscarriage decreases in the second trimester.
Miscarriage is caused by a large amount of male sex hormones and low progesterones - pregnancy hormones. Lack of progesterone is also a symptom of hyperandrogenism.
Abnormalities in the work of the ovaries is reflected in the regularity of the menstrual cycle. If normally the first menstruation occurs at 12-13 years old, then with congenital hyperandrogenism a few years later. However, they are irregular, may linger, alternate with prolonged discharge.
Women with such a diagnosis are at risk of developing complications during childbirth, for example, most often they have amniotic fluid out of time and have a weak labor activity. Therefore, a woman with such a diagnosis, even with a successful conception, should be closely monitored by doctors. In this case, it is necessary to monitor the basal temperature and a number of others in order to timely identify a complication during pregnancy.
The symptoms of deviation include hirsutism - increased hair growth on the body, mainly on the arms and legs. When the cause of the disease is a malfunction of the pituitary gland, obesity is also present. A symptom of a deviation is skin imperfections, for example, acne, which is popularly called acne.
The disease is accompanied by an increase in tissue sensitivity to insulin. At the same time, its level in the blood is constantly increasing, which in itsqueue increases the risk of developing diabetes.
Why does the syndrome of hyperandrogenism occur in women
Most often, the deviation occurs as a result of the so-called androgenital syndrome. As you know, the adrenal glands produce not only androgens, but also a number of other equally important substances, including glucocorticoids. A large amount of androgens under the action of a special enzyme in the ovaries is converted into glucocorticoids.
The production of these enzymes is determined at the genetic level. When a woman is born with a pathology of this enzyme, androgens produced in her body cannot turn into glucocorticoids and accumulate all the time, having a negative effect on health.
Adrenal gland tumor can affect hormonal levels. The more cells produce androgens, the higher the number of the latter. This also applies to neoplasms in the ovaries.
An increase in the amount of male hormones may be due to the pathology of other organs of the endocrine system, for example, the pituitary gland, which regulates the work of other endocrine glands.
Hyperandrogenism can also occur with increased sensitivity to testosterone. Basically, the symptoms of this form of the disease are hirsutism and acne. However, in this case, the increase in androgens in the blood is not observed, the hormonal background does not fail.
How is hyperandrogenism diagnosed in women
The first thing the doctor pays attention to is the time of the onset of the symptoms of the disease. It should be noted that they can develop gradually, from the beginning of puberty, or suddenly, already in reproductive age. This moment allows you to confirm or deny the connection of the violation with a tumor of the adrenal glands or ovaries.
Various tests are used for diagnostics:
- Urine and blood tests allow to determine the level of androgens, their breakdown products and a number of other substances;
- Genital ultrasound;
- Tomography and ultrasound of the adrenal glands.
If necessary, use other diagnostic methods.
Treatment of hyperandrogenic syndrome in women
Methods of restoring hormonal levels primarily depend on the form of the disease. For example, if the increased production of androgens is due to tumor tissue of the adrenal glands or ovaries, they resort to surgical intervention.
When the cause of the failure is not a tumor, but a malfunction of the hypothalamus / pituitary gland, treatment depends on two factors: the cause of the rejection and the goals of the doctor / patient. For example, efforts can be aimed at eliminating the external manifestations of the disease (hirsutism, acne) or restoring reproductive function in infertility.
If the cause of the disease is hidden in the disruption of the pituitary gland with the hypothalamus, there is significant obesity. In this situation, weight normalization becomes one of the main goals.th treatment.
For this purpose, they resort to diets (lowering the calorie content of food) and sports (increasing physical activity), the use of sedatives (rudotel, peritol, diphenin). The doctor may recommend a course of acupuncture.
If a woman does not plan pregnancy in the near future, then hyperandrogenism, or rather her symptoms, is eliminated with the help of oral contraceptives with antiandrogenic action.
Adrenal hypoandrogenism suggests taking dexamethasone during preparation for pregnancy. In most women, after therapy, the menstrual cycle normalizes, ovulation occurs regularly, and a long-awaited pregnancy occurs.
The brain reacts sharply to hormonal disruptions. As a result, various systems of the body fail. But after the introduction of the missing hormone from outside, the deviations are eliminated. Hyperandrogenism during pregnancy requires the use of drugs of this series at the stage of preparation and planning.
In case of infertility due to this deviation, medications are prescribed that stimulate the release of an egg or ovary. For example, Clostilbegid and Clomiphene are most often prescribed.
When medications to stimulate ovulation are ineffective, they resort to surgical intervention.
Modern medicine, instead of extensive operations, resorts to laparoscopy: a small incision is made in the abdominal wall, through which special surgical instruments are inserted, including a microcamera, allowing you to see the operation process.
With the help of such innovative equipment, incisions are made on the ovaries, covered with dense capsules, through which the egg will subsequently be released.
At the stage of planning pregnancy, as well as at the initial stages of pregnancy, a number of fortifying drugs are prescribed. Most often it is folic acid and other vitamin and mineral supplements.
Hyperandrogenism is a serious condition that requires careful examination. If alarming symptoms appear, you should consult a specialist. This could be a gynecologist or endocrinologist. Timely detection of pathology and taking measures will allow you to preserve reproductive function or restore it in the treatment of female and male infertility.