High androstenedione may be associated with polycystic ovary syndrome, but it can also be seen in female masculinization disorders, adrenal tumors, congenital adrenocortical hyperplasia, follicular membrane cell proliferation, hyperadrenocorticism, and hyperinsulinemia. Therefore, it is impossible to make an accurate diagnosis based on laboratory results alone, and it is necessary to make a differential diagnosis in conjunction with ultrasound examination and specific circumstances. High androstenedione is a high level of androgens in women, which may affect female fertility. Therefore, the primary disease should be actively treated to control androstenedione levels, for example, if an adrenal tumor causes high androstenedione, the tumor should be surgically removed. In case of high androstenedione caused by polycystic ovary syndrome, oral drospirenone ethinyl estradiol tablets (II) or ethinyl estradiol cyproterone tablets can be considered to lower androgens and, if necessary, oral dexamethasone can be used for treatment. Polycystic ovary syndrome is the most common endocrine metabolic disease in women of reproductive age, mostly manifested as menstrual disorders, low menstrual flow or amenorrhea, but also acne, hirsutism, hair loss, infertility and other symptoms.