The role and sources of androgens The development, beauty and figure of women depend on the normal secretion of estrogen and progesterone in our body, especially the normal pregnancy of women, which requires the cooperation and coordination of these hormones. However, we always ignore some small content of hormones, such as androgens that we will introduce to you today, although androgens account for a relatively small portion of the female body, compared to men, only about 10% of theirs, but it has a “significant” role – to be able to It promotes the development of the vulva, the growth of armpit and pubic hair, stimulates the growth of red blood cells, and most importantly, it is the raw material for the synthesis of estrogen and progesterone in the body. This means that the abnormal secretion of androgens will inevitably affect the secretion of estrogen and progesterone, which in turn triggers a series of harmful symptoms and chain reactions. Today, to introduce you to this hormone, which can be related to women’s menstruation, fertility and even life-long health problems! The “culprit” of hyperandrogenism The high level of androgens in a woman’s blood and their increased activity is called hyperandrogenemia. The main sources of androgens are the ovaries and the adrenal glands, and naturally there are ovarian and adrenal factors that contribute to this condition. It is reported from polycystic ovary syndrome (PCOS) accounted for about 34%, followed by adrenocortical hyperfunction, accounting for 29%, a few seen in follicular membrane hyperplasia and adrenocortical hyperplasia; about 28% of the source is unknown. 1, ovarian factors: PCOS is the most important cause of hyperandrogenemia in women, 70%-80% of PCOS patients with hyperandrogenemia. Secondly, there are androgen-secreting ovarian tumors, these tumors are usually small in size and not easy to be found, so the measurement of significantly elevated androgens can help in the diagnosis. 2, adrenal factors: congenital adrenocortical hyperplasia (CAH), cortisolism, this type of patients not only have high androgen manifestations, some patients will also appear “full moon face, buffalo back” and other symptoms. What are the dangers of hyperandrogenism? 1, the recent harm (1) skin manifestations: the first manifestation of hyperandrogenism, hirsutism, acne, androgenetic alopecia is the typical skin manifestations of hyperandrogenemia, especially not only the limbs, pubic area, armpits of the hair is more, the upper lip, nipples, the abdomen also appeared in the embarrassing hair of the female friends. However, the degree of hirsuteness does not parallel the level of androgens; the most stimulating effect on hair is dihydrotestosterone, and when this hormone is elevated in the body, it can lead to hirsuteness even when testosterone is normal. Also, hirsutism is often accompanied by seborrhea and oily skin. Androgenetic alopecia occurs less frequently and later, and acne is more common in teenage patients. So moms, when your child develops long lasting acne, accompanied by irregular menstruation, it’s likely that they’re showing signs of hyperandrogenic skin, and they need to go to the hospital for the appropriate tests! (2) Irregular menstruation and infertility: hyperandrogenism interferes with the growth and development of female follicles, leading to ovulation disorders, luteal insufficiency, and the normal growth and development of follicles is the basis of our conception of new life, which in turn leads to menstrual disorders, scanty menstruation, amenorrhea and infertility. According to a large sample survey, half of the women with PCOS have primary infertility and another quarter have secondary infertility. Therefore, it is recommended that PCOS patients with pregnancy intention still need to monitor ovulation. (3) Masculine features: More androgens will lead to some male features in women, such as low voice tone, prominent laryngeal nodes, enlarged pubic empire, male-type pubic hair distribution, temporal baldness, and even cause breast atrophy in patients. (4) Adverse pregnancy outcome: women should know that even after normal pregnancy, hyperandrogenism will affect pregnancy. It was originally mentioned that hyperandrogenism will affect the luteal function, and in the early stage of pregnancy, what is needed is the support of the corpus luteum of pregnancy, so this is inevitably detrimental to pregnancy, and is likely to lead to miscarriage, and also likely to lead to problems with gender differentiation of the fetus, and fetal malformations. In the late stage, some studies have shown that it may lead to pre-eclampsia, premature rupture of membranes, gestational diabetes, preterm labor and other related adverse pregnancy complications. 2, long-term harm: (1) cardiovascular disease: long-term high androgen may cause metabolic disorders in patients, prone to obesity, hypertension, dyslipidemia and coronary heart disease, increasing the incidence of cardiovascular disease and mortality. Some studies have shown that triglyceride is the earliest performance of hyperandrogenemia abnormal lipid indicators, overweight and obesity is a very serious problem, which also leads to an increase in insulin resistance, glucose and lipid metabolism disorders of the vital factors. Therefore, women should be vigilant if the waist circumference thickening, should be considered to have the situation of hyperandrogenism. (2) Obesity, insulin resistance and diabetes mellitus: Obesity, especially abdominal obesity is associated with hyperandrogenemia, can also increase the risk of metabolic abnormalities. Menstrual disorders and sporadic ovulation are more common in obese patients than in normal weight hyperandrogenic patients. Meanwhile, the incidence of impaired glucose tolerance and type 2 diabetes in hyperandrogenic patients is 5-10 times higher than that in normal people. As mentioned above, dyslipidemia and obesity caused by hyperandrogenism may further lead to glucose metabolism disorders, which in turn increases the risk of insulin resistance and diabetes mellitus. Therefore, when you have the symptoms of Kaohsiung, you need to beware of diabetes and other comorbidities, and go to the hospital in time to do glucose tolerance as well as insulin tests. (3) Endometrial cancer: hyperandrogenism interferes with female ovulation, and prolonged non-ovulation leads to continuous proliferation of the endometrium, which may even develop into endometrial cancer in later stages. Meanwhile, obesity, insulin resistance and diabetes mellitus caused by hyperandrogenism are all risk factors of endometrial cancer. Especially patients who are older and have abnormal uterine bleeding should be alerted to endometrial cancer, and undergo diagnostic scraping if necessary. (4) Psychological problems: infertility, abnormal menstruation, masculinized features, miscarriage and long-term disturbance of cardiovascular diseases will certainly increase the psychological burden of this kind of patients, and the tendency of depression and suicide is higher than that of normal people. Therefore, it is important to take a detailed medical history of these patients to detect the “tip of the iceberg” and treat them accordingly. Treatment of hyperandrogenism For different causes, patients should be treated individually to reduce the production and action of androgens and alleviate the symptoms. If the tumor is caused by ovarian or adrenal tumors, the patient should undergo tumor resection accordingly. However, if adrenal cortical hyperplasia, hypercorticism and other adrenal-related diseases, medication can be used. As for hyperprolactinemia and thyroid-related diseases, the treatment of the primary disease is the fundamental problem. 2, all patients with Kaohsiung, the first thing should be to strengthen physical exercise and good eating habits, can be under the guidance of the doctor to help them lose weight, weight control, can reduce the level of insulin resistance, reduce long-term metabolic disorders, reduce the incidence of cardiovascular disease. 3, the most common cause of high androgen is polycystic ovary syndrome (PCOS), in the clinic, this type of patients usually need medication to reduce androgens, at the same time, some patients also have glucose metabolism disorders, need to be combined with the use of hypoglycemic drugs. It is worth noting that PCOS is often a lifelong disease, patients need to repeatedly monitor their androgens and blood glucose and other conditions, even after giving birth to children, still need to pay attention to their own high androgen problem, timely according to the advice of a professional doctor targeted treatment. In conclusion, hyperandrogenemia may last throughout the patient’s life and affect the cardiovascular system, endocrine metabolism system, reproductive system and other aspects, we need to recognize it, continue to pay attention to it, and deal with it under the guidance of a professional doctor to prevent various long-term complications.