home Diseases Symptoms and treatment of ovarian hyperandrogenism. Hyperandrogenism in women: causes, symptoms, treatment Hyperandrogenism of ovarian origin, treatment with folk remedies

Symptoms and treatment of ovarian hyperandrogenism. Hyperandrogenism in women: causes, symptoms, treatment Hyperandrogenism of ovarian origin, treatment with folk remedies

The ovaries are a paired organ of the female reproductive system, which is responsible for the production of eggs and certain hormones. Hyperandrogenism of ovarian origin is a serious hormonal disorder that requires long-term treatment.

Hyperandrogenism in medicine is the process of excessive production of androgen hormones, which are male hormones, by the ovaries or adrenal glands of a woman. The presence of a large amount of male hormones in the female body negatively affects women's health and is often an obstacle to conceiving or bearing a child.

Hyperandrogenism is a pathology that leads to rare and scanty menstruation or its complete cessation, and as a consequence to the absence of ovulation and infertility.

Excess androgens prevent the normal maturation of follicles during ovulation. The ovaries become overgrown with a dense membrane, which prevents the egg from leaving the follicle each menstrual cycle. Due to hyperandrogenism, a woman may develop a hormonal disease - polycystic ovary syndrome. With this disease, the following hormones may be elevated in the patient’s blood: testosterone, androstenedione, dihydrotesteronedione, insulin and anti-Mullerian hormone. Causes of hyperandrogenism.

Hyperandrogenism of ovarian origin is not a common disease. Statistics say that about 5% of women of reproductive age suffer from this disease. There are many reasons that can cause excessive production of male hormones in a woman’s body. The main causes of the development of the disease in medicine are considered to be malfunctions of the hypothalamus or pituitary gland. These disruptions in the hormonal system affect the increased ratio between the hormones FSH and LH.

In turn, excess LH hormone leads to excessive compaction of the ovarian membrane, which prevents the proper growth of follicles. Insufficient production of the FSH hormone affects the impossibility of follicle maturation, which causes persistent annovulation, which requires long-term treatment with hormonal drugs or surgical intervention.

Symptoms

The primary symptoms of hyperandrogenism include the development of hirsutism in women - excessive growth of body hair according to the male pattern. Hair can appear on various areas: cheeks, chin, upper lip, chest, back, stomach.

In some cases, women may experience bald areas on their scalp. Women's faces become covered with acne and pimples. The skin becomes dry and begins to peel.

There are symptoms of hyperandrogenism that can only be identified with a special examination. These include increased levels of blood glucose and the hormone insulin. Women suffering from hyperandrogenism often have problems with excess weight and obesity. Blood pressure often rises.

Hyperandrogenism in women reduces immunity. They are more likely to suffer from viral diseases, get tired quickly and tend to become depressed.

How to identify

To identify hyperandrogenism, a woman needs to visit an endocrinologist and gynecologist. Usually the endocrinologist gives a referral for a blood test, which determines the level of hormones. With hyperandrogenism of ovarian origin, the following hormones increase in the blood: free and total testosterone, prolactin, DHEA, DHEA-S, androstenedione and FSH level. Blood must be donated in the laboratory on an empty stomach. A blood sample must be taken 3 times with an interval of half an hour between each sampling. Next, the blood is mixed and the hormonal level is determined. By significantly elevated levels of the hormone DHEA-S, tumor diseases of the adrenal glands can be diagnosed.

In addition to laboratory tests, an endocrinologist or gynecologist should refer a woman to ultrasound, MRI and CT. Such examinations should confirm the correctness of the diagnosis or refute it. If hyperandrogenism is caused by the presence of polycystic ovary syndrome, on an ultrasound the doctor will see enlarged ovaries with many located follicles enclosed in a dense membrane.

How to treat

Hyperandrogenism must be treated, since this disease significantly worsens a woman’s quality of life.

If the patient is planning a pregnancy, the doctor initially prescribes medications that normalize the levels of insulin and glucose in the blood. These drugs include: metformin, glucophage, Siofor. To reduce the level of male hormones, metipred or cortef are prescribed.

If, against the background of hyperandrogenism, a woman has developed persistent annovulation, the doctor will suggest stimulation of ovulation with clomiphene or drugs containing the FSH hormone. The first group of drugs includes clostilbegit. This medicine stimulates follicle growth. If it is possible to grow the follicle to 18-25 mm, the doctor may prescribe an injection containing the hCG hormone to release the egg. However, not all women's ovaries react to clomiphene. If the ovaries do not respond to stimulation, doctors switch the patient to drugs containing the FSH hormone. Such drugs include menopur and pregnyl.

When stimulating ovulation, it is important for the doctor to select the necessary dosage of drugs so as not to cause ovarian hyperstimulation syndrome. This is a process when an overripe follicle does not burst and develops into a cyst. Several follicular cysts can form on the ovaries, which cause acute nagging pain in the lower abdomen and pose a danger to the life and health of the woman.

If a patient with hyperandrogenism of ovarian origin does not plan pregnancy in the near future, the doctor prescribes a course of treatment with birth control pills containing female sex hormones - estrogens. These include: Yarina, Diane-35, Jess and Chloe. Contraceptive drugs allow the ovaries to “rest”. They prevent the onset of ovulation and help the ovaries not to increase in volume. In addition, there is a theory that some patients were able to become pregnant immediately after stopping birth control.

Tumors on the ovaries are removed promptly. The patient needs surgery if drug treatment does not lead to the desired result. Doctors often perform laparoscopic surgery on women, which involves resection or cauterization of the ovaries. Laparascopic surgery is considered less traumatic and therefore has a quick recovery period. Such surgical procedures allow a woman to restore ovulation and give a chance for a long-awaited pregnancy. You should know that after the operation, the doctor gives the woman a year to conceive a child, since the disease often returns after the specified period. If all attempts to conceive are unsuccessful, a woman should seriously think about the IVF procedure.

If pregnancy occurs, you need to be aware that throughout the entire 9 months, the doctor can prescribe hormonal medications to the patient to reduce the threat of miscarriage or fetal death.

If a woman discovers symptoms inherent in ovarian hyperandrogenism, she should immediately seek help from an endocrinologist and gynecologist. Remember, any disease is easier to treat at an early stage, but hyperandrogenism requires long-term and persistent treatment.

I found this very detailed article. a lot of words, but I hope it helps someone

R.A.MANUSHAROVA, Doctor of Medical Sciences, Professor, E.I.CHERKEZOVA, medical sciences, department of endocrinology and diabetology with a course of endocrine surgery, State Educational Institution of Additional Professional Education RMA PO, Moscow

"Hyperandrogenism", or " hyperandrogenemia", - this term refers to an increased level of male sex hormones () in the blood of women. Hyperandrogenism syndrome implies the appearance in women under the influence of androgens of signs characteristic of men: male-type hair growth on the face and body; the appearance of acne on the skin; hair loss on head (alopecia); decrease in voice timbre (baryphonia); changes in physique (masculinization - masculinus - “male” phenotype) with expansion of the shoulder girdle and narrowing of the hips. The most common and earliest manifestation of hyperandrogenism is hirsutism - excess hair growth in women in androgen-dependent zones, male pattern hair growth.Hair growth with hirsutism is observed on the abdomen along the midline, face, chest, inner thighs, lower back, and in the intergluteal fold.

Women with hyperandrogenism are at increased risk for complications of childbirth. The most common of them are untimely rupture of amniotic fluid and weakness of labor.

It is necessary to distinguish between hirsutism and hypertrichosis - excessive hair growth on any part of the body, including those where hair growth does not depend on androgens.
Hypertrichosis can be either congenital (inherited autosomal dominantly) or acquired as a result of anorexia nervosa, porphyria, and can also occur with the use of certain medications: phenotoin, cyclosporine, diazoxide, anabolic steroids, etc.

There are three stages of hair growth: the growth stage (anagen), the transition stage (catagen), and the resting stage (telogen). During the last stage, hair falls out.

Androgens affect hair growth depending on its type and location. Thus, in the early stages of sexual development, under the influence of a small amount of androgens, hair growth begins in the axillary and pubic areas. With more androgens, hair appears on the chest, stomach and face, and with very high levels, hair growth on the head is suppressed and bald patches appear above the forehead. Moreover, androgens do not affect the growth of vellus hair, eyelashes and eyebrows.

The severity of hirsutism is often arbitrarily defined and graded as mild, moderate, or severe. One of the objective methods for assessing the severity of hirsutism is the Ferrimann and Gallway scale (1961). According to this scale, the growth of androgen-dependent hair is assessed in 9 areas of the body with points from 0 to 4. If the sum of points is more than 8, a diagnosis of hirsutism is made.

With functional hyperandrogenism (polycystic ovary syndrome (PCOS), ovarian thecamatosis, etc.), hirsutism develops gradually, accompanied by the appearance of acne, weight gain and irregular menstruation. The sudden appearance of hirsutism with signs of rapidly developing virilization may indicate androgen-producing tumors of the ovaries or adrenal glands.

Hyperandrogenism– an increase in the level of male sex hormones in the blood of women leads to menstrual irregularities, excessive hair growth, virilization, and infertility.

With hyperandrogenism, tissue sensitivity to insulin is often impaired. In this condition, the level of insulin in the blood increases and the risk of developing diabetes increases.

An increase in the amount of male sex hormones may be associated with pathology of other endocrine organs, such as the thyroid gland or pituitary gland. With neuroendocrine syndrome (dysfunction of the hypothalamus and pituitary gland), the disease is accompanied by a significant increase in body weight.

The main androgens include testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA) and its sulfate, androstenedione, d5 - androstenediol, d4 - androstenedione.

Testosterone is synthesized from cholesterol that enters the human body with animal products or synthesized in the liver, and is delivered to the outer mitochondrial membrane. Transport of cholesterol to the inner mitochondrial membrane is a gonadotropin-dependent process. On the inner membrane of mitochondria, cholesterol is converted into pregnenalone (the reaction is carried out by cytochrome P450). In the smooth endoplasmic reticulum, which follows two pathways for the synthesis of sex hormones: d5 (mainly in the adrenal glands) and d4 (mainly in the ovaries), subsequent reactions take place. Free and albumin-bound testosterone is biologically available.

In women, testosterone is produced in the ovaries and adrenal glands. In the blood, 2% of testosterone circulates in a free state, 54% is bound to albumin, and 44% is bound to globulin-binding sex steroids. The level of GSPS is increased by estrogens, and lowered by androgens, so in men the level of GSPS is 2 times lower than in women.

A decrease in the level of SHPS in blood plasma is observed with:

obesity;
excessive formation of androgens;
treatment with corticosteroids;
hypothyroidism;
acromegaly.

An increase in the level of GSPS occurs when:

treatment with estrogens;
pregnancy;
hyperthyroidism;
liver cirrhosis.

Testosterone associated with GSPC performs some functions on the cell membrane, but cannot penetrate inside. Free testosterone can convert into 5a-DHT or bind to the receptor and penetrate target cells. Biologically available is the sum of the fractions of free and albumin-bound testosterone.

Dehydroepiandrosterone (DHEA) is produced in the testes, ovaries and adrenal glands. It was first isolated in 1931 and is a weak androgen. Once converted to testosterone in peripheral tissues, it has effects on the cardiovascular and immune systems.
Androstenedione, a precursor to testosterone, is produced in the testes, ovaries and adrenal glands. The transition of androstenedione to testosterone is a reversible process.

Androgens exert their action at the cellular level through high-affinity nuclear receptors. Under the action of the enzyme aromatase, androgens are converted to estrogens.
Free testosterone enters the target cell and binds to the androgen receptor on the DNA of the X chromosome. Testosterone or DHT, depending on the activity of 5a-reductase in the target cell, interacts with the androgen receptor and changes its configuration, resulting in a change in receptor dimers that are transmitted to the cell nucleus and interact with the target DNA.

Dehydrotestosterone and then testosterone have a high affinity for androgen receptors, while adrenal androgens (DHEA, androstenedione) have a low affinity.
The effects of testosterone include: differentiation of male sexual characteristics; the appearance of secondary sexual characteristics; growth of male genital organs; pubic hair growth; hair growth in the armpits and on the face; growth spurt during puberty; closure of the epiphyses; growth of the Adam's apple; thickening of the vocal cords; increased muscle mass, thickening of the skin; functioning of the sebaceous glands. Testosterone also affects libido and potency, and increases aggression.

With hyperandrogenism it is noted:

male pattern hair growth on the face and body;
the appearance of acne on the skin;
hair loss on the scalp (alopecia);
decreased voice timbre (baryphonia);
change in physique (masculinization) with expansion of the shoulder girdle and narrowing of the hips.

Hyperandrogenism develops with the following diseases of the hypothalamic-pituitary system:

neuroendocrine-metabolic syndrome with obesity and gonadotropic
dysfunction;
corticotropinoma (Itsenko-Cushing's disease);
somatotropinoma (acromegaly);
functional hyperprolacthymemia and against the background of prolactinoma;
gonadotropinomas, hormonally inactive pituitary adenoma, “empty” sella syndrome;
anorexia nervosa;
obesity and type 2 diabetes mellitus;
insulin resistance syndromes (including acanthosis nigricans type A (insulin receptor gene mutation) and leprechaunism);
secondary hypothyroidism.

There are ovarian and adrenal forms of hyperandrogenism, and each of them has tumor and non-tumor forms. PCOS, stromal hyperplasia and ovarian thecamatosis are indicated by non-tumor or functional hyperandrogenism of ovarian origin, and congenital adrenal cortex dysfunction (CAD) is indicated by functional hyperandrogenism of adrenal origin. The tumor form of hyperandrogenism causes androgen-producing tumors of the ovaries or adrenal glands. With corticosteroma, severe hyperandrogenism is observed.

Treatment of the non-classical form of congenital adrenal dysfunction must begin with the suppression of elevated levels of ACTH (corticotropin). Dexamethasone is used for this purpose. In equivalent doses, it has a more pronounced effect compared to other glucocorticoids and retains fluid to a lesser extent. When treating with dexamethasone, it is necessary to monitor cortisol concentrations. Control is carried out in the morning.

In patients with CAI, after taking adequate doses of dexamethasone, the menstrual cycle is usually restored, and in the majority it becomes ovulatory.

In the absence of ovulation while taking glucocorticoid drugs in the non-classical form of CAH or in case of insufficiency of the luteal phase of the menstrual cycle, clomiphene citrate (clostilbegit (Egis, Hungary); clomid (Hoechst Marion RousseI, Germany) is prescribed according to the generally accepted scheme from 5 to 9 or s Days 3 to 7 of the menstrual cycle. Due to its similarity with estrogen receptors in target cells in the ovaries, pituitary gland and hypothalamus, the drug clomiphene citrate has two opposite effects: weak estrogenic and pronounced antiestrogenic. Due to the fact that the effectiveness of therapy is noted when androgen synthesis is suppressed adrenal glands, stimulation of ovulation should be carried out while taking glucocorticoids.

In women with combined therapy, ovulation often occurs and pregnancy occurs. Discontinuation of glucocorticoid treatment after pregnancy may lead to spontaneous miscarriage or cessation of development of the fertilized egg, so therapy should be continued.

Gonadotropic drugs LH and FSH can be used to stimulate ovulation according to the usual regimen, but always while taking glucocorticoids.

If, during therapy with clostilbegit on the days of expected ovulation (day 13-14 of the cycle), insufficiency of the corpus luteum phase persists, then drugs containing gonadotropins (LH and FSH) are administered: prophase, pregnyl, pergonal, etc. in large doses (5000-10,000 ED). It should be remembered that when using these drugs, ovarian hyperstimulation syndrome (OHSS) may develop.

Patients with CDCN over the age of 30 years with ineffective treatment of infertility for more than 3 years and the presence of an ultrasound picture of polycystic ovaries are indicated for surgical treatment - wedge resection using a laparoscopic approach, demedulation or electrocauterization of the ovaries. At the same time, treatment with glucocorticoids is continued.
Low- and micro-dose combined oral contraceptives (COCs) with antiandrogenic effects are used to treat patients with CAH and severe hirsutism. The most effective among them are: Diane-35, Janine, Yarina, etc. These drugs contain estrogens and gestagens. Under the influence of estrogens, the production of sex steroid binding globulin (SHBG) in the liver increases, which is accompanied by increased binding of androgens. As a result, the content of free androgens decreases, which reduces the manifestations of hirsutism. The antigonadotropic effect of these drugs suppresses the formation of gonadotropins in the anterior lobe of the pituitary gland, and the gonadotropic function of the pituitary gland in CAH is suppressed by the high level of androgens circulating in the blood. Consequently, the effect of COCs can lead to an even greater decrease in the concentration of gonadotropins and aggravate menstrual irregularities. In this regard, the use of COCs for VDC should not be long-term.

Treatment of androgen-producing ovarian tumors. In order to identify metastases, the pelvis and omentum are examined. Chemotherapy is carried out when distant metastases are detected. In the absence of signs of malignant growth and dissemination in such patients of reproductive age, unilateral adnexectomy is performed, and in postmenopausal women, extirpation of the uterus and appendages is performed. After the operation, dynamic monitoring of patients, monitoring of hormone levels, and ultrasound of the pelvic organs are necessary. In the absence of metastases and dissemination, after removal of the ovarian tumor, patients of reproductive age experience complete recovery: symptoms of virilization disappear, the menstrual cycle and fertility are restored. Ten-year survival depends on histological features and tumor size and ranges from 60-90%.

For hormonally active adrenal tumors, surgery is indicated, since there is no conservative treatment. A contraindication is only severe dissemination of the process. In case of decompensation of the cardiovascular system or purulent complications, the operation is postponed. In this case, according to indications, cardiac, antihypertensive, and sedatives are prescribed; Before surgery, patients with diabetes mellitus are transferred to simple insulin therapy in fractional doses.

The surgical approach depends on the size and location of the tumor. Recently, surgical treatment on the adrenal glands is carried out using the laparoscopic method. The course of the postoperative period depends on the degree and type of hormonal activity of the tumor and the metabolic disorders caused by it. Therefore, patients need to be prescribed specific hormonal therapy.

Treatment of idiopathic hirsutism. To treat idiopathic hirsutism, antiandrogens are used - modern microdosed drugs containing estrogens and gestagens. Among these drugs, Diane-35 in combination with Androcur, as well as Zhanin, Belara, Yarina, have the greatest antiandrogenic activity.

In addition to combined oral contraceptives, androgen antagonists are prescribed:

spironolactone, which inhibits 5a-reductase at the cellular level and reduces the rate of conversion of testosterone to dehydrotestosterone;
cyproterone acetate is a progestin that blocks androgen receptors at the cellular level;
cimetidine is an antagonist of histamine receptors that blocks the action of androgens at the cellular level;
desogestrel, ketoconazole, metrodin - increasing the level of GSPS, binding testosterone and making it biologically inactive;
flutamide is a non-steroidal antiandrogen that binds to androgen receptors, suppressing testosterone synthesis to a lesser extent;
finasteride – has an antiandrogenic effect due to inhibition of 5a-reductase activity and does not affect androgen receptors;
ketocanazole – suppresses steroidogenesis;
medroxyprogesterone - suppresses the secretion of gonadoliberin and gonadotropins, reducing the secretion of testosterone and estrogens;
analogues of gonadotropin-releasing hormone (GnRH) – acting on the functional state of the ovaries, suppressing the secretion of estrogens and androgens;
glucocorticoids.

If there is no effect from the use of combined oral contraceptives, the administration of flutamide reduces hair growth, reduces the levels of androstenedione, dihydrotestosterone, LH and FSH. COCs and flutamide can cause the following side effects: dry skin, hot flashes, increased appetite, headache, dizziness, breast engorgement, decreased libido, etc.

The use of ketoconazole is accompanied by a significant decrease in the level of androstenedione, total and free testosterone in the blood serum. A decrease in androgen levels leads to weakening or elimination of hair growth.

Medroxyprogesterone acts on the level of sex hormone binding globulin, reducing the content of the latter. When using the drug, 95% of patients note a decrease in hirsutism. When using the drug, the following side effects may be observed: amenorrhea, headache, edema, weight gain, depression, changes in biochemical parameters of liver function.

The use of GnRH analogues causes reversible drug castration, which is accompanied by a weakening of hirsutism. However, their use for more than 6 months leads to the development of symptoms of the postmenopausal period (hot flashes, feeling of heat, vaginal dryness, dyspareunia, osteoporosis). The development of the above symptoms is prevented by the administration of estrogens or COCs simultaneously with GnRH analogues.

If the level of dehydroepiandrosterone or 17 OH-progesterone in the blood is elevated, glucocorticoids are prescribed. Of these, dexamethasone is the most effective. While taking the drug, hirsutism decreases in patients and other symptoms of hyperandrogenism disappear. When dexamethosone is prescribed to patients, the pituitary-adrenal system may be suppressed, so it is necessary to monitor the level of cortisol in the blood.

Treatment of polycystic ovary syndrome

When treating PCOS, it is necessary to restore the ovulatory menstrual cycle and fertility, eliminate the manifestations of androgen-dependent dermopathy; normalize body weight and correct metabolic disorders; prevent late complications of PCOS.
Insulin resistance (IR) and obesity, which potentiates it, are the most important pathogenetic link of anovulation in PCOS.

In the presence of obesity (BMI>25 kg/m2), treatment of PCOS should begin with weight loss. Drugs that reduce body weight are prescribed against the background of a low-calorie diet containing no more than 25-30% fat, 55-60% slowly digestible carbohydrates, 15% protein of the total calorie intake. Salt intake is limited. Diet therapy must be combined with increased physical activity.

Excess body weight in PCOS causes hyperinsulinemia (HI) and decreased sensitivity of peripheral tissues to insulin (IR). However, a number of studies have shown that in PCOS, insulin sensitivity is reduced in patients not only with increased, but also with normal or decreased BMI. Thus, PCOS is an independent factor that reduces tissue sensitivity to insulin. Obesity, observed in 50-70% of patients with PCOS, has an independent negative effect, potentiating IR.

To relieve IR, biguanides are prescribed. In Russia, metformin is used (Siofor, Berlin Chemie, Germany). The use of this drug in PCOS reduces blood glucose levels, suppresses gluconeogenesis in the liver and increases the sensitivity of peripheral tissues to insulin. As a result of the use of metformin, body weight is reduced, the menstrual cycle is normalized, and the level of testosterone in the blood decreases, but ovulation and pregnancy are not always observed.

Stimulation of ovulation is the second stage of treatment for PCOS. But with a combination of obesity and PCOS, ovulation stimulation is considered a medical error. After normalization of body weight, clomiphene is prescribed to stimulate ovulation. If stimulation is ineffective after 6 months of treatment, the patient can be considered clomiphene-resistant. This is observed in 20-30% of patients with PCOS. In this case, FSH drugs are prescribed: menogon - human menopausal gonadotropin or synthesized recombinant FSH. GnRH analogues are prescribed to patients with PCOS and high LH levels. Under the influence of these drugs, desensitization of the pituitary gland occurs, increasing the frequency of ovulation after the administration of FSH drugs.

If there is no effect from conservative therapy, surgical stimulation of ovulation is resorted to. Laparoscopic access is used to perform wedge resection or demedulation or cauterization of both ovaries. The use of the endoscopic method of intervention made it possible to significantly reduce the incidence of adhesions compared to laparotomy.

Surgical treatment of PCOS is used in the following cases:

when PCOS is combined with recurrent dysfunctional uterine bleeding and endometrial hyperplasia, regardless of the presence or absence of obesity;
in women with normal body weight with a significant increase in the level of LH in the blood plasma;
in women over 35 years of age, even if they are obese. In this case, intensive obesity therapy is carried out immediately after surgery.

The following factors can lead to a decrease in the frequency of regulation of the menstrual cycle and pregnancy:

duration of anovulation and woman’s age over 30 years;
large ovaries with a subcapsular arrangement of atretic follicles around a hyperplastic stroma;
pronounced IR and GI regardless of body weight;
menstrual irregularities such as amenorrhea.

Treatment of hirsutism in PCOS. To treat hirsutism in PCOS, the same drugs are used as for the treatment of idiopathic hirsutism (see above).

Due to the fact that hirsutism is caused by hyperandrogenism, drugs that reduce androgen levels and suppress androgen receptors are used for treatment; reducing the formation of androgens; suppressive enzyme systems involved in the synthesis of androgens, in the production of (extragonadal) testosterone and its conversion to DHT.

Due to the fact that treatment of hirsutism with medication is a lengthy process, many women use various types of hair removal (electrical, laser, chemical, mechanical, photoepilation).

Treatment of complications of PCOS

To prevent the development of metabolic disorders, it is necessary to reduce body weight. To prevent the development of endometrial hyperplasia, it is necessary to conduct ultrasound monitoring of the condition of the endometrium and, if necessary, treat with progesterone derivatives. In the presence of GE (endometrial thickness more than 12 mm), curettage of the uterine mucosa is prescribed under the control of hysteroscopy, and a histological examination is also performed.
In addition to restoring fertility, treatment of PCOS must be carried out in order to correct metabolic disorders that are the background to the occurrence of type 2 diabetes mellitus, early atherosclerosis, hypertension, as well as a high risk of developing endometrial hyperplasia and adenocarcinoma.

Hyperandrogenism in women is a hormonal imbalance in which the concentration of male sex hormones (androgens) increases. Sex hormones are active substances that perform a regulatory function and ensure the appearance of secondary sexual characteristics and the difference between men and women.

Sex hormones play a key role in the process of human reproduction: maturation of germ cells, pregnancy and childbirth.

Normally, a certain amount of male sex hormones circulates in a woman’s body.. However, in some cases, their concentration may exceed permissible values, as a result of which a woman will begin to exhibit male characteristics and the normal functioning of the ovaries will be disrupted.

A particular danger is the increase in androgen levels during pregnancy. An increase in the amount of male sex hormones may be associated with their secretion in the ovaries or adrenal glands.

To normalize hormonal balance, you can use folk remedies. This treatment of hyperandrogenism has a gentle complex effect on the body, improves metabolism and normalizes ovarian function. In order for therapy to be effective, medications must be taken systematically.

Androgens in women

Normally, a certain amount of male sex hormones circulates in the female body. Androgens are produced by the adrenal glands, ovaries and, in small quantities, by subcutaneous fat. Regulation of the synthesis of male sex hormones is carried out using pituitary hormones. Androgens are precursors to other hormones: corticosteroids and estrogens. These substances are also involved in the process of human growth and puberty. The ratio of androgens and estrogens determines libido.

However, if the amount of androgens in a woman’s body exceeds the norm, she develops pathological processes, metabolic disorders and reproductive function occur. This condition also increases the likelihood of developing diseases of the reproductive system, in particular erosion, dysplasia and cervical cancer.

Hyperandrogenism in women: classification

Depending on the source of male sex hormones, there are:

hyperandrogenism of ovarian origin;
adrenal hyperandrogenism;
mixed.

Depending on the origin, there are two forms of the disease;

hereditary;
acquired.

Depending on the amount of androgens, two types of the disease are distinguished:

absolute hyperandrogenism – there is an increase in the concentration of male sex hormones in the blood;
relative - the concentration of androgens remains normal, but their activity increases or the sensitivity to target cell hormones increases.

Reasons why hyperandrogenism develops in women

Hyperandrogenism is a complex of syndromes that have similar manifestations, but are caused by different reasons:

Adrenogenital syndrome.
This disease is the most common cause of hyperandrogenism in women. In this case, the adrenal glands produce a normal amount of androgens, but do not convert them further.
Normally, male sex hormones are produced in the adrenal glands, and then, under the action of a special enzyme, are converted into glucocorticoids - other very important hormones. However, if a woman does not produce enough of this enzyme or the enzyme itself is defective, androgens are not converted into glucocorticoids, but remain unchanged in the woman’s body, binding to target cells and having a pathological effect.
Adrenal tumors.
The development of a tumor increases the number of active adrenal cells, and therefore increases the production of male sex hormones.
.
In this case, there is an increase in the number of ovarian cells that produce androgens. Disruption of the normal functioning of the pituitary gland.
Pituitary hormones regulate the production of other hormones, in particular androgens. Disruption of the normal functioning of the pituitary gland causes complex endocrine disorders of the body, including hyperandrogenism in women.
Increased sensitivity of target cells.
Some women experience individual signs of hyperandrogenism, in particular (excessive hair growth) and acne, but the concentration of androgens in their body does not exceed the norm. Symptoms of this pathology appear in them because the skin cells of such women are overly sensitive to androgens, and even a small concentration of them leads to the manifestation of pathological symptoms.

Symptoms of pathology

Signs of hyperandrogenism may vary. They depend on the form of the disease, the level of androgens and the woman’s sensitivity to them. The first signs of a disorder in the congenital form of the disease are observed during the girl’s puberty.

Hyperandrogenism is manifested by skin disorders: acne, oily seborrhea, profuse acne.
Excessive hair growth on the face, arms and legs.
Also, a girl’s menstrual cycle may be disrupted: menstruation is irregular, delays often occur, and in some patients menstruation may be absent.

As the disease progresses and male sex hormones accumulate, the girl may develop pathological changes in ovarian tissue, in particular polycystic disease. Amenorrhea occurs and an insufficient amount of female sex hormones is produced. Hyperplasia of the endometrium of the uterus also develops. Emerging disorders often manifest themselves.

Manifestations of hyperandrogenism continue after menopause. These women experience male pattern hair loss. They also suffer from skin diseases. Hormonal imbalance and external manifestations of hyperandrogenism often lead to the development of depression and neurosis.

In more severe cases of hyperandrogenism, disturbances in the structure of the genital organs and reproductive function occur. Against the background of this condition, a woman may develop pseudohermaphroditism, late onset of menstruation, masculine appearance, poor breast development, and a rough voice. Another symptom of this condition is male pattern obesity.

An increase in the concentration of male sex hormones provokes systemic disorders of the body:

metabolic diseases;
increased blood pressure;
heart failure.

With hyperandrogenism, the sensitivity of cells to the hormone insulin is impaired. This can lead to the development of type 2 diabetes, in which the cells of the pancreas produce a sufficient amount of insulin, but it cannot fully perform its functions. This condition is difficult to treat.

If the disease is not caused by a tumor, then the symptoms of this pathology gradually increase. This process can last several years. If hyperandrogenism is caused by a tumor process in the ovaries or adrenal glands, the symptoms of the disease are similar, but increase very quickly.

Hyperandrogenism during pregnancy

An increase in the concentration of androgens affects the general hormonal background of a woman and reproductive function. Pathological changes in the body against this background can become a serious obstacle to the conception and birth of a healthy child. However, for some girls with this disease, pregnancy is still possible. It all depends on the form and severity of the disease.

Hyperandrogenism can cause disruption of the structure of ovarian tissue and the development of polycystic disease. Also, a dense capsule may form around the organ. This interferes with the normal functioning of the ovaries: estrogen production and ovulation. When the amount of androgens exceeds a certain critical level, the patient experiences anovulation.

If the patient develops mild hyperandrogenism, conception may still occur. However, in this case, the likelihood of miscarriage in the first or second trimester of pregnancy increases. This can be caused by both an excess of male sex hormones and a decrease in the level of progesterone, a hormone that plays a key role in bearing a baby. A decrease in the amount of progesterone is often observed with hyperandrogenism in women.

Women with this disease also have a difficult time giving birth. They may experience untimely discharge of amniotic fluid. An insufficient amount of female sex hormones can cause weak contractile activity of the uterus.

Diagnosis of the disease

To make an accurate diagnosis, anamnesis is collected, including family history, in order to establish a hereditary predisposition to this pathology. A physical examination of the patient is also carried out, which allows us to identify external manifestations of hyperandrogenism: skin diseases, increased hair growth, developmental disorders of the genital organs. However, the main diagnostic criterion is an increase in the concentration of androgens in the blood. A laboratory blood test is performed for hormones. It is important to determine the concentration of all hormones, this will help determine the cause of the pathology.

To exclude the possibility of a tumor, an ultrasound examination of the abdominal and pelvic organs, as well as a more informative computed tomography of the adrenal glands, are performed. Ultrasound examination also reveals polycystic ovary syndrome.

Treatment of the disease

Hyperandrogenism is a disease that has a complex negative effect on a woman’s body and causes many disorders: endocrine and metabolic pathologies, reproductive dysfunction. A systematic approach is important for its treatment.

Traditional medicine suggests correcting the hormonal balance of a woman’s body with the help of oral contraceptives. However, such treatment completely eliminates the possibility of pregnancy. There are folk remedies that help normalize metabolism and hormonal balance in the body. This treatment has a mild effect. To achieve a positive effect, it is necessary to use folk remedies systematically and for a long time. Treatment of hyperandrogenism with folk remedies lasts at least six months.

Traditional recipes:

Also, in addition to taking medications, it is necessary to change your lifestyle. Women with hyperandrogenism are often overweight. Such a woman needs to fight obesity. For these purposes, it is useful to adjust your diet and exercise. Moderate sports exercises will help improve your well-being and metabolism. Weight correction is necessary not only to improve a woman’s well-being, but also for her psychological comfort.

To improve psychological comfort, positive emotions are necessary. Patients with hyperandrogenism often experience neurotic disorders caused by external manifestations of the disease and the inability to conceive and bear a child. Sports and walking in the fresh air, communication with loved ones, new acquaintances and interests, walks and trips will help improve your overall health. This will improve a woman’s mood and help cope with depression.

Hyperandrogenism in women is a collective term that includes a number of syndromes and diseases accompanied by an absolute or relative increase in the concentration of male sex hormones in a woman’s blood. Today, this pathology is quite widespread: according to statistics, 5-7% of teenage girls and 10-20% of women of childbearing age suffer from it. And since hyperandrogenism not only entails various defects in appearance, but is also one of the causes of infertility, it is important for women to have an understanding of this condition so that, if they notice such symptoms, they can immediately seek help from a specialist.

You will learn from our article about the causes of hyperandrogenism in women, its clinical manifestations, as well as how the diagnosis is made and the tactics for treating this pathology. But first, let's talk about what androgens are and why they are needed in the female body.

Androgens: basic physiology

Androgens are male sex hormones. The leading and most famous representative of them is testosterone. In a woman’s body, they are formed in the cells of the ovaries and adrenal cortex, as well as in subcutaneous fatty tissue (SFA). Their production is regulated by adrenocorticotropic (ACTH) and luteinizing (LH) hormones synthesized by the pituitary gland.

The functions of androgens are multifaceted. These hormones:

are precursors of corticosteroids and estrogens (female sex hormones);
form a woman’s sexual desire;
during puberty, they determine the growth of tubular bones, and therefore the growth of the child;
participate in the formation of secondary sexual characteristics, namely, female-type hair growth.

Androgens perform all these functions under the condition of their normal, physiological concentration in the female body. An excess of these hormones causes both cosmetic defects and metabolic disorders and a woman’s fertility.

Types, causes, mechanism of development of hyperandrogenism

Depending on the origin, there are 3 forms of this pathology:

ovarian (ovarian);
adrenal;
mixed.

If the root of the problem is located in these organs (ovaries or adrenal cortex), hyperandrogenism is called primary. In the case of pathology of the pituitary gland, which causes disturbances in the regulation of androgen synthesis, it is regarded as secondary. In addition, this condition can be inherited or develop during a woman’s life (that is, acquired).

Depending on the level of male sex hormones in the blood, hyperandrogenism is distinguished:

absolute (their concentration exceeds normal values);
relative (the level of androgens is within normal limits, but they are intensively metabolized into more active forms, or the sensitivity of target organs to them is significantly increased).

In most cases, the cause of hyperandrogenism is. It also occurs when:

adrenogenital syndrome;
neoplasms or ovaries;
and some other pathological conditions.

Hyperandrogenism can also develop as a result of a woman taking anabolic steroids, male sex hormones and cyclosporine.

Clinical manifestations

Such women are concerned about increased hair loss on the head and its appearance in other places (on the face or chest).

Depending on the causative factor, the symptoms of hyperandrogenism vary from insignificant, mild hirsutism (increased hair growth) to pronounced virile syndrome (the appearance of secondary male sexual characteristics in a sick woman).

Let us consider in more detail the main manifestations of this pathology.

Acne and seborrhea

– a disease of the hair follicles and sebaceous glands that occurs if their excretory ducts become blocked. One of the reasons (or rather, the pathogenesis links) of acne is precisely hyperandrogenism. It is physiological for the puberty period, which is why rashes on the face are found in more than half of adolescents.

If acne persists in a young woman, it makes sense for her to be examined for hyperandrogenism, the cause of which in more than a third of cases turns out to be polycystic ovary syndrome.

Acne can occur independently or be accompanied (increased production of sebaceous gland secretions selectively - in certain areas of the body). It can also occur under the influence of androgens.

Hirsutism

This term refers to excess hair growth in females in areas of the body that are dependent on androgens (in other words, a woman’s hair grows in places typical for men - on the face, chest, between the shoulder blades, and so on). In addition, the hair changes its structure - from soft and light vellus it becomes hard, dark (they are called terminal).

Alopecia

This term refers to baldness. Alopecia associated with excess androgens means a change in the structure of hair on the head from terminal (saturated with pigment, hard) to thin, light, short vellus and its subsequent loss. Baldness is found in the frontal, parietal and temporal areas of the head. As a rule, this symptom indicates prolonged high hyperandrogenism and is observed in most cases with neoplasms that produce male sex hormones.

Virilization (viril syndrome)

This term refers to the loss of female characteristics by the body, the formation of male characteristics. Fortunately, this is a fairly rare condition - it is found in only 1 in 100 patients suffering from hirsutism. The leading etiological factors are adrenoblastoma and ovarian tecomatosis. Less commonly, this condition is caused by androgen-producing adrenal tumors.

Virilization is characterized by the following symptoms:

hirsutism;
acne;
androgenetic alopecia;
decrease in voice timbre (baryphonia; the voice becomes rough, similar to a man’s);
reduction in the size of the gonads;
increase in the size of the clitoris;
muscle growth;
redistribution of subcutaneous fat tissue according to the male type;
menstrual irregularities up to;
increased sexual desire.

Diagnostic principles

An increase in the level of androgens in the patient's blood confirms the diagnosis.

In the diagnosis of hyperandrogenism, both complaints, anamnesis and data on the objective status of the patient, as well as laboratory and instrumental research methods, are important. That is, after assessing the symptoms and medical history, it is necessary not only to identify the fact of an increase in the level of testosterone and other male sex hormones in the blood, but also to detect their source - a neoplasm, polycystic ovary syndrome or other pathology.

Sex hormones are examined on days 5-7 of the menstrual cycle. The blood levels of total testosterone, SHBG, DHEA, follicle-stimulating hormone, luteinizing hormone, and 17-hydroxyprogesterone are determined.

To detect the source of the problem, an ultrasound of the pelvic organs is performed (if ovarian pathology is suspected, using a transvaginal sensor) or, if possible, magnetic resonance imaging of the area.

In order to diagnose an adrenal tumor, the patient is prescribed a computer scan, or scintigraphy with radioactive iodine. It is worth noting that small tumors (less than 1 cm in diameter) cannot be diagnosed in many cases.

If the results of the above studies are negative, the patient may be prescribed catheterization of the veins that carry blood from the adrenal glands and ovaries in order to determine the level of androgens in the blood flowing directly from these organs.

Principles of treatment

The treatment tactics for hyperandrogenism in women depend on the pathology that caused this condition.

In most cases, patients are prescribed combined oral contraceptives, which, in addition to contraception, also have an antiandrogenic effect.

Adrenogenital syndrome requires the administration of glucocorticoids.

If the level of androgens in a woman’s blood is elevated due to hypothyroidism or elevated prolactin levels, drug correction of these conditions comes to the fore, after which the concentration of male sex hormones decreases by itself.

In case of obesity and hyperinsulism, a woman is advised to normalize her body weight (by following dietary recommendations and regular physical activity) and take metformin.

Neoplasms of the adrenal glands or ovaries that produce androgens are removed surgically, even despite their benign nature.

Which doctor should I contact?

If you have symptoms of hirsutism, you should contact a gynecologist-endocrinologist. Additional assistance will be provided by specialized specialists - dermatologist, trichologist, nutritionist.

Conclusion

Hyperandrogenism in women is a complex of symptoms that arise as a result of increased concentrations of male sex hormones in the blood, accompanying the course of a number of endocrine diseases. The most common causes are polycystic ovary syndrome and adrenogenital syndrome.

The pathological state of hormonal balance in the female body, in which there is excessive production of male sex hormones - androgens, is called hyperandrogenism. The disease is associated with disturbances in the functioning of the endocrine system. Hyperandrogenism syndrome is observed in approximately 5-7% of women, about 20% of them cannot become pregnant or bear a child.

Normally, androgens are produced by the genitals in quantities that ensure the growth of pubic and armpit hair, the formation of the clitoris, timely puberty and sexual desire. Androgens are responsible for the normal functioning of the liver and kidneys.

Active production of androgens occurs in adolescence, during the formation of secondary sexual characteristics. In adulthood, androgens are necessary to strengthen bone tissue. However, excessive production of these hormones leads to pathological changes that significantly worsen a woman’s quality of life. The most disastrous results include and. In these cases, treatment is necessary that will help normalize hormonal levels.

Types and causes of the syndrome

The process of androgen maturation occurs in the ovaries and adrenal glands. The normal amount of hormone produced and its correct ratio with estrogens ensures the hormonal balance necessary for the full functioning of the body.

Depending on the origin of the pathology, there are several forms:

Hyperandrogenism of ovarian origin – occurs with polycystic ovary syndrome. The reason is a disruption of the hypothalamic-pituitary system. The disorder is hereditary.
Hyperandrogenism of adrenal origin is caused by disruption of the adrenal cortex. The disease is congenital and can also be caused by tumors (Itsenko-Cushing's disease). In this case, the first menstruation begins late, with scanty discharge, and over time it may stop altogether. Other characteristic signs are an abundance of acne in the back and chest, underdevelopment of the mammary glands, formation of a male-type figure, and enlargement of the clitoris.

A number of patients are diagnosed with hyperandrogenism of mixed origin. In this case, the functioning of the ovaries and adrenal glands is simultaneously impaired in the body. This pathology is caused by hypothalamic and neuroendocrine disorders. Disturbances in hormonal balance are aggravated by vegetative-neurotic disorders. In some cases, mild hyperandrogenism is diagnosed, in which androgen levels are normal, but does not reveal the presence of tumors in the internal organs.

The mixed form prevents pregnancy and makes it impossible to successfully bear a child.

Considering the degree of excess of the permissible level of androgens, absolute and relative forms of adrenogenital syndrome are distinguished. In the first case, the concentration of male hormones exceeds the permissible norms. Relative hyperandrogenism is diagnosed with acceptable levels of male hormones. At the same time, an increased sensitivity of the woman’s organs and glands to their effects is noted.

To summarize, the following main causes of this syndrome can be identified:

improper production of a special enzyme that synthesizes androgens, resulting in their excessive accumulation in the body;
presence of adrenal tumors;
diseases and malfunctions of the ovaries, provoking excessive production of androgens;
pathologies of the thyroid gland (hypothyroidism), pituitary tumors;
long-term use of steroids during professional strength sports;
obesity in childhood;
genetic predisposition.

If there are disturbances in the functioning of the ovaries, enlargement of the adrenal cortex, hypersensitivity of skin cells to the effects of testosterone, tumors of the reproductive and thyroid glands, pathology may develop in childhood.

Congenital hyperandrogenism sometimes makes it impossible to accurately determine the sex of a born child. A girl may have large labia and a clitoris enlarged to the size of a penis. The appearance of the internal genital organs is normal.

One of the varieties of adrenogenital syndrome is the salt-wasting form. The disease is hereditary and is usually detected in the first months of a child’s life. As a result of unsatisfactory functioning of the adrenal glands, girls experience vomiting, diarrhea, and cramps.

In older age, hyperandrogenism causes excess hair growth throughout the body, delayed formation of mammary glands and the appearance of the first menstruation.

Clinical manifestations

Symptoms can range from mild (excessive body hair growth) to severe (development of secondary male sexual characteristics).

Clinical manifestations of hyperandrogenism in women in the form of acne and male pattern hair growth

The main manifestations of pathological disorders are:

acne – occurs when the skin is too oily, which leads to blockage and inflammation of the sebaceous glands;
seborrhea of the scalp;
hirsutism - the appearance of heavy hair growth in places atypical for women (face, chest, abdomen, buttocks);
thinning and loss of hair on the head, the appearance of bald patches;
increased muscle growth, formation of male-type muscles;
deepening of voice timbre;
, scarcity of discharge, sometimes complete cessation of menstruation;
increased sexual desire.

Disturbances in hormonal balance cause the development of diabetes, excess weight, and lipid metabolism disorders. Women become very susceptible to various infectious diseases. They often develop depression, chronic fatigue, increased irritability and general weakness.

One of the most severe consequences of hyperandrogenism is virilization or virile syndrome. This is the name for the pathology of the development of the female body, in which it acquires pronounced male characteristics. Virilization is a rare disorder; it is diagnosed in only one patient out of 100 who experience excessive body hair growth.

The woman develops a masculine figure with increased muscle growth, menstruation stops completely, and the size of the clitoris increases significantly. Very often, such signs develop in women who uncontrollably take steroids to increase endurance and physical strength when playing sports.

Establishing diagnosis

Diagnosis of the pathological condition includes an external and gynecological examination of the patient, analysis of her complaints about general health. Pay attention to the duration of the menstrual cycle, the localization of excess hair, body mass index, and the appearance of the genitals.

What tests need to be taken to determine androgen levels?

Doctors (gynecologist, endocrinologist, geneticist) prescribe the following studies:

determination of the level of testosterone, follicular hormone, prolactin, estradiol in the blood and cortisol in the urine;
tests with dexemethasone to determine the cause of the syndrome;
Ultrasound of the ovaries and adrenal glands;
CT scan of the pituitary gland;
studies of glucose, insulin, cholesterol levels.

An ultrasound of the pelvic organs will determine the possible presence. Testing is necessary to determine the type of disease.

Materials for research are taken in the morning, before meals. Since hormonal levels are unstable, for an accurate diagnosis three samples are taken at intervals of at least half an hour. It is advisable to take tests in the second half of the menstrual cycle, closer to the expected start of menstruation.

Principles of therapy

Treatment of hyperandrogenism should be comprehensive and, first of all, aimed at eliminating problems and diseases that act as provoking factors. The list of such diseases includes pathologies of the thyroid gland, polycystic ovary syndrome, and adrenogenital syndrome.

The choice of treatment methods depends on the form of the pathology and the goal pursued by the therapy (combat hirsutism, restore reproductive function, maintain pregnancy when there is a threat of miscarriage).

Main treatment measures include:

drug therapy;
surgical intervention;
use of traditional medicine;
normalization of nutrition and physical activity.

Conservative therapy

It is used to reduce the amount of male hormones produced and to block processes that contribute to their excessive activity. The presence of tumors in the genital organs, causing ovarian hyperandrogenism, is eliminated through surgery.

If a woman is not planning a pregnancy in the near future, but suffers from acne and an excessive amount of body hair, to get rid of these symptoms, they are prescribed with an antiandrogenic effect (for example, Diana 35).

Such drugs not only eliminate unpleasant external signs, but also help normalize the menstrual cycle. For a cosmetic effect, anti-inflammatory ointments are prescribed that reduce sebum production.

If there are contraindications to the use of contraceptives, Spironolactone is used for treatment. It is prescribed for severe premenstrual syndrome and polycystic ovaries. The drug successfully treats acne and excess hair growth.

An analogue drug is Veroshpiron. Its main active ingredient is also spironolactone. Taking Veroshpiron is highly undesirable without consulting your doctor about the duration of use and the required dosage.

If hyperandrogenism is caused by the lack of an enzyme that converts androgens into glucocorticoids, agents that normalize this process are indicated. The drug Metipred is very effective. Its release forms are tablets and powders for injection. The drug is contraindicated in the presence of infectious and viral diseases, tuberculosis, and heart failure. The duration of the course of treatment and dosage are determined by the doctor.

Drugs used to treat hyperandrogenism

One of the successful methods of conservative treatment is a low-calorie diet. It is necessary to get rid of excess weight, which often complicates the course of the disease and brings additional psychological discomfort to the woman.

The total number of calories consumed daily should not exceed 2000. In this case, with sufficient physical activity, the number of calories consumed will be lower than those expended, which will lead to gradual weight loss.

The diet indicated for hyperandrogenism involves the exclusion of fatty, salty and spicy foods, as well as alcohol, sauces and fatty gravy.

Compliance with the principles of proper nutrition is reinforced by regular exercise. Running, aerobics, swimming, active games in the fresh air are useful.

The fight against hirsutism is carried out using various cosmetic procedures: waxing, depilation, laser removal of unwanted hair.

Application of traditional medicine

Treatment with folk remedies is quite applicable in combination with drug therapy, but is not a complete replacement for traditional methods.

Popular recipes:

The herbs of sweet clover, sage, meadowsweet and knotweed are mixed in equal parts, poured with 200 ml of water, kept in a water bath for 20 minutes and filtered. Add 1.5 ml of Rhodiola rosea tincture to the resulting decoction. Take a third of a glass of the decoction several times a day before meals.
2 tablespoons of chopped string, 1 spoon of yarrow and motherwort are poured with boiling water, left for about an hour, filtered. Take half a glass on an empty stomach in the morning and before bed.
A few tablespoons of dried nettle leaves are poured into a glass of water, infused in a closed container, and filtered. Take a tablespoon several times a day.
Rose hips and black currants are poured with boiling water and left for about an hour. Then add a little honey. The resulting cocktail is drunk several times a day after meals.

Among the most common folk remedies in the fight against gynecological diseases is the hog uterus. It is used in conjunction with other medicinal products in the form of a decoction or tincture.

Pour 100 g of boron uterus into 500 ml of vodka and leave for 2 weeks. Take 0.5 teaspoon of tincture three times a day.
Pour 2 tablespoons of boron uterus with a glass of boiling water, leave for about an hour. Drink in small portions throughout the day.
Mix 100 g of green peeled nuts and boron uterus with 800 g of sugar, add the same amount of vodka. Place the bottle with the mixture in a dark place for 14 days. After straining, take a teaspoon half an hour before meals.

Peppermint is used to reduce the amount of androgens produced. On its basis, tinctures and teas are prepared. For greater effectiveness, you can add milk thistle to mint. Regular intake of green tea normalizes female hormonal balance.

Your doctor will always tell you how to treat the problem using medicinal herbs and combine this method with other types of treatment. Self-medication is unacceptable!

Hyperandrogenism and infertility

Excess androgen production often becomes an obstacle to a desired pregnancy.

How to get pregnant with the help of drug therapy and how realistic is it?

Infertility treatment in this case is aimed at using drugs that stimulate the release of eggs from the ovaries. An example of such a drug would be Clomiphene.

One of the most effective drugs used to stimulate ovulation and normalize the menstrual cycle is Duphaston. After pregnancy occurs, the drug is continued to prevent miscarriage and normalize the development of pregnancy.

If stimulation is ineffective, doctors advise resorting to surgical treatment. Modern medicine widely uses the method. During this procedure, the ovaries are excised to help the mature egg “release.” The chance of getting pregnant after laparoscopy is higher, the less time passes from the day of surgery. Maximum fertility is observed in the first three months.

But even after successful conception, the presence of hyperandrogenism can prevent the successful bearing of a child. Excess male hormones often lead to the fact that the fertilized egg cannot stay in the uterus. The likelihood of miscarriage remains high.

Dangerous weeks of pregnancy with hyperandrogenism are the period before the 12th week and after the 19th. In the first case, hormones are produced by the placenta, and after the 19th week they can be produced by the fetus itself.

To maintain pregnancy, the patient is prescribed Dexamethasone (metipred). It helps reduce androgen levels. The dosage of the drug is selected exclusively by the doctor!

Many expectant mothers are very afraid of the side effects of the drug and fear that it could harm the unborn baby. Many years of experience in using this drug proves its safety, both for the development of the unborn child and for the course of the birth itself.

In most cases, to avoid the risk of miscarriage, doctors advise first completing a full course of treatment, and only then planning a pregnancy. If a woman fails to conceive a child, it is possible to carry out.

Prevention

There are no specific measures to prevent hyperandrogenism, since this syndrome develops at the hormonal level.

General preventive measures include:

balanced diet, including foods rich in fiber in the menu, weight control;
quitting smoking and alcohol abuse;
regular visits to the gynecologist;
taking medications and contraceptives only after a doctor’s recommendation;
timely treatment of pathologies of the thyroid gland, liver and adrenal gland diseases.

Hyperandrogenism is not only problems with the skin, hair and menstrual cycle. This is a general disease of the body that does not allow a woman to lead a quality lifestyle and often deprives her of the joys of motherhood. Modern methods of diagnosis and treatment make it possible to identify pathology in time and successfully eliminate its manifestations.