What conditions cause high levels of androgens in women?
About 50% of females with acne have an imbalance of hormones although this is usually only mild. It is seldom necessary to test hormone levels in patients with acne unless there are other features suggesting they are excessive (hyperandrogenism). Such features include balding (androgenetic alopecia), hirsutism, clitoral enlargement (virilisation). High levels of male sex hormones may arise from: • Disease of the ovaries • Polycystic ovary syndrome: this results in hirsutism, infertility and/or irregular menstruation • Benign (non-invasive) or malignant (cancerous) ovarian tumours • Disease of the adrenal gland • Partial deficiency of the adrenal enzyme 21-hydroxylase (late onset CYP21A2 defiency) and other forms of congenital adrenal hyperplasia • Benign or malignant adrenal tumours • Disease of the pituitary gland • Cushing’s syndrome due to excessive adrenocorticotrophic hormone (ACTH) causes moon face, truncal obesity, thin skin, easy bruising, stretch marks (striae), hirsutism and
