Ovarian overproduction of androgens

In healthy women, the ovaries and adrenal glands produce about 40% to 50% of their body's testosterone. Tumors of the ovaries and polyendocrine metabolic ovarian syndrome (PMOS, previously called polycystic ovary syndrome or PCOS) can both cause too much androgen production.

Cushing disease is a problem with the pituitary gland that leads to excess amounts of corticosteroids. Corticosteroids may cause masculine body changes in women. Tumors in the adrenal glands can also cause too much production of androgens and can lead to male body characteristics in women.

High levels of androgens in a female can cause:

• Acne
• Changes in female body shape
• Decrease in breast size
• Increase in body hair in a male pattern, such as on the face, chin, and abdomen (called hirsutism)
• Lack of menstrual periods (amenorrhea)
• Oily skin

These changes may also occur:

• Increase in the size of the clitoris
• Deepening of the voice
• Increase in muscle mass
• Thinning hair and hair loss at the front of the scalp on both sides of the head

Your health care provider will perform a physical exam. Any blood and imaging tests ordered will depend on your symptoms, but may include:

• 17-hydroxyprogesterone test
• ACTH stimulation test (unusual)
• Cholesterol blood tests
• CT scan
• DHEA blood test
• Glucose test
• Insulin test
• Pelvic ultrasound
• Prolactin test (if periods come less often or not at all)
• Testosterone test (both free and total testosterone)
• TSH test (if there is hair loss)

The treatment depends on the problem that is causing the increased androgen production. Medicines can be given to decrease hair production in women with excess body hair, or to regulate menstrual cycles. In some cases, surgery may be needed to remove an ovarian or adrenal tumor.

Treatment success depends on the cause of excess androgen production. If the condition is caused by an ovarian tumor, surgery to remove the tumor may correct the problem. Most ovarian tumors are not cancerous (benign) and will not come back after they have been removed.

In women with PMOS, the following measures can reduce symptoms caused by high androgen levels:

• Careful monitoring
• Weight loss
• Dietary changes
• Medicines
• Regular vigorous exercise

Infertility and complications during pregnancy may occur.

Women with PMOS may be at increased risk for:

• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• Uterine cancer

Women who have PMOS can reduce their chances of long-term complications by maintaining a normal weight through healthy diet and regular exercise.

Ovarian overproduction of male hormones

Bulun SE, Babayev E. Physiology and pathology of the female reproductive axis. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 15.

Catherino WH. Reproductive endocrinology and infertility. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 218.

Huddleston HG, Quinn MM, Gibson M. Polycystic ovary syndrome and hirsutism. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 589.

Lobo RA. Androgen excess in women. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 38.

Updated by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.