Androgen Excess - Acne, Hair Growth & Hair Loss?

Androgen Excess - acne vulgaris, hirsutism (hair growth) and androgenic alopecia (hair loss)

Androgens are often referred to as ‘male sex hormones,’ but they’re present in both men and women. When it comes to women, we hear the most about testosterone, DHEA-S and DHT.


Testosterone comes from the ovaries, DHEAS comes from the adrenal glands and DHT is created by the conversion of testosterone by an enzyme called 5a-reductase. Most testosterone is tightly bound to something called Sex Hormone Binding Globulin (SHBG) and albumin (making it inactive), but about 1-2% is unbound, and biologically active. (1)

And androgen excess is exactly what it sounds like – too much of those hormones (we might start investigating this by testing testosterone levels in your blood). But hey, let’s not demonize androgens either – androgens are important for your libido, energy, bone health, muscle growth and strength.

 

When it comes to androgen excess, the WHY is of utmost importance – approximately 85% of androgen excess is caused by PCOS (see my PCOS post here) and idiopathic hyperandrogenism (essentially, we don’t know why). (2) There are many, less common causes, but they can include things like thyroid dysfunction, adrenal dysfunction, medications, pregnancy, tumor (ovarian, adrenal) and abnormal sexual development. (1) 


Anyway – why would women care? Because the major manifestations of androgen excess include acne, hirsutism and androgenic alopecia. (1)

Hirsutism is defined as excessive body/facial hair growth that appears in a male pattern (feel free to Google the Ferriman-Gallwey tool).

Androgenic alopecia is also sometimes described as female pattern hair loss. Please note that there are many other causes of this type of hair loss; so don’t jump to any conclusions on Dr. Google.

So, hirsutism = increased hair on the face and body, androgenic alopecia = decreased hair on the head. Not ideal, I agree.


When we can figure out what’s causing the androgen excess, we can target it and help balance out your androgens. I speak from personal experience here – during naturopathic school I had terrible acne on my chin and neck (ugh). Through diet and herbal medicine I was able to have greater control over the beast that is hormonal acne – by targeting those androgens safely and gently.

 

Reference(s):

(1) Lobo, R.A. Comprehensive Gynecology: Hyperandrogenism and Androgen Excess: Physiology, Etiology, Differential Diagnosis, Management. 40, pp 865-880. E3.

(2)  PMID: 31361105

 
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