Androgens

What are androgens?

Androgens are a group of sex hormones. They help start puberty and play a role in reproductive health and body development.

All genders make androgens, but males make more of them. Testosterone is the most common androgen.

The testicles in the male reproductive system and the ovaries in the female reproductive system make androgens. The adrenal glands that sit on top of each kidney also produce these hormones.

What are the types of androgens?

Testosterone is the predominant androgen in all genders. Other androgens include:

• Androstenedione.
• Dehydroepiandrosterone (DHEA).
• DHEA sulfate (DHEA-S).
• Dihydrotestosterone (DHT).

What is the role of androgens?

In all genders, androgens help with:

• Bone density.
• Muscle development.
• Puberty.
• Red blood cell production.
• Sexual desire and function.

What is the role of androgens in men?

In people assigned male at birth (AMAB), androgens contribute to:

• Deep voice (vocal cord lengthening).
• Hair growth on the face, scalp, chest, underarms and genitals.
• Sperm development.

What is the role of androgens in women?

In people assigned female at birth (AFAB), other body chemicals convert androgen into estradiol, a form of estrogen. This hormone:

• Regulates menstruation.
• Aids conception and pregnancy.
• Minimizes bone loss (osteoporosis).
• Stimulates pubic and underarm hair growth.

How do healthcare providers measure androgen levels?

Your healthcare provider uses a calculation called the free androgen index (FAI) to measure androgen levels. FAI starts with a blood test to measure:

• Total testosterone.
• Free testosterone.
• Sex-hormone-binding globulin (SHBG).

SHBG is a protein that carries androgens (testosterone and DHT) and estrogen in the blood. Your provider compares total testosterone to SHBG to determine the FAI or amount of androgen in the blood.

Androgen levels can change throughout the day. They naturally decline with age. A woman’s age, menstrual cycle stage or menopause status can also affect hormone levels.

What are common androgen-related health problems?

High levels of androgen (hyperandrogenism) is more commonly a problem for people assigned female at birth (AFAB). The most common cause of hyperandrogenism is polycystic ovary syndrome (PCOS). Rarely, adrenal or ovarian tumors case hyperandrogenism.

Low levels of androgen (hypoandrogenism) can lead to:

• Bone fractures and osteoporosis.
• Fatigue.
• Low sex drive.

What androgen conditions affect males?

Androgen can fuel the growth of prostate cancer. Some people take hormone medications to lower the body’s natural production of androgen as part of treatment for prostate cancer.

Low androgen or low testosterone (male hypogonadism) can cause fatigue, anxiety and depression, difficulty concentrating, poor exercise tolerance, low sex drive and erectile dysfunction. It can also lead to breast development (gynecomastia).

What androgen conditions affect females?

People with polycystic ovary syndrome or high androgen levels may have:

• Acne.
• Amenorrhea (missed periods) or abnormal menstruation.
• Excessive hair growth (hirsutism) or hair loss.
• High blood pressure and high cholesterol.
• Infertility.
• Obesity.
• Ovarian tumors.

What androgen conditions affect children?

Androgen helps genitals as the fetus develops in your uterus. At birth, some babies have disorders of sex differentiation. These conditions affect a child’s reproductive organs and how the genitals look.

A parent may pass a gene mutation (change) to a child. The gene mutation can cause:

• Androgen insufficiency syndrome (AIS): In a baby with AIS, the body doesn’t respond to its androgen or testosterone. The baby has male chromosomes, but the penis may be unusually small (micropenis) or not fully formed. The genitals may look female or be a mix of sexes.
• Congenital adrenal hyperplasia (CAH): High androgen levels cause a baby with female chromosomes to have genitals that look male.

A note from Cleveland Clinic

While some people view androgens as primarily male sex hormones, these hormones help people enter puberty and develop physically and sexually. When androgen levels are too low or too high, it can affect your energy level and sex drive. Unhealthy androgen levels can also increase your risk of problems like diabetes. A blood test can measure androgen levels. Your healthcare provider can treat tumors and other issues that affect androgen levels.