What is Androgen?

Androgens are a group of hormones primarily responsible for developing and maintaining male characteristics in humans and other animals. The most well-known androgen is testosterone, produced primarily in the testes in males and smaller quantities in the ovaries and adrenal glands in females.

Androgens play a crucial role in various physiological processes, including the growth of facial and body hair, the deepening of the voice, and the development of muscle mass and bone density. Beyond their role in sexual differentiation, androgens influence mood, energy levels, and overall well-being. However, imbalances in androgen levels can lead to health issues, such as polycystic ovary syndrome (PCOS) in women and andropause in men. Understanding and managing androgen levels is essential for maintaining a healthy hormonal balance and overall quality of life.

Functions of the androgen hormone

Androgens play a key role in the hormonal cascade that stimulates puberty and hair growth in the pubic and armpit areas. It also regulates the function of many organs, including bones and muscles, the reproductive system, kidneys, and liver. In women, androgens are also necessary for synthesizing estrogen hormones and play an important role in controlling libido, keeping bones strong, etc. The important functions of androgen hormones in men are:

They produce anabolic effects on carbohydrate and protein metabolism.
They play a vital stimulating role in the phenomena of spermatogenesis.
They affect the central nervous system and affect the sexual behavior of men.
Secretion of growth hormones during puberty.
They cause muscle growth, facial and armpit hair, low pitch of voice, aggression, etc.
It examines the maturation, growth, and function of male accessory sex organs such as vas deferens, epididymis, seminal vesicles, urethra, prostate gland, etc.
In addition to sexual health, this hormone plays a role in maintaining the body’s metabolism, insulin sensitivity, and possibly body composition.

Types of androgens

Testosterone is the dominant androgen in all sexes. Other androgens include:

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

Androgen deficiency in women

Androgens play an important role in the female body. When androgen levels are low, women may experience a variety of symptoms. Sometimes there is no clear cause for androgen deficiency, and there is limited research on the effectiveness of different treatment options. But if you have symptoms, you must see your doctor to rule out other medical conditions. Symptoms include:

Tiredness
Poor concentration
Loss of muscle mass and strength
Low sex drive
Low mood

Causes of androgen deficiency

Some possible causes of androgen deficiency in women include:

Surgical removal of the ovaries
Certain medications, chemotherapy, or radiotherapy
Estrogen tablets or pills
Hormonal imbalance related to stress, excessive exercise, or not eating enough calories
Premature or early menopause (the last menstrual period occurs before the age of 40)

Diagnosis of androgen deficiency

Some androgen levels are difficult to measure accurately because levels are generally low in women, and tests cannot measure such low levels. Also, androgen levels can change.

If you check your androgen levels, blood should be taken in the morning, when testosterone is at its highest.

Treatment for androgen deficiency in women

The treatment for androgen deficiency in women depends on the underlying cause and the severity of the condition. Before any treatment is initiated, it’s essential to accurately diagnose the deficiency through a comprehensive medical evaluation, including blood tests to measure hormone levels.

The treatment will focus on managing the underlying condition if the androgen deficiency is due to a specific medical condition, such as polycystic ovary syndrome (PCOS). Lifestyle changes like weight loss and regular exercise may also be recommended.

In certain situations where androgen deficiency significantly impacts a woman’s quality of life, hormone replacement therapy (HRT) might be considered. HRT involves administering synthetic androgens, such as testosterone, to supplement the low levels in the body. However, it’s crucial to approach HRT with caution and under the guidance of a knowledgeable healthcare professional, as excessive androgens can lead to unwanted side effects.

Treatment decisions should be tailored to each individual’s unique needs, and it’s essential to monitor hormone levels and adjust the therapy as necessary under medical supervision. Women with concerns about androgen deficiency should consult their healthcare provider to determine the most appropriate course of action for their case.

Androgen deficiency in men

Androgen deficiency occurs when the body has lower levels of male sex hormones, especially testosterone than is needed for health. This deficiency may be caused by problems in the areas of the brain that control the function of the testicles (pituitary gland and hypothalamus) or problems with the testicles themselves.

A mild and gradual decrease in the level of sex hormones can be seen in male populations from around the age of 30, but this decrease is not seen in all men. In most cases, the decrease in testosterone is due to them contracting other diseases.

Androgens are a group of sex hormones that give men characteristics. The main sex hormone in men is testosterone, mainly produced in the testicles. The testicles are controlled by a small gland in the brain called the pituitary gland, which in turn is controlled by an area of the brain called the hypothalamus.

Androgens are very important for male sexual function and reproduction. They are also responsible for developing secondary sexual characteristics in males, including facial and body hair growth and voice changes. Androgens also affect bone and muscle growth and metabolism.

The term androgen deficiency means your body does not produce enough androgens, especially testosterone, to be healthy. The effects of this depend on the severity of the deficiency, its cause, and the age of onset of the deficiency.

Symptoms of androgen deficiency

When there is not enough testosterone circulating in the body, it can cause a wide range of symptoms. However, some of these symptoms may be non-specific and can mimic symptoms of other diseases and conditions. Some of the symptoms of androgen deficiency include:

Breast development
Lethargy and fatigue
Reduced sexual desire
Hot flushes and sweating
Weaker erections and orgasms
Reduced amount of ejaculate
Loss of body hair
Reduced bone mass
Depression
Reduced muscle mass and strength
Increased body fat, particularly around the abdomen

Causes

Some causes of androgen deficiency include conditions that affect the following.

Testes

Medical problems that affect the testicles can prevent them from producing enough testosterone. Some conditions are present from birth (for example, Klinefelter syndrome). Other conditions may occur at different stages of a boy’s or a man’s life, such as:

Complications following mumps
Side effects of chemotherapy or radiotherapy
Undescended testes
Loss of testicles due to trauma or kinking of blood flow

Pituitary gland

The most common condition that affects the pituitary gland and leads to a decrease in testosterone levels is the presence of a benign tumor. The tumor may interfere with the function of the pituitary gland, or it may produce the hormone prolactin, which stops the production of gonadotropins. These hormones are needed to signal the testicles to produce testosterone.

Hypothalamus

Certain conditions, such as tumors or a genetic disorder (Kallmann’s syndrome), can prevent the hypothalamus from stimulating the pituitary gland to release hormones. This prevents the production of testosterone by the testicles. This is a rare cause of androgen deficiency.

Diagnosis

Androgen deficiency is diagnosed using a number of assessments, including:

Medical history:

Physical examination
Blood tests
Other tests

Treatment of androgen deficiency in man

The treatment of androgen deficiency in men, commonly known as “low testosterone” or “hypogonadism,” typically involves hormone replacement therapy (HRT). Before starting any treatment, a comprehensive evaluation, including blood tests to measure hormone levels, is essential to confirm the diagnosis and identify the underlying cause of the deficiency. HRT for androgen deficiency in men involves administering synthetic testosterone to supplement the low levels in the body. There are various forms of testosterone replacement, including:

Testosterone injections
Testosterone patches
Testosterone gels
Testosterone pellets

Testosterone replacement therapy can help improve symptoms related to androgen deficiency, such as low energy, reduced muscle mass, decreased libido, and mood changes. However, like any medical treatment, it comes with potential risks and side effects, so it’s crucial to work closely with a qualified healthcare professional to determine the appropriate dosage and monitor for adverse reactions.

It’s important to note that testosterone therapy may not be suitable for everyone, especially those with certain medical conditions like prostate cancer or severe heart problems. Therefore, individualized treatment plans and close medical supervision are necessary to ensure the safest and most effective management of androgen deficiency in men. Regular follow-up visits and hormone level monitoring are essential components of successful treatment.

Androgen conditions affect children

Androgen conditions can affect children in various ways, depending on whether there is an excess or deficiency of androgens. Androgens are hormones that play a critical role in sexual development and the development of male characteristics. When these hormones are imbalanced in children, it can lead to different medical conditions.

Androgen excess conditions include:

Congenital Adrenal Hyperplasia (CAH): CAH is a group of genetic disorders that result in a deficiency of certain enzymes needed to produce cortisol and aldosterone in the adrenal glands. This leads to excess androgens, which can cause ambiguous genitalia in female infants and early virilization (masculinization) in both male and female infants.
Precocious Puberty: This condition involves the early onset of puberty, including the development of secondary sexual characteristics, before the age of 9 in boys and 8 in girls.
Androgen-producing Tumors: Rarely children can develop tumors in the adrenal glands or gonads (testes or ovaries) that produce excess androgens, leading to various symptoms related to androgen excess.

Androgen Deficiency conditions include:

Androgen Insensitivity Syndrome (AIS): AIS is a genetic condition where individuals with male chromosomes (XY) are partially or completely insensitive to the effects of androgens. This results in incomplete development of male sexual characteristics, leading to individuals having a female appearance, despite having male chromosomes.
Hypogonadism refers to a deficiency in the production of sex hormones, including androgens, by the testes or ovaries. In boys, it can lead to delayed puberty or incomplete development of secondary sexual characteristics. In girls, it may cause delayed puberty and menstrual irregularities.

In both androgen excess and deficiency conditions, early detection, and proper management are crucial to ensure the child’s healthy physical and emotional development. Treatment options vary depending on the specific condition and may involve hormone replacement therapy, surgery, or other medical interventions.

The bottom line

While some think of 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 levels and libido. Unhealthy androgen levels can also increase the risk of developing problems such as diabetes. A blood test can measure androgen levels. Your healthcare provider can treat tumors and other issues that affect androgen levels. Arjang Naim, MD, performs the necessary treatments for hormonal disorders.

Additional questions

What is the most well-known androgen?

The most well-known androgen is testosterone, produced primarily in the testes in males and smaller quantities in the ovaries and adrenal glands in females.

What medical conditions are associated with androgen excess in females?

Androgen excess in females can be related to conditions like polycystic ovary syndrome (PCOS), which can cause irregular menstrual cycles, excessive hair growth (hirsutism), and acne.

How do androgens influence mood and emotions?

Androgens can influence mood and emotions by affecting brain function and neurotransmitters. Balanced androgen levels contribute to overall well-being and energy levels.

Are there any risks or side effects associated with testosterone replacement therapy?

Yes, testosterone replacement therapy can have potential risks and side effects, including an increased risk of blood clots, fluid retention, mood swings, and in some cases, it may affect fertility.