Virilization is a condition that causes a female to develop male-pattern hair growth and other masculine traits. Women with virilization often have an imbalance in the sex hormones estrogen and testosterone.
Virilization is caused by an overproduction of testosterone or use of anabolic steroids, synthetic substances that act like the male hormone testosterone.
Any medical condition that causes an imbalance in sex hormone levels can result in virilization. These conditions are likely to cause adrenal hyperplasia, an overproduction of hormones in the adrenal cortex. In some cases, the overproduction of adrenal hormones is caused by an adenoma (cancerous tumor). This type of tumor is normally located within the adrenal glands.
Other causes of virilization include:
- use of male hormone supplements
- use of steroids to increase muscle mass
- development of ovarian cysts (normally seen in patients with polycystic ovary syndrome (PCOS))
Cases of virilization caused by PCOS are usually mild. Doctors don’t know exactly what causes PCOS. However, they believe that high insulin levels and genetics play a role. Women with PCOS often have masculine characteristics, including male pattern baldness and facial hair.
Women with this condition often experience male-pattern baldness. They also tend to have an eruption of acne on the:
Other symptoms of virilization include:
- excessive facial hair (normally located on the cheeks, chin, and upper lip)
- deepening of the voice
- increased sex drive
- smaller-than-normal breasts
- enlarged clitoris
- irregular menstrual cycles
Tell your doctor about all the symptoms or physical changes you’ve experienced. Mention any medications you’re currently taking, including birth control. PCOS tends to run in families, so learning your family’s medical history can help your doctor determine the cause of your virilization.
If your doctor is unable to diagnose the cause of virilization right away, he or she may take a blood sample. The blood sample will be tested for the presence of testosterone, estrogen, progesterone, and other hormones. An increased level of male sex hormones is usually an indication of this condition.
The doctor will perform a test called the dexamethasone suppression test if you have a higher-than-normal level of androgens in your blood. This test will help determine where the excess androgens are coming from. If the doctor suspects that they are caused by a cancerous adenoma, he or she will perform an imaging test, such as a computed tomography (CT) scan. This will allow the doctor to view structures within the body in detail. Your doctor can determine if abnormal growths are present using the imaging scans.
Removal of an adrenal gland that contains an adenoma is the most common treatment for this condition. This is normally done surgically. However, the doctor may choose chemotherapy or radiation treatments if the tumor is in a dangerous area or is difficult to reach. These therapies help shrink the growth before it’s removed.
If a tumor isn’t to blame, the doctor may prescribe oral contraceptives to help balance your hormone levels. He or she may prescribe an oral contraceptive that blocks your testosterone production completely.