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What causes virilism? 2 possible conditions

What Is Virilization?

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.

What Causes Virilization?

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.

Recognizing the Symptoms of Virilization

Women with this condition often experience male-pattern baldness. They also tend to have an eruption of acne on the:

  • chest
  • back
  • face
  • hairline
  • underarms
  • groin

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

Diagnosing Virilization

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.

How to Treat Virilization

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.

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See a list of possible causes in order from the most common to the least.


Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a condition in which a woman's levels of the sex hormones estrogen and progesterone are out of balance. This leads to the growth of ovarian cysts.

Read more »


Adrenal Cortical Carcinoma

Adrenal cortical carcinoma (ACC) is a rare disease. It is caused by a cancerous growth in the adrenal cortex, which is the outer layer of the adrenal glands. The adrenal glands lie on top of the kidneys. They play a...

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.