Androgens like testosterone are male hormones that help regulate sex characteristics in the body. Everyone has androgens, but those born with male sex traits typically have higher levels.
Androgens increase around puberty. They’re key to:
- muscle growth
- bone density
- red blood cell production
- sexual function
The four types of androgen hormones
- testosterone
- dihydrotestosterone (DHT)
- dehydroepiandrosterone (DHEA)
- androstenedione
Here’s what to know about androgens in your body, including how they can affect certain conditions like polycystic ovarian syndrome (PCOS).
Even though androgens are considered ‘male’ hormones, everyone has them.
In people assigned male at birth (AMAB), androgens typically support:
- vocal cord lengthening/voice deepening
- hair growth on your face, scalp, chest, armpits, and genitals
- sperm development
In people assigned female at birth (AFAB), androgens are also converted into estradiol, which is a type of estrogen. This process is key to:
- menstruation
- conception and pregnancy
- hair growth on your pubic area and armpits
People who are intersex at birth also have androgens. These individuals may experience a combination of the above processes.
Anti-androgen medication may be prescribed for certain conditions to block the effects of androgens. Meanwhile, androgen therapy, also called testosterone replacement therapy (TRT), may help treat low androgen levels.
These types of therapies may play a role in the treatment of several conditions, including the following.
Polycystic ovarian syndrome (PCOS)
Though most females produce few androgens, people with PCOS tend to produce more. This can cause:
- ovulation and fertility issues
- painful or extended periods
- excess hair growth
- acne
Hormonal therapy
While many females with PCOS will want to reduce androgen levels to reduce their symptoms ― transgender individuals will likely have a different experience of the condition and desire different treatment. In these situations, it has been found that raising androgen levels can also manage the undesirable symptoms of PCOS.
Tumors and related conditions
Some other conditions linked to high androgen levels in females include:
While anti-androgens might not be able to treat the conditions themselves, they can help treat common comorbid conditions, including:
Prostate cancer
Androgens play a role in stimulating cancer cell growth in the prostate. As a result, anti-androgen therapy may sometimes be used to treat prostate cancer, especially if the cancer has spread too far for treatment with surgery or radiation alone.
For that reason, it’s typically reserved for advanced prostate cancer diagnoses. Anti-androgen therapy
However, since anti-androgens don’t stop androgen production altogether, doctors may recommend additional treatments like surgery or other medications to reduce androgen levels even further.
Be aware of side effects
TRT can negatively affect male fertility and sperm production.
If you’re interested in TRT and want to conceive, you should discuss this with a fertility doctor or reproductive endocrinologist.
Alternative medications can increase testosterone levels without negatively affecting male fertility and may help improve male fertility.
Breast cancer
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Though more research is needed to know for sure, it may be a promising treatment to reduce tumor size and growth in the future.
Gender-affirming care
For AMAB people who are transitioning or who identify as nonbinary, anti-androgens may be taken as a part of gender-affirming care. This can block some of the characteristically masculinizing effects of androgens, such as:
- facial hair growth
- male pattern baldness
- erections
Transgender women may also take estrogen in conjunction with anti-androgens.
TRT may also be used for AFAB people who are transitioning or who identify as nonbinary to increase masculine physical characteristics, including:
- deepening the voice
- increasing muscle mass and strength
- redistributing fat (including reducing breast tissue and fat around the hips)
- reducing or eliminating menstruation
- increasing libido
Are androgens safe to use for bodybuilding?
Anabolic-androgenic steroids (AAS) are a synthetic type of testosterone sometimes taken by bodybuilders or other athletes in an attempt to boost strength and muscle mass, reduce fat, and increase performance.
Taking steroids comes with serious risks, including:
- increasing the risk of heart attack and stroke
- reducing “good” (HDL) cholesterol and raising “bad” (LDL) cholesterol
- decreasing liver function
- a high risk of infection
- decreasing fertility
AAS are also illegal in most places unless a doctor has prescribed them for therapeutic purposes. On the black market, they also may be produced in labs that carry a high risk of contamination or infection.
Learn more about the hazards of steroid use and alternatives here.
Signs of high androgen levels in AFAB people include:
- lack of menstrual periods (amenorrhea)
- decreased breast size
- increased in body hair (possibly on the face, chin, and stomach)
- changes in fat distribution
- acne or oily skin
- voice deepening
- thinning hair and hair loss
- increased muscle mass
- increased clitoral size
Low levels of androgens (called androgen deficiency) in AMAB people
- reduced libido
- decreased erections
- reduced testicle size
- low or no sperm count
- loss of pubic and facial hair
- hot flashes
- difficulty concentrating
- depressed mood
- increased body fat percentage
- decreased energy or strength
- reduced muscle mass
If you think you may have abnormal androgen levels, it’s a good idea to speak with your doctor. A blood test can help determine whether you have a deficiency or a surplus of androgens that requires treatment.
Androgens are “male” sex hormones like testosterone that regulate sex characteristics in your body, such as muscle growth.
Androgen therapy, including anti-androgen therapy and androgen replacement therapy, can be used to balance hormone levels in your body. It may be used to treat conditions like PCOS, prostate cancer, and ovarian tumors, as well as serve as a form of gender-affirming care.
If you think you may have an androgen imbalance, talk with your doctor. Common signs of an issue include lack of menstruation in females or reduced testicle size in males.
