21 Aug 2025 11 min read

Androgen Excess in PCOS: Causes and Symptoms

Androgen excess is a key feature of Polycystic Ovary Syndrome (PCOS), affecting millions of women. This hormonal imbalance leads to symptoms like excessive hair growth, acne, irregular periods, and fertility challenges. It’s often linked to issues like insulin resistance, obesity, and disruptions in ovarian and adrenal hormone production. Addressing androgen excess early can help manage symptoms and reduce long-term health risks such as diabetes, heart disease, and endometrial cancer.

Here’s what you need to know:

Causes: Hormonal imbalances, insulin resistance, obesity, genetics, stress, and thyroid dysfunction.
Symptoms: Hirsutism, acne, hair thinning, irregular cycles, and skin changes like dark patches.
Health Risks: Diabetes, heart disease, endometrial problems, and mental health challenges.
Management: Lifestyle changes (diet, exercise), addressing insulin resistance, and seeking medical advice for persistent symptoms.

Understanding androgen excess helps you focus on treating the root cause rather than isolated symptoms. Early action is key to improving your health and well-being.

The Link Between Androgens, Testosterone & PCOS You Need to Know (Balance Your Hormones Naturally)

What Causes Androgen Excess in PCOS

Androgen excess in PCOS arises from a complex web of hormonal and metabolic disruptions, which explains the wide range of symptoms individuals experience.

Hormonal Imbalances and Androgen Overproduction

In PCOS, the follicles in the ovaries don’t mature as they should. Instead of producing estrogen, these underdeveloped follicles continue to generate androgens, leading to an imbalance. This hormonal shift triggers a rise in luteinizing hormone (LH), which further fuels androgen production and disrupts normal ovulation. The adrenal glands also contribute by releasing androgens like DHEA-S, while issues with the hypothalamic-pituitary-ovarian (HPO) axis amplify these imbalances.

The HPO axis, which typically regulates the body’s monthly hormonal rhythm, becomes dysregulated in PCOS. This disruption skews the balance of hormone release, favoring androgen production over the regular cycling needed for ovulation and menstrual consistency.

Beyond ovarian and adrenal contributions, metabolic problems further drive androgen overproduction, creating a reinforcing cycle of hormonal imbalance.

The Role of Insulin Resistance and Obesity

Insulin resistance - a hallmark of PCOS - forces the pancreas to produce higher levels of insulin. This excess insulin stimulates the ovaries to produce more androgens while simultaneously reducing levels of sex hormone-binding globulin (SHBG). With lower SHBG, more free androgens circulate in the body, worsening PCOS symptoms.

Obesity, especially when concentrated around the abdomen, compounds the issue. Visceral fat, the type found around internal organs, acts almost like a hormone-producing organ itself. It releases inflammatory substances that disrupt hormone balance and worsen insulin resistance. This inflammation also increases how sensitive tissues are to androgens, further intensifying symptoms.

Together, insulin resistance and obesity create a feedback loop that raises androgen levels and exacerbates PCOS-related issues.

Other Contributing Factors

Several other factors can contribute to androgen excess in PCOS:

Genetics: A family history of PCOS or related conditions may make individuals more prone to issues with insulin processing, androgen production, and inflammation.
Environmental Exposures: Endocrine-disrupting chemicals in the environment can interfere with hormone metabolism, especially in those with a genetic predisposition.
Rare Tumors: Benign ovarian or adrenal tumors, though uncommon, can cause a sudden spike in androgen levels and require immediate medical attention.
Thyroid Dysfunction: Thyroid problems often coexist with PCOS and can influence androgen levels. Hypothyroidism (underactive thyroid) can slow metabolism and worsen insulin resistance, while hyperthyroidism (overactive thyroid) may heighten tissue sensitivity to androgens.
Chronic Stress: Prolonged stress elevates cortisol levels, which can stimulate androgen production and worsen insulin resistance.

Understanding the specific factors contributing to androgen excess in PCOS requires comprehensive hormone testing and a personalized approach. Each individual’s hormonal profile is unique, and addressing the root causes is key to managing symptoms effectively.

Symptoms of Androgen Excess in PCOS

When androgen levels are elevated in PCOS, they can lead to a range of physical and reproductive symptoms that often develop gradually over time.

Physical Symptoms: Hair Growth, Acne, and Hair Loss

One of the hallmark signs of androgen excess is hirsutism, or excessive hair growth in areas where men typically grow hair. This can include the chin, upper lip, jawline, chest, back, abdomen, and inner thighs. The hair is often coarse and dark, which makes managing it a persistent challenge for many women.

Another common issue is acne, which tends to be severe and long-lasting. It frequently appears along the jawline, chin, and lower face - areas where oil glands are particularly sensitive to androgens. In some cases, the acne can be deep and cystic, leaving scars behind if untreated.

Hair thinning, known as androgenic alopecia or male-pattern hair loss, is also frequently reported. This type of hair loss generally starts at the crown and temples, leading to noticeable thinning over time. Additionally, increased sebum production caused by androgens can result in oily skin, which further aggravates acne, especially in the T-zone.

These physical changes are often accompanied by disruptions in reproductive health.

Reproductive Symptoms: Irregular Periods and Fertility Challenges

Elevated androgens interfere with the hormonal balance required for regular ovulation, leading to irregular menstrual cycles. Women with PCOS often experience infrequent or unusually long cycles, making periods unpredictable. This irregularity also affects fertility, as ovulation becomes inconsistent or even absent.

For those trying to conceive, the hormonal imbalance can make it difficult to rely on typical fertility signs, such as changes in cervical mucus or basal body temperature, further complicating family planning.

Skin and Metabolic Symptoms

Beyond acne and oily skin, androgen excess can cause other visible skin changes. Acanthosis nigricans, characterized by dark, velvety patches on the neck, armpits, or groin, is often linked to insulin resistance - a common metabolic issue in PCOS. The presence of these patches can serve as a warning sign of underlying metabolic dysfunction.

Additionally, some women notice increased skin sensitivity and inflammation. Conditions like eczema or dermatitis may flare up more easily, and the skin may react strongly to stress, hormonal shifts, or new products. Metabolic imbalances, such as central weight gain, can exacerbate these symptoms, creating a cycle where physical and metabolic issues feed into one another.

The combination of these visible and physical symptoms often impacts emotional well-being, leading to challenges with self-esteem and mental health. Addressing these interconnected symptoms requires a well-rounded approach that tackles both hormonal imbalances and metabolic health.

Health Risks of Androgen Excess

Androgen excess in PCOS isn't just about outward symptoms - it carries serious long-term health implications. Recognizing these risks sheds light on the broader impact of androgen excess and highlights the importance of a well-rounded approach to managing this condition. Being aware of these risks empowers women to make informed choices about their health and take steps to safeguard their overall well-being.

Metabolic and Heart Health Risks

High androgen levels can worsen insulin resistance, driving up insulin levels and increasing the likelihood of developing type 2 diabetes. Women with PCOS often face a higher risk of type 2 diabetes, sometimes at an earlier age than expected.

The metabolic challenges linked to PCOS also extend to heart health. Insulin resistance, chronic inflammation, and hormonal imbalances combine to elevate the risks of high blood pressure, abnormal cholesterol levels, and heart disease. Excess weight, particularly when concentrated around the abdomen, can make these risks even more pronounced. These metabolic issues don’t just stop at physical health - they can also affect reproductive health in significant ways.

Reproductive and Endometrial Health Concerns

Hormonal imbalances in PCOS often disrupt ovulation, leading to lower progesterone levels. Without sufficient progesterone, the uterine lining can thicken excessively, increasing the risk of endometrial cancer.

Women with androgen excess may also face complications during pregnancy, such as gestational diabetes, high blood pressure, and preeclampsia. Irregular ovulation can lead to ovarian cysts, which may cause discomfort or require medical attention. Beyond the physical challenges, these reproductive health issues often bring emotional strain, adding another layer of complexity to the condition.

Mental Health and Emotional Wellbeing

The visible symptoms of androgen excess can take a toll on mental health, often triggering body image concerns and social anxiety. Many women report feelings of self-consciousness and isolation, which can increase the likelihood of mood disturbances.

On top of that, hormonal fluctuations can directly affect mood, leading to irritability, mood swings, and difficulty managing stress. Sleep problems - sometimes connected to weight gain or hormonal changes - can further disrupt emotional balance. Together, these factors create a challenging mix of physical and emotional hurdles that call for a holistic approach to care.

For more information and tailored advice on managing PCOS and its related health concerns, visit mypcoslife.com.

When to See a Doctor

Knowing when to seek medical advice can make a big difference in managing symptoms and preventing complications. Here are some signs that it’s time to consult a healthcare provider.

Symptoms That Need Medical Attention

Severe or rapidly worsening hirsutism: If thick, dark hair starts appearing on areas like the face, chest, or abdomen and begins interfering with daily life, it’s important to get evaluated.
Persistent, severe acne: Acne that doesn’t respond to typical treatments, especially if it starts suddenly or worsens significantly in adulthood, may point to underlying hormonal issues that need medical attention.
Irregular menstrual cycles: If your cycles are consistently more than 35 days apart or you’ve missed periods for three months or more, it could signal ovulation problems that require assessment.
Male-pattern hair loss: Rapid thinning or balding, especially at the crown or temples, should be addressed early to prevent further hair loss.
Unexplained weight gain around the midsection: If you’re gaining weight in this area despite maintaining a healthy diet and exercise routine, it could indicate insulin resistance that needs to be managed.
Skin changes: Dark, velvety patches - often found around the neck, armpits, or groin - can be a sign of insulin resistance and should be checked out promptly.

Why Early Diagnosis and Treatment Matter

Acting early can significantly improve outcomes and help manage symptoms more effectively. Timely medical care not only reduces discomfort but also helps prevent more serious health issues linked to androgen excess.

Fertility preservation: Irregular ovulation over time can affect egg quality. Early treatment can help restore regular cycles and improve the chances of pregnancy when desired. It also lowers the risk of endometrial problems caused by prolonged cycle irregularities.
Better symptom control: Addressing issues like hair growth, acne, and hair loss early often leads to better results. For example, male-pattern baldness can become permanent if left untreated for too long.
Mental health improvements: Understanding your condition and having a clear treatment plan can ease anxiety, boost self-esteem, and give you a greater sense of control over your health.

Getting help early allows for more treatment options and better results. Simple blood tests can check hormone levels, and healthcare providers can recommend treatments tailored to your needs. The sooner you act, the better your chances of managing your condition effectively.

Taking Control of Androgen Excess in PCOS

Understanding androgen excess is key to managing PCOS symptoms effectively. Once you grasp how these hormones impact your body, you can take steps to restore balance and improve your overall health.

Lifestyle changes are a powerful tool in this process. Adjusting your diet, incorporating regular exercise, and making behavioral changes can directly reduce androgen levels. Research shows that these interventions can lower the free androgen index by 1.11 points and lead to an average weight loss of 3.7 pounds ^[2]. Even a small reduction in BMI - around 0.34 kg/m² - can help decrease androgen production and reduce excess hormones, like estrogen, that are produced by fat tissue ^[1]^[2].

For a natural boost, consider drinking spearmint tea. Studies suggest that having 2 cups daily can lower both total and free testosterone levels. Within just 30 days, many notice reduced hair growth, and hormonal improvements can be seen as early as 5 days into the follicular phase ^[1].

Addressing insulin resistance is equally important. High insulin levels can worsen ovarian dysfunction and ramp up androgen production. To break this cycle, focus on consistent meal timing, choose complex carbohydrates, and stay physically active. These habits can help regulate blood sugar and support hormonal balance ^[1]^[2].

Taking action early makes a difference. Whether you’re facing unwanted hair growth, acne, irregular periods, or weight challenges, addressing these symptoms promptly gives you a better chance of managing them successfully. At mypcoslife.com, we’re here to provide science-backed advice and practical steps to guide you toward better hormone health and overall well-being.

FAQs

What role does insulin resistance play in causing androgen excess in PCOS?

The Role of Insulin Resistance in Androgen Excess in PCOS

Insulin resistance plays a significant role in driving androgen excess in women with PCOS. When the body doesn't respond effectively to insulin, it compensates by producing more of it, leading to elevated insulin levels in the blood - a condition known as hyperinsulinemia. This surplus insulin overstimulates the ovaries, prompting them to produce higher levels of androgens, such as testosterone.

But that's not all. Insulin resistance also disrupts normal ovarian function, hindering follicle development and further boosting androgen production. This creates a vicious cycle where elevated androgens worsen insulin resistance, and the worsening insulin resistance, in turn, exacerbates androgen levels. Breaking this cycle often requires a multi-faceted approach, including lifestyle adjustments, medications, or other targeted interventions to address insulin resistance directly.

What are the best lifestyle changes to lower androgen levels in women with PCOS?

To help lower androgen levels in women with PCOS, making a few lifestyle adjustments can go a long way. Regular exercise, particularly strength training or resistance workouts, plays a key role in reducing both insulin and androgen levels. Pair this with a balanced diet rich in fiber and low in refined carbs to boost insulin sensitivity and support hormone balance.

For women who are overweight, shedding weight gradually through healthy eating and consistent physical activity can have a big impact. It may not only lower androgen levels but also help restore regular ovulation. Stress management is another crucial piece of the puzzle - practices like mindfulness, yoga, or meditation can help regulate hormones and promote overall balance. These manageable changes can significantly improve PCOS symptoms and enhance overall health.

What natural remedies or dietary changes can help reduce androgen excess in PCOS?

Managing Androgen Excess in PCOS Naturally

Addressing androgen excess in PCOS may benefit from incorporating natural remedies and making thoughtful dietary changes. For instance, spearmint tea is often highlighted for its potential anti-androgen effects, which could help in reducing androgen levels.

Dietary adjustments can also play a role. Focus on eating more fiber, cutting back on refined carbohydrates, and minimizing trans and saturated fats. These changes may support better hormone regulation and overall health.

Additionally, some supplements and herbs might be useful. Options like inositol and berberine are often mentioned for their potential to support hormonal balance. Herbs such as licorice, ginseng, and cinnamon might also contribute positively. That said, it’s essential to tailor these approaches to individual needs and consult with a healthcare provider to ensure they’re safe and suitable for your situation.