Testosterone's major adverse effects include virilization
(oily skin, acne, hirsutism, alopecia, deep voice), liver toxicity, polycythemia, breast carcinoma, and unfavorable changes in cardiovascular risk markers such as reduction in high-density lipoprotein cholesterol or insulin sensitivity.
Hormonal evaluation of women with virilization
or irregular menses should be strongly considered before initiation of oral contraceptive therapy for acne, she added.
Hyperandrogenism manifests in females as hirsutism, acne, frontal and temporal balding, deepening voice, increased muscle mass, decreased breast size, and in severe cases, virilization
involving clitoromegaly (Marshall, 2001).
SAN FRANCISCO -- Prenatal treatment of congenital adrenal hyperplasia with dexamethasone effectively reduced virilization
of the genitalia in female infants with few, mostly mild effects on the mothers, according to one of the largest series of such cases ever reported.
Many patients have symptoms of virilization
due to the presence of androgen element in tumor.
Testosterone produced by Leydig cells subsequently induces virilization
of the Wolffian ducts into epididymides, vasa deferentia and seminal vesicles.
PORD shows adrenal dysfunction, disorders of sex development in 46,XX and 46,XY, skeletal dysplasia, maternal virilization
during pregnancy, and increased serum 17OHP.
The goal of treatment should be to increase sexual desire without producing the side effects of hirsutism, acne, or virilization
Multinucleated tumor giant cells are found in rare hepatoblastomas, sometimes associated with HCG production and clinical virilization
Cancer can also cause virilization
, so androgen levels should be measured in the tests to rule out a tumor.
Secondary causes of hyperandrogenism may be suggested by clinical findings, including 1) abrupt onset, short duration, or sudden progressive worsening of hirsutism; 2) onset of symptoms in the third decade of life or later; or 3) signs of virilization
(deepening voice, clitoromegaly).
If hyperandrogenism is suspected in females with acne based on signs of virilization
, menstrual irregularities, infertility, or obesity, screening blood levels of free testosterone and dehydroepiandrosterone sulfate (DHEAS) may be obtained.