Androgens and Their Effects on Hair, Skin, and Fertility

Androgen refers to a group of hormones, including testosterone, that help regulate sexual development, body hair, muscle mass, bone health, and metabolism in both males and females. When androgen levels are too high, too low, or not working normally, they can affect skin, hair, periods, fertility, sexual function, mood, and overall well-being.

What androgen means and why it matters

Androgen is the name for a group of hormones that play important roles in growth, development, reproduction, and body composition. Testosterone is the best-known androgen, but it is not the only one. Other androgens are made in the ovaries, testes, adrenal glands, and in body tissues that convert one hormone into another.

Although androgens are often described as “male hormones,” they are important for everyone. In males, they help guide puberty, voice deepening, facial and body hair growth, sperm production, and muscle development. In females, smaller amounts of androgens support bone strength, libido, energy, and normal hormone balance.

Problems can happen when the body makes too much androgen, too little androgen, or when tissues respond to these hormones differently. The effects may appear in the skin, hair, menstrual cycle, fertility, sexual function, mood, or physical development. Because symptoms can overlap with many other conditions, medical evaluation is often needed to identify the reason.

How androgens work in the body

Androgens act as chemical messengers. They travel through the bloodstream and attach to androgen receptors in many tissues, including the skin, muscles, bones, brain, reproductive organs, and hair follicles. Once attached, they help control how cells grow and function.

The body carefully regulates androgen levels through signals between the brain and hormone-producing glands. The hypothalamus and pituitary gland send signals to the ovaries or testes, while the adrenal glands make additional hormone precursors. A change anywhere in this system can affect hormone balance.

Normal androgen activity supports several everyday functions. These include maintaining muscle mass, supporting bone density, influencing oil production in the skin, regulating sex drive, and contributing to red blood cell production. This is why androgen imbalance can affect more than one part of the body at the same time.

• In puberty: sexual development and body hair changes
• In adulthood: muscle, bone, metabolism, libido, and fertility support
• In skin and hair: acne, scalp hair thinning, or increased facial/body hair when levels are abnormal

Symptoms of high or low androgen levels

Symptoms depend on a person’s sex, age, and underlying health condition. High androgen levels in females may cause acne, increased facial or body hair, scalp hair thinning, irregular periods, difficulty becoming pregnant, and weight-related metabolic changes. One common condition linked to excess androgen is polycystic ovary syndrome (PCOS).

High androgen levels in males are less commonly discussed because normal male development depends on androgens, but unusually high levels may occur with certain medications, hormone use, adrenal disorders, or tumors. Possible effects can include acne, mood changes, infertility, testicular shrinkage when external hormones are used, and changes in cholesterol or blood pressure.

Low androgen levels may also cause symptoms. In males, this can include reduced libido, erectile difficulties, low energy, reduced muscle mass, lower bone density, depressed mood, and decreased facial or body hair. In females, symptoms may be more subtle and can include low sexual desire, fatigue, reduced sense of well-being, and, in some cases, reduced muscle strength.

Children and adolescents may present differently. Too much or too little androgen can affect the timing of puberty and patterns of physical development. These situations should always be assessed by a qualified doctor because hormone changes during childhood require careful interpretation.

Causes and risk factors of androgen imbalance

There is no single cause of androgen imbalance. In females, excess androgen is often related to PCOS, but it may also result from adrenal gland disorders, ovarian conditions, insulin resistance, or certain medications. In males, low androgen may be linked to aging, testicular disease, pituitary problems, obesity, long-term illness, or medicines that affect hormone signaling.

Adrenal disorders can also influence androgen production. For example, excess hormone production from the adrenal glands may be seen in some endocrine conditions, while rare tumors of the adrenal glands or ovaries/testes can produce abnormal hormone levels. Doctors consider these less common causes when symptoms are severe, appear suddenly, or progress quickly.

Body weight, metabolic health, sleep, and chronic medical conditions may also affect androgen balance. Some people notice symptoms alongside diabetes, thyroid disease, severe stress, or use of anabolic steroids. Hair and skin changes may overlap with other disorders, including hair loss (alopecia), which is why a full assessment can be helpful.

• PCOS and insulin resistance
• Adrenal gland disorders
• Testicular, ovarian, or pituitary conditions
• Aging and obesity
• Certain medicines, including steroid-related drugs
• Rare hormone-producing tumors

How doctors diagnose androgen-related problems

Diagnosis begins with a detailed medical history and physical examination. A doctor will ask about symptoms such as acne, unwanted hair growth, scalp hair loss, menstrual changes, reduced libido, erectile symptoms, fertility concerns, or changes in body composition. The timing of symptoms matters because sudden changes may suggest a different cause than symptoms that develop gradually.

Blood tests are commonly used to check hormone levels. These may include total or free testosterone and other related hormones, depending on the person’s symptoms and sex. Additional tests may assess thyroid function, blood sugar, cholesterol, adrenal hormones, or pituitary hormones to understand the bigger picture.

Imaging is sometimes needed if doctors suspect a structural cause, such as an ovarian, testicular, pituitary, or adrenal problem. Pelvic ultrasound may be useful in suspected PCOS, and MRI or CT scans may be recommended in selected cases. If fertility is a concern, semen analysis or gynecologic evaluation may also be part of the workup.

Because normal hormone ranges vary by age, sex, and laboratory method, test results must be interpreted in context. A single number is rarely enough on its own. Careful diagnosis helps avoid unnecessary treatment and directs attention to the true cause.

Treatment options for androgen imbalance

Treatment depends on whether androgen levels are high, low, or being used abnormally by the body. The main goal is to treat the underlying cause, not just the hormone level. For example, management may focus on PCOS, pituitary disease, adrenal disorders, medication side effects, or age-related hormone deficiency after careful evaluation.

For excess androgen in females, treatment may include lifestyle changes, medicines that regulate periods or reduce androgen effects, and therapies for acne or hair growth. Some patients benefit from support through fertility treatment if hormonal imbalance affects ovulation and pregnancy planning. In selected endocrine or gynecologic cases, a doctor may recommend further imaging or procedures.

For low androgen in males, doctors may assess whether testosterone deficiency is truly present and whether treatment is appropriate. Possible management can include addressing obesity, sleep problems, chronic disease, or medication effects. Some men may be considered for testosterone replacement therapy after a specialist evaluation, especially when symptoms and repeated blood tests support the diagnosis.

If a growth or tumor is found in a hormone-producing gland, treatment may involve surgery or other specialist care. In some situations this can include adrenal surgery or referral for broader endocrine management. Treatment plans are individualized because hormone balance affects many body systems and needs ongoing follow-up.

Self-care, lifestyle, and long-term health

Healthy daily habits can support hormone balance and improve symptoms, even when medical treatment is also needed. Regular physical activity, good sleep, balanced meals, and weight management may help reduce insulin resistance and improve metabolic health. These steps are especially useful when androgen imbalance is linked to PCOS, obesity, or low energy.

Skin and hair symptoms often improve slowly, so patience is important. Gentle skin care, avoiding harsh products, and speaking to a doctor about acne, scalp hair thinning, or excess hair growth can help people choose safe treatments. Self-prescribing hormones or supplements is not recommended because it can worsen symptoms and make diagnosis harder.

Long-term follow-up may be important if androgen imbalance is tied to fertility, bone health, sexual function, or metabolic risks. Monitoring may include repeat blood tests, menstrual tracking, semen evaluation, or checks for blood pressure, cholesterol, and blood sugar. In complex cases, multidisciplinary assessment can be helpful. Acıbadem Health Point’s multidisciplinary specialists and JCI-accredited hospitals diagnose and treat hormone-related conditions for international patients.

When to seek medical care

A person should consider medical care if symptoms are persistent, bothersome, or affecting fertility, sexual health, or quality of life. Examples include new facial hair growth in females, irregular or absent periods, severe acne, unexplained scalp hair thinning, low libido, erectile difficulties, or delayed puberty. Ongoing fatigue and loss of muscle strength can also justify evaluation, especially when several symptoms happen together.

More urgent assessment is needed if symptoms appear suddenly or progress quickly. This includes rapid voice deepening in females, sudden severe hair growth, marked clitoromegaly, testicular changes, or signs that suggest a tumor or serious endocrine disorder. Children with unusually early or delayed puberty should also be seen promptly by a doctor.

People trying to conceive may benefit from earlier hormone testing if cycles are irregular or there are signs of ovulation or sperm problems. Anyone considering hormone therapy should seek professional advice rather than starting treatment independently. A qualified doctor can explain whether symptoms are related to androgen levels and what next steps are safest.

Frequently asked questions