Cause | Common Features* | Tests |
---|---|---|
Adrenal gland disorders | ||
Adrenal hyperplasia (enlarged adrenal glands that produce abnormally large amounts of male hormones) | Development of masculine characteristics (virilization), such as a deepened voice, baldness, an enlarged clitoris, increased muscle size, irregular or absent menstrual periods, and acne When adrenal hyperplasia is present at birth, external genital organs that are not clearly male or female (ambiguous) | Blood and sometimes urine tests to measure hormone levels A dexamethasone suppression test (dexamethasone, taken by mouth, followed several hours later by a blood test to measure hormone levels) |
Adrenal tumors (usually cancerous) | Development of masculine characteristics if an adrenal tumor produces excess androgens (like testosterone), or if the person has Cushing syndrome (an adrenal tumor that makes excess cortisol [see below]) | MRI or CT Blood and urine tests to measure hormone levels |
Excess fat throughout the torso, a pad of fat between the shoulders (buffalo hump), thin arms and legs, purple stretch marks on the abdomen, easy bruising, a large and round face (moon face), high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more , and diabetes mellitus Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more | Urine and usually blood tests to measure the level of cortisol (which may be high in Cushing syndrome) Usually a dexamethasone suppression test | |
No disorder present | ||
Familial hirsutism | Hirsutism in family members No other symptoms (normal menstrual cycles and no other masculine characteristics) | A doctor’s examination Blood tests to measure hormone levels (which are normal) |
Ovarian disorders | ||
Hirsutism that begins after puberty Development of masculine characteristics, obesity, infertility, menstrual irregularities, acne, loss of scalp hair, decreased sensitivity to insulin, and darkened and thickened skin in the underarms, on the nape of the neck, and in skinfolds (acanthosis nigricans) | A doctor’s examination Blood tests to measure levels of hormones, such as testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) Usually ultrasonography | |
Tumors | Sometimes one or more of the following symptoms, which often begin suddenly:
| Ultrasonography Sometimes CT or MRI |
Pituitary disorders | ||
A pituitary adenoma (a noncancerous tumor) that secretes prolactin | Production of breast milk in women who are not breastfeeding ( galactorrhea Prolactinoma Prolactinomas are noncancerous tumors made up from special cells (lactotrophs) in the pituitary gland. The most common symptom of a prolactinoma is galactorrhea, which is the production of breast... read more ) No menstrual periods Sometimes vision problems | Blood tests to measure the level of prolactin MRI of the brain |
A pituitary disorder that causes Cushing disease (such as a pituitary tumor) | Blood and sometimes urine tests to measure the level of cortisol (which may be high) A dexamethasone suppression test MRI of the brain | |
Drugs | ||
Androgenic drugs:
| Development of male characteristics Use of anabolic steroids (sometimes not admitted by the user) | A doctor's examination |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
CT = computed tomography; MRI = magnetic resonance imaging. |