Virilization

Normally, low levels of male sex hormones are present in females and are produced by the adrenal glands and the ovaries. However, if the production of these hormones increases significantly, various male characteristics begin to develop, a condition called virilization.

Virilization most commonly occurs in adulthood, causing symptoms such as deepening of the voice, excessive hair growth on the face and body known as hirsutism, and thinning of the hair on the temples and crown. These symptoms often cause psychological distress. Rarely, the condition is present at birth, virilization is usually due to a genetic disorder that causes abnormal hormones levels.

What are the causes?

When virilization develops later in life, the possible causes induce abnormalities of the ovaries, such as certain types of ovarian cysts, cancer of the ovary, and polycystic ovary syndrome. Hormone levels can also be increased by adrenal tumours and the use of certain male hormone supplements by athletes.

What are the symptoms?


Symptoms appear gradually as male sex hormone levels rise. They include:

- Excessive growth of hair on the face and body.
- Less regular or absent menstruation.
- Reduction in breast size or in rare cases failure of the breasts to develop.
- Enlargement of the clitoris.
- Irreversible enlargement of the larynx (Adam’s apple), causing the voice to become deeper.
- Thinning of the hair around the temples and crown.

The hormonal imbalance may lead to increased muscles development, producing a male body shape.

What may be done?

Your doctor will examine you and may arrange tests to determine the cause of your symptoms. These tests include blood tests to measure hormone levels, MRI or CT scanning to look for an adrenal tumour, and ultra-sound scanning to check the ovaries. Treatment of the cause, such as removal of a tumour, should reverse some of the changes. If no cause is found, oral contraceptives may be given to suppress hormone production by the ovaries and reduce male sex hormone levels. You may be given advice on how to manage excessive hair, perhaps by using electrolysis or waxing. Counseling is often helpful.