Masculinization (Androgenization)

By | June 10, 2022

Masculinization or androgenization refers to physical masculine changes in a woman. These occur when there is an excess of male hormones (androgens) in a woman’s body.

What is masculinization (androgenization)?

Masculinization occurs in a woman who shows an increased effect of the male hormones, the androgens. In men and boys, these hormones ensure that the primary and secondary sexual characteristics can form and develop.

These include, for example, the testicles, the broken voice and the increased body hair from puberty onwards. In addition, androgens ensure that more muscle mass is built up through protein formation. Females also normally produce small amounts of these hormones, but increased levels are found in the blood when masculinization occurs. For all you need to know about germ cell tumor, please visit

The main symptoms are that there is increased hair growth all over the body and the voice sounds much deeper.


There are different reasons for masculinization to occur. Usually there is a disturbance of the hormone metabolism, in which the male hormones are particularly affected. Here, for example, the androgens cannot be broken down or converted properly; there is an increase in the level of androgens in the blood.

Another reason for the increased production of male hormones can be a tumor in the adrenal cortex, which is responsible for the production of hormones, or on the ovaries. Hormone production is controlled by the pituitary gland (also called the pituitary gland) by releasing certain hormones. A tumor on the pituitary gland can also ensure that the adrenal cortex or the ovaries produce more androgens, which then also leads to masculinization.

A disruption in enzymes and enzyme formation can also lead to masculinization; this can be congenital or occur later in the period leading up to puberty. Anyone who, as a woman, frequently takes hormone preparations, for example anabolic steroids, can derive another cause for masculinization.

Symptoms, Ailments & Signs

Androgenization in women is primarily reflected in physical characteristics. Depending on the intensity, these symptoms can vary and vary in severity. There is often a visible increase in facial and body hair ( hirsutism ). In the affected women, dark whiskers initially grow on the face, which can become increasingly dense.

A mustache often develops. Typically, no new hair grows on the face, but the existing soft downy hair gradually thickens. There may also be increased chest hair. At the same time, the affected women show a pathological, increased loss of hair in typical male hair loss patterns (alopecia).

Diffuse hair loss usually occurs in the crown area in the form of a receding hairline. Sometimes there are light spots on the back of the head. Due to the influence of male hormones, the complexion deteriorates significantly. The sebaceous glands secrete more sebum. As a result, pimples, abscesses and nodules form more frequently. Acne sometimes occurs.

Other possible physical symptoms of androgenization include clitoral enlargement, a noticeable increase in muscle mass, a deepening voice, progressive breast regression, and menstrual cycle disorders. Advanced disease can lead to infertility. Very rarely, androgenization manifests itself psychologically through increased aggression or an increased sex drive.

Diagnosis & History

If masculinization is suspected, the doctor carries out a detailed examination and questioning. In order to be able to find the exact cause, some laboratory tests must be carried out to determine the hormone balance. In this way, the concentration of the various hormones in the body can be determined.

If there is some evidence of a possible tumor in the area of ​​the pituitary gland, ovaries or adrenal cortex, imaging tests are necessary. Above all, computed tomography and ultrasound examinations are carried out in the abdomen, and magnetic resonance imaging is used to examine the pituitary gland, as this is more accurate for diagnosing the head.

When should you go to the doctor?

If abnormalities in the hormone system are noticed in sexually mature girls or women, a check-up visit with a doctor should be initiated. Disturbances of menstrual bleeding, peculiarities of the libido as well as optical abnormalities should be clarified by a doctor. Excessive growth of hair on the face or a beard are signs of an existing disorder. If a mustache develops, a medical examination should be initiated to clarify the cause. A doctor’s visit is also advisable in the event of hair loss, hair growth in the chest area and skin irregularities. An increased occurrence of pimples, abscesses and impure skin are indications that should be followed up. If strong receding hairline forms, research into the cause is also recommended.

Peculiarities of behavior, a male-dominated appearance or a particularly deep voice should be discussed with a doctor. If psychological problems occur or existing irregularities increase in intensity, the person concerned needs help and support. An unfulfilled desire to have children, an enlarged clitoris and an unusually strong muscle mass on the body are also signs of an existing hormonal disorder. In order for a diagnosis to be made, medical tests are necessary, which are used to clarify the cause. If there is an age-inappropriate regression and thus a reduction in the size of the breast, the observations should be clarified by a gynecologist.

Treatment & Therapy

The therapy of masculinization is often lengthy and can extend over several years. It is important not to interrupt the treatment, otherwise the symptoms may reoccur. So it takes a lot of perseverance to achieve a successful therapy.

In order to start the right treatment, it is first necessary to know the exact cause of the masculinization. In the case of a tumor, for example, an operation is unavoidable, as is subsequent therapy. If, on the other hand, the cause of the masculinization lies in a defect in the enzymes, hormone therapy is initiated in which the production of androgens is suppressed.

The active ingredients are similar to those used in hormonal contraceptives. Depending on how severe the masculinization is, it can also be relieved without hormone therapy, for example in the case of signs on the skin. Permanent epilation or laser treatment can reduce excess body hair; the roots of the hair are destroyed and hair growth gradually decreases over time.


Masculinization can only be prevented if the cause can be found in the use of anabolic steroids. These androgenic preparations should no longer be taken so that the masculinization does not progress any further. These are mainly anabolic steroids and doping agents, which ensure that muscle mass is built up more quickly by the body.


Masculinization represents a strong emotional burden for the patients. Therefore, the primary follow-up care is carried out in the form of psychotherapeutic sessions. The self-esteem of those affected should be stabilized and mental disorders such as depression should be prevented. Patients often experience bullying or discrimination in their immediate environment.

Psychotherapy can intervene in these cases and prevent the resulting mental damage. Appropriate handling of the disease is also learned during psychological follow-up care. Follow-up care after androgenization is not limited to the patient alone. Relatives can also suffer from the change and feel overwhelmed.

Then the psychological counseling also extends to them. At the psychotherapeutic facility, they have a point of contact where they can obtain professional advice in the stressful situation. In the case of an affected woman, the follow-up care consists not only of psychotherapeutic approaches but also of a consultation with a gynaecologist.

Androgenization cannot be completely cured, only contained. Hormones are administered by the specialist to regulate the estrogen balance. As part of the aftercare, the estrogen levels are checked with regular blood tests. If a higher or lower dosage of hormones is required, the amount will be adjusted accordingly during follow-up care.

You can do that yourself

In the treatment of masculinization, a distinction is made between causal and purely symptomatic treatment. The causal treatment aims to treat an underlying disease. This includes, for example, discontinuing so-called anabolic steroids, which athletes often use. However, if a tumor is the trigger in those affected, the masculinization slowly regresses on its own after successful therapy.

In many cases of those affected, the therapy of masculinization is lengthy, since the actual causes are often not known. In the case of masculinization, in which too many androgens are produced in the affected female body, special hormone therapy can be very promising. However, taking hormone preparations, such as the birth control pill, is only a purely symptomatic therapy. Because when the hormones are stopped, the problems reappear.

Without such hormone therapy, all of the various symptoms need to be treated. In the case of clear acne, special skin care products and cleansing masks made of healing earth can be used. If the patient has increased body hair, techniques such as laser hair removal can be used. The treatment of masculinization is very lengthy and should be individually tailored to the symptoms of those affected. Except for avoiding anabolic steroids, affected women can hardly do anything themselves to treat an occurring masculinization.

Masculinization (Androgenization)