Hyperandrogenism is a medical condition in which the body produces excessive androgens – male sex hormones – such as testosterone. It is more commonly experienced by women, though it is seen in men, and people who are intersex as well.
All bodies produce androgens, but women normally produce them in lower amounts than men. So, when androgen levels become excessive, women may experience symptoms such as excessive hair growth, acne, and irregular menstrual cycles, among others. Hyperandrogenism can be caused by various factors, one of the most common being polycystic ovary syndrome (PCOS).
Apart from the medical concerns it poses, the condition is often viewed with stigma because of rigid gender roles in society, especially since it can also affect women’s reproductive health. In the sporting arena, too, the condition has historically caused much furore, as it places women’s bodies under question and intense scrutiny.
Here’s all you need to know about hyperandrogenism:
What causes hyperandrogenism?
In men, androgens are produced in the testicles, and in women, the ovaries. Both men and women also produce androgens in the adrenal glands (two endocrine glands located on top of the kidneys). Studies have shown that in women with PCOS, higher levels of insulin are often present, and this in turn causes the ovaries to produce more testosterone.
Besides PCOS, hyperandrogenism may also be caused by congenital adrenal hyperplasia (CAH). CAH refers to a group of genetic disorders that affect the adrenal glands. Due to certain enzyme deficiencies, these disorders prevent the glands from producing crucial hormones (like cortisol) and this in turn, leads to the excess production of androgens. CAH is one of the common genetic causes of intersex traits in persons with XX chromosomes, and it can lead to enlarged or atypical genitalia in female bodies.
Though rare, certain tumours, such as those in the adrenal glands, testicles, or ovaries, can also lead to hyperandrogenism. Some medications can cause it as well.
Symptoms and treatment
Hyperandrogenism may commonly manifest in symptoms such as acne and oily skin, excess body hair, male pattern baldness (in women), and irregular periods. If untreated, in some cases, it can also lead to infertility, high blood pressure, type 2 diabetes, and even heart disease.
While these may vary with age, body weight, and ethnicity, hyperandrogenism is typically diagnosed through a subjective assessment of such symptoms, besides blood tests determining the levels of testosterone in the body.
Depending on the underlying cause, hyperandrogenism can be treated or managed with birth control pills – which are a common treatment for PCOS – or with corticosteroids, which mimic cortisol produced by the adrenal glands. The latter can help treat the condition when it is linked to inadequate cortisol production. There are also certain drugs that block the effects of excess androgens, helping to manage symptoms such as acne and excess body hair.
Hyperandrogenism and women’s sport
Under the guise of preventing “undue advantage” for female athletes in the international sporting arena, many women with hyperandrogenism have historically been subjected to controversial sex verification tests, widely criticised as “unscientific”. These tests – which have evolved from forcing female athletes to parade naked before doctors and specialists, to analysing their blood for testosterone levels – have resulted in Indian athletes such as Santhi Soundarajan and Dutee Chand losing medals or being forced to fight for their sporting opportunities.
Algerian boxer Imane Khelif was also at the centre of a gender controversy during the 2024 Paris Olympics, after she was falsely accused of being male or transgender, with many claiming that her participation was unfair to women’s sport. Experts, however, have argued that testosterone alone – which naturally occurs at higher levels in some female bodies – cannot be considered the most decisive factor when it comes to athletic ability.
While hyperandrogenism is a condition that is almost always irreversible, it can be managed. Equally important is the need to address and change the stigma surrounding the condition, through greater awareness and a more nuanced understanding of sex and gender.
Published – December 25, 2025 04:30 pm IST