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Virilization is a condition in which women develop male-pattern hair growth and other masculine physical traits. Women with virilization often have an imbalance in sex hormones, such as estrogen and male sex hormones, or androgens, like testosterone.

An overproduction of androgens can cause virilization. Androgens are primarily produced by the adrenal glands, which are present in both females and males, and the testicles. To a lesser extent, they’re produced in ovaries. The testicles are the primary source of testosterone, but the androgens produced by the adrenal glands are just as important for secondary male sexual characteristics.

The use of anabolic steroids can also cause virilization. These are synthetic substances that act like the male hormone testosterone.

Recognizing the Symptoms of Virilization

The symptoms of virilization include:

  • excessive facial hair, usually on the cheeks, chin, and upper lip
  • deepening of the voice
  • an increased sex drive
  • smaller-than-normal breasts
  • an enlarged clitoris
  • irregular menstrual cycles
  • male-pattern baldness

Acne also tends to appear on the:

  • chest
  • back
  • face
  • hairline
  • underarms
  • groin

What Causes Virilization?

Any medical condition that causes an imbalance in sex hormone levels can result in virilization. These conditions tend to cause an overproduction of hormones in your adrenal glands. Sometimes, an adenoma, which is a type of cancerous tumor, causes virilization. A dysfunction in your hormone production pathway or in increased adrenal gland size, which is called hyperplasia, can also cause virilization.

Other causes of virilization include:

  • the use of male hormone supplements
  • the use of steroids to increase muscle mass
  • polycystic ovary syndrome (PCOS), which is a condition in which women of childbearing age have multiple cysts in their ovaries

Cases of virilization caused by PCOS are usually mild. Doctors don’t know exactly what causes PCOS. However, they believe that high insulin levels, low-grade inflammation, and genetics may play a role. Women with PCOS often have masculine physical characteristics, including male-pattern baldness and facial hair.

Diagnosing Virilization

Tell your doctor about all of the symptoms or physical changes you’ve experienced. Mention any medications you’re currently taking, including birth control. Learning and sharing your family’s medical history can also help your doctor determine the cause of your virilization.

If your doctor suspects that you may have characteristics of virilization, they’ll take a blood sample. Your blood sample will be tested for testosterone, estrogen, progesterone, and other hormones. An increased level of androgens is usually a sign of this condition.

If you have elevated levels of androgens in your blood, your doctor may perform a test called the dexamethasone suppression test. This test will help them determine the cause of the excess androgens. If your doctor suspects you have a cancerous adenoma, they’ll perform an imaging test, such as a CT scan. This will allow them to view structures within your body in detail. Your doctor can learn if abnormal growths are present using the imaging scans.

How Is Virilization Treated?

If you have an adenoma in your adrenal gland, your doctor will likely suggest removing it surgically. If the tumor is located in an area that’s dangerous or hard to reach, your doctor may recommend chemotherapy or radiation treatments. These therapies help shrink the tumor before it’s removed.

If a tumor isn’t to blame, your doctor may prescribe birth control pills. These can help regulate your hormone levels. They may also prescribe medications that block your androgen receptors.

The Takeaway

Virilization can cause women to develop masculine traits such as male-pattern baldness because of an imbalance in sex hormones. This can be a result of using male hormone supplements or steroids or having a condition such as PCOS or a cancerous tumor. Treatment options are available and depend on the cause. Talk to your doctor about your options.

Content licensed from:

Written by: April K and Megan McCrea
Medically reviewed on: Mar 18, 2016: University of Illinois-Chicago, College of Medicine

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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