Higher than usual androgen levels or activity, detected through clinical signs or blood tests.
What androgens are
Androgens are a group of hormones such as testosterone that women normally have in small amounts and that play a role in many body functions, including bone health, muscle, and sex drive. When their level or activity rises above the usual range, the situation is called hyperandrogenism. This rise can happen because the ovaries or adrenal glands make more androgen, or because more androgen is present in its active, free form. Some androgen in the blood is bound to proteins and inactive, so when the binding protein falls, more free androgen becomes available to act on the body.
How it shows up
Hyperandrogenism can be clinical or biochemical. The clinical form refers to visible signs, such as persistent acne, excess facial or body hair (hirsutism), and male-pattern hair loss. The biochemical form is picked up through blood tests such as total testosterone or the free androgen index. A person can show one form without the other; for example, some women have clear clinical signs while their blood tests sit in the usual range, and others show the reverse. That is why a doctor considers both together rather than relying on a single measure.
Why it matters for PCOS
Hyperandrogenism is one of the three Rotterdam criteria used to assess PCOS, alongside irregular cycles and ultrasound findings on the ovaries. Higher androgen levels often link to insulin resistance, because high insulin can push the ovaries to make more androgen and lower the hormone-binding protein. These effects can reinforce one another, and it is one reason androgen signs so often appear alongside metabolic concerns in PCOS. This connection is explained further on the insulin resistance page.
When to talk to a doctor
Androgen signs alone do not confirm PCOS. A doctor needs to exclude other causes, such as adrenal gland conditions or the effects of certain medicines, and weigh them alongside cycle pattern and other clinical findings, as described in what is PCOS. If signs appear suddenly or increase quickly, get a doctor’s review early so the cause can be investigated carefully. The options for managing androgen signs depend on the cause and your own situation, so they are best discussed with a doctor or pharmacist.
This glossary is education, not diagnosis. For your own situation, ask a doctor or pharmacist.