Unmasking hyperandrogenism: What clinical symptoms reveal about hormonal mysteries

Objectives This single-center observational study aimed to explore the relationship between clinical features and hormonal indices in affected patients while determining the underlying etiology of hyperandrogenism. Materials and Methods In this cross-sectional study performed at a tertiary care hospital, 200 patients with features of hyperandrogenism were included. Patients underwent comprehensive clinical assessment and laboratory tests, including serum hormonal profile, free androgen index (FAI), fasting blood glucose, fasting insulin, and Homeostatic Model Assessment of Insulin Resistance. Results The mean age of the participants was 28.80 ± 10.15 years (range 15–59 years). Hirsutism was the most prevalent symptom (99%) followed by alopecia (61.5%), acne (54.5%), seborrhea (38%), and acanthosis nigricans (29.5%). Polycystic ovary syndrome (PCOS) was the leading cause (60%) followed by idiopathic hirsutism (19.5%). Mean values of serum luteinizing hormone/follicle-stimulating hormone ratio, total and free testosterone, and FAI were elevated beyond the reference range in patients with clinical features of hyperandrogenism, suggesting a link between these clinical features and altered hormonal profile. However, despite these elevated levels, no significant correlation was found between specific clinical symptoms and hormonal levels. Conclusion The study identified ovarian causes as predominant, with significant associations between PCOS and elevated serum androgens. However, clinical manifestations of hyperandrogenism were not reliable predictors of specific hormonal abnormalities, suggesting that biochemical assessment is crucial for accurate diagnosis.