What is Virilization
The term virilization refers to a set of signs and symptoms attributable to the presence of an important hyperandrogenism in women.
Causes
The causes of virilization can be pathological in nature (ie due to diseases or dysfunctions), or they can reside in the excessive and poorly controlled abuse of testosterone derivatives for anabolic or sexual purposes.
Among the possible causes of pathological nature, we find androgen-secreting tumors.
Other pathological situations that cause hyperandrogenism and virilization, on the other hand, manifest themselves with similar but more blurred and less evident symptoms; it is the case, for example, of the polcisitic ovary syndrome (PCOS) or of conditions of adrenal hyperplasia.
Symptoms
The symptoms of virilization consist, as mentioned, in the appearance of typically male characters and signs in female patients.
This symptomatology, however, may vary depending on the age of the affected patient.
However, at the skin level, the virilization phenomena manifest themselves with marked hypertrichosis and hirsutism.
Hypertrichosis is characterized by a local and generalized increase in body terminal hair, in areas where it is normally present in women.
Hirsutism, on the other hand, indicates the presence of terminal hairs in non-physiological locations for the female organism, for example at the level of the upper lip, cheeks, chin, linea alba, thighs and genital region. In these places, the so-called sprite hairs, present in all women, become long, thick and pigmented.
Also in the skin, virilization leads to excessive sebum secretion, with a tendency to comedogenic phenomena (presence of acne, blackheads, seborrhea).
In general, however, symptoms are noted, such as:
- Lowering of the tone of the voice;
- Increased muscle mass;
- clitoromegaly;
- Sexual disorders;
- Androgenetic alopecia;
- Breast reduction;
- Modification of body fat deposits in the male direction, with a tendency to accumulate at the thoraco-abdominal level instead of the gluteal-femoral level.
At the same time, it is possible that there is a decrease or total cessation of menstrual flows.
Diagnosis
The combination of all these abnormal changes in a woman's body can facilitate the diagnosis of the doctor who will then have to confirm it through specific tests, such as, for example, blood tests for hormone dosage.
After that, the doctor's task will be to determine the root cause of virilization. Once the abuse of anabolic steroids is excluded, it will be necessary to discriminate between the presence of an eventual androgen-secreting tumor or the presence of any dysfunctions of the ovaries or adrenal glands. In this regard, a dexamethasone suppression test can be performed. In fact, in the case of adrenal hyperplasia, dexamethasone will be able to suppress the production of androgens by the latter; which, on the other hand, will not happen if the cause of virilization resides in a neoplasm.
Once the diagnosis is complete, the doctor will then be able to tell the patient which therapeutic strategy to follow to solve the problem.
Treatment
Of course, the treatment of virilization varies depending on the cause that caused it.
Faced with adrenal hyperplasia, for example, virilization can be counteracted by administering small doses of corticosteroids, such as dexamethasone, while in cases of dysfunctional hyperandrogenism, the basic administration of cyproterone acetate (with important antiandrogenic activity) is performed, side by side with that of ethinyl estradiol for contraceptive and preventive purposes against osteoporosis.
If virilization is caused by androgen-secreting tumors, on the other hand, therapy can be surgical if the removal of tumors or adrenal glands is necessary. At the same time, it is possible to proceed - both before and after any surgical operation - with the prescription of adequate chemotherapy or anti-cancer radiotherapy.
In any case, in order to allow the doctor to make a correct diagnosis and to intervene promptly with the most appropriate treatment, it is of fundamental importance to immediately contact him as soon as the first symptoms of virilization are noticed.
