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Virilization

Virilization is a condition in which a female develops male sex characteristics, or a newborn boy has increased male characteristics at birth.

Information

Virilization may be caused by:

  • Excess testosterone production
  • Use of anabolic steroids

In newborn girls, the condition may be caused by:

  • Certain medications taken by the mother during pregnancy
  • Congenital adrenal hyperplasia in the baby or her mother
  • Other medical conditions in the mother (such as tumors of the ovaries or adrenal glands that release male hormones)

In girls who are going through puberty, the condition may be caused by:

  • Polycystic ovarian syndrome
  • Certain medications, or anabolic steroids
  • Congenital adrenal hyperplasia
  • Tumors of the ovaries, or adrenal glands that release male hormones

In adult women, the condition may be caused by:

  • Certain medications, or anabolic steroids
  • Tumors of the ovaries or adrenal glands that release male hormones

Signs of virilization in a female often depend on the level of testosterone in the body.

       Low level:

  • Thick, dark facial hair in the beard or mustache area
  • Increase in body hair
  • Oily skin or acne
  • Irregular menstrual periods

       Moderate level:

  • Male-pattern baldness
  • Loss of female fat distribution
  • Decreased breast size

       High level:

  • Enlargement of the clitoris
  • Deepening of the voice
  • Male muscle pattern

Tests may include:

  • Blood tests to detect excess testosterone in females
  • CT scan, MRI, or ultrasound to rule out tumors of the ovaries and adrenal glands

References

Bright TM. Hirsutism and virilization. In: McDermott MT, ed. Endocrine Secrets. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 48.

Stewart PM. The adrenal cortex. In: Kronenberg HM, Shlomo M, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 14.

Styne DM, Grumbach MM. Puberty: ontogeny, neuroendocrinology, physiology, and disorders. In: Kronenberg HM, Shlomo M, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 24.

Update Date: 5/24/2013

Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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