what is androgen excess? | fast facts | glossary of terms | faq
Excess hair growth (hirsutism), acne, or scalp hair loss
excessive hair growth, scalp hair loss, and acne | irregular ovulation or menstrual period | infertility
Women affected by androgen excess or PCOS commonly report bothersome excess hair growth, acne or balding (scalp hair loss or thinning). Hirsutism refers to the excess growth of coarse, often long and dark hair, in a male-like pattern over the face, chest, abdomen, back, arms and legs. Scalp hair loss or balding, also called androgenic alopecia, refers to the loss or thinning of scalp hair. Acne, including of the face, back, or vulva, can also be a sign of androgen excess. Hirsutism, acne or androgenic alopecia can be the result of increased production of male hormone, called androgens, in women with PCOS.
The ovaries, and frequently the adrenal of women with PCOS 
overproduce androgens. The excess male hormones circulate in the blood and act on hair follicles in the skin to stimulate the growth of long, coarse, and commonly dark hairs. They also cause hairs in the scalp to stop growing, resulting in balding. Excess androgens also result in the overproduction of sebum, the skin oil, which results in clogged pores and acne.
In addition to being considered a significant cosmetic problem for many women, hirsutism, acne and androgenic alopecia may indicate an underlying problem of significant concern – elevated androgen levels. There is evidence to suggest that long-standing elevations in androgens in women with PCOS can lead to problems with cholesterol and other lipid levels, which are risk factors for heart disease.
It is important to note that not all women with hirsutism, acne or alopecia have PCOS. Also, not all women with hirsutism will be found to have elevated androgen levels. Conversely, not all women with PCOS will have hirsutism. An important factor in the development – or lack thereof – hirsutism is race and ethnicity. For example, women of Asian extraction will have little or no hair growth despite similar levels of androgens as other women.