By Dr. Vaia Siapka (Gynaecologist – Reg. No. 030314546).
Sex hormones play a very important, almost indispensable role in the proper functioning of the reproductive system. There are many types of hormones that influence the process to a greater or lesser extent. Among them are androgens, such as testosterone, androstenedione, or dehydroepiandrosterone (DHEA), which contribute to the development of sexual characteristics, gamete production, and the maintenance of sexual desire.
The problem arises when they are found in the body above normal levels, resulting in a condition known as hyperandrogenism. This condition can directly affect fertility in both men and women.
In fact, although it is mainly associated with women, men can also have imbalances in the levels of these hormones, with different consequences depending on the case.
The most visible signs in women are:
In men, this excess of androgen hormones may alter testicular function, affect sperm quality, or even modify sexual desire. In both cases, the hormonal imbalance impacts the reproductive system's ability to function normally.
They can be very varied, although in women of reproductive age, the most common cause is

In men, however, it is usually mainly due to the exogenous use of testosterone or anabolic steroids, used for sports or aesthetic purposes, which artificially elevate hormone levels and disrupt the hormonal axis balance. Hormone-producing tumors, both testicular and adrenal, can also be found in men, causing a sudden increase in testosterone. To a lesser extent, it may be caused by congenital disorders such as adrenal hyperplasia or metabolic alterations associated with obesity and insulin resistance.
From a medical perspective, it is necessary to distinguish between clinical hyperandrogenism (when visible signs or characteristic symptoms exist) and biochemical hyperandrogenism (when hormonal excess is detected only in laboratory tests). Diagnosis requires a complete evaluation including medical history, physical examination, and specific hormonal tests. Ultrasounds or imaging studies are often conducted to rule out ovarian or adrenal abnormalities.
The treatment of hyperandrogenism depends on the cause and the manifestations present in the body. In women, treatments usually focus on regulating the menstrual cycle and reducing the effects of androgen excess through oral contraceptives, anti-androgens, or insulin-sensitizing medications. In men, the goal is to restore hormonal balance and, if infertility occurs, to improve sperm quality with specific therapies.
In general, adopting healthy habits such as maintaining an adequate weight, exercising, or managing stress is usually fundamental to favor hormonal stability.
When hyperandrogenism exists and is untreated, it can have a significant impact on fertility, especially in women. Excess androgens can interfere with the maturation of ovarian follicles, prevent ovulation, and even alter the menstrual cycle, thus reducing the chances of conceiving naturally.
In men, although less common, elevated levels of these hormones can affect sperm production and testicular function, which also compromises fertility. For this reason, identifying and treating this imbalance in time is essential to improve reproductive prognosis. With proper monitoring and correct treatment, most patients with hyperandrogenism can restore normal hormonal function and increase their chances of achieving pregnancy.