By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 31, 2026

Hyperandrogenism is the clinical or biochemical state of excess androgen effect in women, presenting as hirsutism, acne, alopecia, and/or menstrual irregularity. It is the defining feature of PCOS in most international diagnostic criteria.

Biochemical hyperandrogenism is established by elevated free or total testosterone, DHEA-S, or androstenedione above age-specific reference ranges. Source identification is clinically essential: adrenal-origin hyperandrogenism (characterized by elevated DHEA-S and 17-OHP) must be distinguished from ovarian-origin excess (elevated testosterone and androstenedione). Congenital adrenal hyperplasia, particularly non-classic 21-hydroxylase deficiency, mimics PCOS and must be excluded before a PCOS diagnosis is finalized.

In RRM, hyperandrogenism drives a source-directed workup. RRM clinicians treat the identified cause with targeted interventions (which may include metformin, myo-inositol, or adrenal support) rather than suppressing androgen production with oral contraceptives. The distinction between masking the signal and correcting the underlying dysfunction is central to the RRM approach.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.