Androgens

Reviewed: May 11, 2021
You will sometimes hear about 'progestogens' or progestins' (the man-made hormone (aka chemical messenger) they put into contraceptives) being described as ‘androgenic’ or ‘anti-androgenic’. But what exactly does this mean?

Androgens are a group of sex hormones generally associated with men, although some are also found naturally in women’s bodies in lower concentrations. Testosterone is the main hormone in this group.

High levels of androgens in women can cause a hormonal imbalance, which can lead to a number of problems, such as acne, excess body hair and balding. These can also be symptoms of Polycystic Ovary Syndrome (PCOS), which is associated with high levels of androgens, as well as irregular periods and problems with insulin sensitivity.

How is this related to my contraception?

All hormonal methods of contraception contain progestins. Some methods, known as ‘combined’ methods, contain progestin in combination with oestrogen.

Because they are similar to testosterone, some progestins can bind with the androgen receptors in our cells and either block or activate them. A progestin is considered androgenic if it triggers an androgenic response in the body, leading to unwanted side effects such as oily acne-prone skin, excessive hair growth (on places such as the face and the chest) and hair loss from the head.

Natural progesterone (the kind that our bodies make) is actually anti-androgenic, and the most recent generations of progestins have been developed in an attempt to create progestins that do not have an androgenic effect1.

Progestins can be described as ‘androgenic’ or ‘anti-androgenic’ – but the reality is that they all fall somewhere between the two extremes. The table below summarises how ‘androgenic’ the progestins used in contraception are…

 

 

We should treat this table with some caution. Much of the information available on androgenic activity is extrapolated from data obtained from experiments on rats and rabbits. It is also quite old. Much of the data is not for pre-menopausal women (users of contraception) as the focus in studies was on hormone therapy used to manage symptoms of the menopause. It is also hugely important to be aware that that the androgenic activity of different progestins changes according to individual, sex, whether or not the progestin is taken with an oestrogen and even the type of cell. Some have specific androgenic effects in breast cancer cells, for example.

Basically, it’s not very straightforward and knowing how this information affects you and your contraception is complex to say the least. If you are concerned about the possible androgenic effects of your contraception, or symptoms or side effects such as acne, hair growth or hair loss, then speak to your GP.

References

  1. Mathur R, Levin O, Azziz R. Use of ethinylestradiol/drospirenone combination in patients with the polycystic ovary syndrome. Therapeutics and Clinical Risk Management. 2008. 4(2):487-492. Available from: doi:10.2147/tcrm.s6864
  2. Regidor PA. The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget. 2018. 9(77):34628-34638. Available from: https://doi.org/10.18632/oncotarget.26015
  3. Vieira S, Ferriani RA, and others. Use of the etonogestrel-releasing implant is associated with hypoactivation of the coagulation cascade. Human Reproduction. 2007. Volume 22. Issue 8:2196–2201. Available from: https://doi.org/10.1093/humrep/dem153
  4. Louw-du Toit R, Perkins MS, Hapgood JP, Africander D. Comparing the androgenic and estrogenic properties of progestins used in contraception and hormone therapy. Biochemical and Biophysical Research Communications. 2017. 491(1):140-146. Available from: doi:10.1016/j.bbrc.2017.07.063
  5. Africander D, Verhoog N, Hapgood JP. Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids. 2011. 76:636–652. Available from: doi: 10.1016/j.steroids.2011.03.001.

 

Reviewed and edited on 26/4/21 in line with our content policy.

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