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Androgen disorders cannot be cured but they can be treated, usually with medication. If you are overweight, losing as little as 7 percent in body weight can restore fertility and decrease hirsutism in some women with androgen excess, according to the American Association of Clinical Endocrinologists clinical practice guidelines.

For example, if you are of reproductive age, the right oral contraceptive choice can reduce hyperandrogenic symptoms, while the wrong one can make them worse. When you hear the term oral contraceptives or birth control pills, it most often refers to "combination pills" -- pills that contain both estrogen and progestin. The estrogen used is almost always ethinyl estradiol in varying doses, but numerous progestins are used, also in varying doses. The key is the type of progestin included. Some progestins can mimic androgens and make symptoms worse, but some avoid this problem, allowing the estrogen in birth control pills to raise levels of sex hormone binding globulin (SHBG), reducing blood levels of free testosterone and improving symptoms. Talk to your health care professional about a pill formulation with the progestins norgestimate, drospirenone or desogestrel.

For some women, the most bothersome symptoms of high levels of androgen are acne and hirsutism. For women with such symptoms, spironolactone (Aldactone or Spironol) may be prescribed. The drug, a diuretic, has few side effects, and at high doses can clear oily skin and make unwanted hair finer. The combination of spironolactone and oral contraceptives is frequently used. If you are trying to conceive, however, do not take this drug because it can harm an unborn baby.

Bear in mind that it can take up to nine months to see effects on hair growth, and a year to achieve peak effect. The hair will still be there, but will generally grow more slowly and will be lighter and finer. Electrolysis or repeated laser treatments are the only ways to get rid of the hair for extended periods or permanently.

A class of drugs called 5-alpha reductase inhibitors may help some women, though they should be taken only with extreme caution. These drugs inhibit an enzyme crucial to converting testosterone to dihydrotestosterone (DHT). Finasteride (Propecia and Proscar) and flutamide (Eulexin) are in this class. They were designed to treat prostate growth and cancer in men (which is exacerbated by excessive androgen levels), while Propecia is also prescribed as a treatment for male pattern baldness.

These drugs are not specifically approved by the U.S. Food and Drug Administration for use in women, and manufacturers advise against women taking them. If one is prescribed for you, you will have to be especially vigilant about birth control, because both cause birth defects. Flutamide has the potential, although infrequent, adverse effect of fatal liver toxicity.

Treating congenital adrenal hyperplasia (CAH) is a bit more complex, because CAH is characterized not just by high levels of androgens, but by low levels of two other hormones, cortisol and aldosterone. Treatment in an adult woman may incorporate a glucocorticoid, such as prednisone, to make up for the missing cortisol.

Androgen Deficiency

If you are androgen deficient, the benefits of a hormonal supplement can make it worth your while to investigate whether such a drug is right for you. Although not typically prescribed solely to prevent osteoporosis, testosterone supplements have been shown in several studies to not only slow bone loss, but also to stimulate bone formation in postmenopausal women and women with surgically induced menopause.

Some compounding pharmacies may be able to provide testosterone creams that are applied to the vulva for more targeted delivery of the hormone, but such formulations are not widely available. And there is no scientific testing for safety, whether or not they are effective and if the specially made batch will be exactly the same each time.

There's also a prescription combination estrogen (esterified estrogens) and testosterone (oral methyltestosterone) pill called Estratest that may help combat androgen deficiency. Because women with low androgen levels often have low estrogen levels, the combination of the two hormones can be the most effective treatment for hyperandrogenemia.

In addition, women with androgen deficiency may benefit from treatment with dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands. DHEA is available over-the-counter without a prescription in the U.S. and is not FDA-regulated. It may improve such androgen-deficiency side effects as sexual dysfunction. However, while the hormone is available over the counter, it should not be taken without medical guidance.

The quantity and quality of DHEA contained in available preparations are not routinely monitored or tested for contaminants. For instance, in 2004, FDA investigators found DHEA levels in 45 commercial products labeled as containing DHEA contained between 0--109.5 percent of the declared amount. Therefore, it's important that your health care professional monitor blood levels of DHEA and any side effects if you're taking the hormone.

Since DHEA is converted to estrogen and testosterone in women,the levels of these hormones should also be measured when taking DHEA. Additionally, scientific data is lacking about safety and efficacy of this product in women.

A testosterone skin patch for women is in development that may provide a better choice. The patch would deliver testosterone directly into the bloodstream. Initial reports of the testosterone patches' effectiveness and safety in women are promising. Patches currently on the market are designed for men and contain dosages that are too high for women, although some health care professionals prescribe smaller doses "off label" for women. The testosterone patch for women has not been approved by the FDA.

Androgen supplements are generally safe at the dosages prescribed for women, but possible side effects include facial hair growth, deepening of the voice, thinning hair, and acne.

Noncosmetic side effects can include fluid retention, liver toxicity and unfavorable changes in your cholesterol levels, which should be monitored periodically. If they occur, side effects can be minimized or eliminated with lower androgen doses, and can usually be reversed by discontinuing therapy. Higher doses can cause deepening of the voice or clitoral enlargement, which may be irreversible. However, this is not usually seen in doses prescribed for women. Early side effects usually include facial hair, oily skin or acne. If they occur, talk to your health care professional about decreasing your dose before more serious side effects occur.

Androgen supplements are not the answer for everyone with a slumping libido and fatigue -- particularly if you have any signs of androgen excess, such as hirsutism, acne or thinning hair. Such medications are also ruled out if you are pregnant or nursing.

As your body changes, it is very important to communicate with both your partner and your health care professional. Tell both about your symptoms and the changes in your body. Your partner's support can be helpful to ease the stress caused by symptoms that affect intimacy. Because every woman is unique, you and your health care professional will need to work together to determine which treatment option best meets your medical and personal needs.