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AWARE: Recognizing and diagnosing androgen excess
The AWARE group is an international panel of independent physicians with an expert interest in androgen excess in women. Formation of the AWARE group was supported and funded by Bayer AG.
The group has developed a series of expert resources to support the general health of women suffering from androgen excess.
Androgen excess in women can be characterized by either clinical symptoms of hyperandrogenism and/or biochemical hyperandrogenism1
Clinical hyperandrogenism
- The pilosebaceous unit has increased sensitivity to normal serum androgen levels and causes hyperandrogenic skin symptoms1
Biochemical hyperandrogenism
- Excessive production and/or secretion of androgens, which may be of ovarian or adrenal origin1
- Women with biochemical hyperandrogenism may present solely with clinical symptoms or have accompanying anovulation and/or PCOS2
Early recognition and diagnosis of androgen excess is important
It allows prompt treatment of hyperandrogenic skin symptoms and can lead to improvements in quality of life and psychological wellbeing 3-7
PCOS – polycystic ovary syndrome
- Fauser BCJM, Tarlatzis BC, Rebar RW et al. Fertil Steril 2012;97:28–38. Return to content
- Bitzer J. Eur J Contracept Reprod Health Care 2017;22:172–182 Return to content
- Ekback MP, Lindberg M, Benzein E et al. Dermatol 2013;227(3):278–284. Return to content
- Aktan S, Özmen E and Sanli B. Int J Dermatol 2000;39:354–357. Return to content
- Koo JYM and Smith LL. Pediatr Dermatol 1991;8:185–188. Return to content
- Stern RS. Dermatol 2000;43:1042–1048. Return to content
- Kellet SC and Gawkrodger DJ. Br J Dermatol 1999;140(2):273–82. Return to content
Defining PCOS1
Diagnostic criteria for PCOS is defined as two out of three of the following:*1
- Clinical hyperandrogenism or biochemical hyperandrogenism OR
- Irregular menses OR
- Polycystic ovaries on ultrasound, after excluding other endocrine causes such as hyperprolactinemia
The prevalence of PCOS
PCOS is a common endocrine disorder affecting up to 1 in 6 women of reproductive age.*1
Primary presentation of PCOS symptoms may vary with age and includes: 2-5
- Skin symptomatology
- Menstrual dysfunction
- Infertility
- Insulin resistance
- Dyslipidemia
- Type 2 diabetes
- Cardiovascular disease
The majority of girls who have PCOS will have developed the phenotype clearly by the age of 18 years.5
* When assessed using the Rotterdam criteria
HCP – healthcare professional; PCOS – polycystic ovary syndrome
- Azziz R, Carmina E, Chen Z et al. Nat Rev Dis Primers 2016;11;2:16057. Return to content
- Sirmans SM and Pate KA. Clin Epidemiol 2014;6:1–13. Return to content
- Legro RS, Arslanian SA, Ehrmann DA et al. J Clin Endocrinol Metab 2013;98:4565–4592. Return to content
- Fauser BCJM, Tarlatzis BC, Rebar RW et al. Fertil Steril 2012;97:28–38. Return to content
- Lizneva D, Suturina L, Walker W et al. Fertil Steril 2016;106(1):6–15. Return to content
The Female acne manual for non-dermatologists
This manual aims to increase awareness of the role androgen excess plays in female acne, as well as facilitate understanding and appropriate use of hormonal antiandrogens as an effective treatment.
This manual addresses gaps in knowledge and provides practical guidance to non-dermatologists, helping them to:
- Recognize the type of acne they can treat quickly and effectively by non-dermatologists
- Understand the role antiandrogens can play in treatment of female acne
- Identify situations where referral to a dermatologist is required
To find out more about AWARE and for questions about the diagnosis and treatment of androgen excess, please download the AWARE FAQ
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