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Virilization

Virilization

Overview
In biology and medicine, virilization refers to the biological development of sex differences, changes which make a male
Male
Male refers to the sex of an organism, or part of an organism, which produces small mobile gametes, called spermatozoa. Each spermatozoon can fuse with a larger female gamete or ovum, in the process of fertilization...

 body different from a female
Female
Female is the sex of an organism, or a part of an organism, which produces mobile ova .- Defining Characteristics :The ova are defined as the larger gametes in a heterogamous reproduction system, while the smaller, usually motile gamete, the spermatozoon, is produced by the male...

 body. Most of the changes of virilization are produced by androgen
Androgen
Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. This includes the activity of the accessory male sex organs and...

s. Virilization is most commonly used in three medical and biology of gender
Biology of gender
The biology of gender is scientific analysis of the physical basis for behavioural differences between men and women. It is more specific than sexual dimorphism, which covers physical and behavioural differences between males and females of any sexually reproducing species, or sexual...

 contexts: prenatal sexual differentiation
Sexual differentiation
Sexual differentiation is the process of development of the differences between males and females from an undifferentiated zygote...

, the postnatal changes of normal male puberty
Puberty
Puberty is the process of physical changes by which a child's body becomes an adult body capable of reproduction. Puberty is initiated by hormone signals from the brain to the gonads . In response, the gonads produce a variety of hormones that stimulate the growth, function, or transformation of...

, and excessive androgen effects in girls or women.

In the prenatal period, virilization refers to closure of the perineum
Perineum
In human anatomy, the perineum is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is the region of the body inferior to the pelvic diaphragm and between the legs. It is a diamond-shaped area on the inferior surface of the...

, thinning and rugation of the scrotum
Scrotum
In some male mammals the scrotum is a protuberance of skin and muscle containing the testicles. It is an extension of the abdomen, and is located between the penis and anus. In humans and some other mammals, the base of the scrotum becomes covered with curly pubic hairs at puberty...

, growth of the phallus
Phallus
Phallus can refer to a penis, or to an object shaped like a penis. The word comes from Late Latin "phallus", from Ancient Greek "φαλλός" phallos, penis.-In art:...

, and closure of the urethral groove
Urethral groove
The urethral groove is a temporary linear indentation on the underside of the male penis during embryonic development.In humans, it typically appears around 8 weeks of gestation and becomes closed into a normal male urethra by the 12th week....

 to the tip of the penis
Penis
The penis is an external sexual organ of certain biologically male organisms, in both vertebrates and invertebrates....

.
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Encyclopedia
In biology and medicine, virilization refers to the biological development of sex differences, changes which make a male
Male
Male refers to the sex of an organism, or part of an organism, which produces small mobile gametes, called spermatozoa. Each spermatozoon can fuse with a larger female gamete or ovum, in the process of fertilization...

 body different from a female
Female
Female is the sex of an organism, or a part of an organism, which produces mobile ova .- Defining Characteristics :The ova are defined as the larger gametes in a heterogamous reproduction system, while the smaller, usually motile gamete, the spermatozoon, is produced by the male...

 body. Most of the changes of virilization are produced by androgen
Androgen
Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. This includes the activity of the accessory male sex organs and...

s. Virilization is most commonly used in three medical and biology of gender
Biology of gender
The biology of gender is scientific analysis of the physical basis for behavioural differences between men and women. It is more specific than sexual dimorphism, which covers physical and behavioural differences between males and females of any sexually reproducing species, or sexual...

 contexts: prenatal sexual differentiation
Sexual differentiation
Sexual differentiation is the process of development of the differences between males and females from an undifferentiated zygote...

, the postnatal changes of normal male puberty
Puberty
Puberty is the process of physical changes by which a child's body becomes an adult body capable of reproduction. Puberty is initiated by hormone signals from the brain to the gonads . In response, the gonads produce a variety of hormones that stimulate the growth, function, or transformation of...

, and excessive androgen effects in girls or women.

Prenatal virilization


In the prenatal period, virilization refers to closure of the perineum
Perineum
In human anatomy, the perineum is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is the region of the body inferior to the pelvic diaphragm and between the legs. It is a diamond-shaped area on the inferior surface of the...

, thinning and rugation of the scrotum
Scrotum
In some male mammals the scrotum is a protuberance of skin and muscle containing the testicles. It is an extension of the abdomen, and is located between the penis and anus. In humans and some other mammals, the base of the scrotum becomes covered with curly pubic hairs at puberty...

, growth of the phallus
Phallus
Phallus can refer to a penis, or to an object shaped like a penis. The word comes from Late Latin "phallus", from Ancient Greek "φαλλός" phallos, penis.-In art:...

, and closure of the urethral groove
Urethral groove
The urethral groove is a temporary linear indentation on the underside of the male penis during embryonic development.In humans, it typically appears around 8 weeks of gestation and becomes closed into a normal male urethra by the 12th week....

 to the tip of the penis
Penis
The penis is an external sexual organ of certain biologically male organisms, in both vertebrates and invertebrates....

. In this context masculinization is synonymous with virilization. Prenatal virilization of genetic females and undervirilization of genetic males are common causes of ambiguous genitalia and intersex conditions.

Undervirilization can occur if a genetic male cannot produce enough androgen or the body tissues cannot respond to it. Extreme undervirilization occurs when no significant androgen can be produced or the body is completely insensitive to it, and results in a female body. Partial undervirilization produces ambiguous genitalia part way between male and female. The mildest degree of undervirilization may be a slightly small penis with hypospadias
Hypospadias
Hypospadias is a birth defect of the urethra in the male that involves an abnormally placed urinary meatus . Instead of opening at the tip of the glans of the penis, a hypospadic urethra opens anywhere along a line running from the tip along the underside of the shaft to the junction of the penis...

. Examples of undervirilization are androgen insensitivity syndrome
Androgen insensitivity syndrome
Androgen insensitivity syndrome , also referred to as androgen resistance syndrome, is a set of disorders of sex development caused by mutations of the gene encoding the androgen receptor. The nature of the resulting problem varies according to the structure and sensitivity of the abnormal receptor...

, 5 alpha reductase deficiency, and some forms of congenital adrenal hyperplasia
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia refers to any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands ....

.

Prenatal virilization (or masculinization) of a genetically female fetus can occur when an excessive amount of androgen is produced by the fetal adrenal gland
Adrenal gland
In mammals, the adrenal glands are the star-shaped endocrine glands that sit on top of the kidneys; their name indicates that position...

s or is present in maternal blood. In the severest form of congenital adrenal hyperplasia
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia refers to any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands ....

 complete masculinization of a genetically female fetus results in an apparently normal baby boy with no palpable testes. More often, the virilization is partial and the genitalia are ambiguous.

Normal virilization


In common as well as medical usage, virilization often refers to the process of normal male puberty
Puberty
Puberty is the process of physical changes by which a child's body becomes an adult body capable of reproduction. Puberty is initiated by hormone signals from the brain to the gonads . In response, the gonads produce a variety of hormones that stimulate the growth, function, or transformation of...

, in which testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands. It is the principal male sex hormone and an anabolic steroid.In men,...

 changes a boy's body into a man's. These effects include growth of the penis and testes, accelerated growth, development of pubic hair
Pubic hair
Pubic hair is hair in the frontal genital area, the crotch, and sometimes at the top of the inside of the legs; these areas form the pubic region....

 and other androgenic hair of face, torso, and limbs, deepening of the voice, increased musculature, thickening of the jaw, prominence of the neck cartilage, and broadening of the shoulders.

Abnormal childhood virilization


Virilization can occur in childhood in either boys or girls due to excessive amounts of androgens. Typical effects of virilization in children are pubic hair
Pubic hair
Pubic hair is hair in the frontal genital area, the crotch, and sometimes at the top of the inside of the legs; these areas form the pubic region....

, accelerated growth and bone maturation, increased muscle strength, acne
Acne vulgaris
Acne vulgaris is a common skin condition, caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, via androgen stimulation. It is characterized by noninflammatory follicular papules or comedones and by inflammatory papules,...

, adult body odor, and sometimes growth of the penis. In a boy, virilization may signal precocious puberty
Precocious puberty
Precocious puberty is an unusually early onset of puberty, the process of sexual maturation triggered by the brain or exogenous chemicals, which usually begins in late childhood and results in reproductive maturity and completion of growth...

, while congenital adrenal hyperplasia
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia refers to any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands ....

 and androgen producing tumors (usually) of the gonad
Gonad
The gonad is the organ that makes gametes. The gonads in males are the testes and the gonads in females are the ovaries. The product, gametes, are haploid germ cells. For example, spermatozoon and egg cells are gametes...

s or adrenals are occasional causes in both sexes.

Virilization in adolescent or adult women


Virilization in a woman can manifest as clitoral
Clitoris
The clitoris is a sexual organ that is present only in female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not...

 enlargement, increased muscle strength, acne, hirsutism
Hirsutism
Hirsutism is excessive and increased hair growth on female humans in locations where the occurrence of terminal hair normally is minimal or absent. For example, a beard, or chest hair. It refers to a male pattern of body hair and it is therefore primarily of cosmetic and psychological concern...

, frontal hair thinning, deepening of the voice, and menstrual disruption due to anovulation
Anovulation
An anovulatory cycle is a cycle during which the ovaries fail to release an oocyte. Therefore, ovulation does not take place. However, a woman who does not ovulate at each menstrual cycle is not necessarily going through menopause...

.
Some of the possible causes of virilization in women are:
  • Polycystic ovary syndrome
    Polycystic ovary syndrome
    Polycystic ovary syndrome is an endocrine disorder that affects approximately 5% of all women.It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility.The principal features are obesity, anovulation ,...

  • Androgen
    Androgen
    Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. This includes the activity of the accessory male sex organs and...

    -producing tumors of the
    • ovaries
    • adrenal glands
    • pituitary gland
  • Hypothyroidism
    Hypothyroidism
    Hypothyroidism is the disease state in humans and in animals caused by insufficient production of thyroid hormone by the thyroid gland. Cretinism is a form of hypothyroidism found in infants.-Causes:...

  • Anabolic steroid
    Anabolic steroid
    Anabolic steroids, or anabolic-androgenic steroids , are a class of steroid hormones related to the hormone testosterone. They increase protein synthesis within cells, which results in the buildup of cellular tissue , especially in muscles...

     exposure
  • Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
    Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
    Congenital adrenal hyperplasia due to 21-hydroxylase deficiency , in all its forms, accounts for over 95% of diagnosed cases of congenital adrenal hyperplasia, and "CAH" in most contexts refers to 21-hydroxylase deficiency...

     (late-onset)
  • Hormone replacement therapy (female-to-male)
    Hormone replacement therapy (female-to-male)
    Hormone replacement therapy for transgender people replaces the hormones naturally occurring in their bodies with those of the other sex. However, not all cases of hormone replacement therapy are used by transgender people. Some reasons for this include men who wish to have a hair-free body, as a...


See also

  • Sexual differentiation
    Sexual differentiation
    Sexual differentiation is the process of development of the differences between males and females from an undifferentiated zygote...

  • Secondary sex characteristic
    Secondary sex characteristic
    Secondary sex characteristics are traits that distinguish the two sexes of a species, but that are not directly part of the reproductive system. They are believed to be the product of sexual selection for traits which give an individual an advantage over its rivals in courtship and aggressive...

    s
  • Ambiguous genitalia
  • Androgen
    Androgen
    Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. This includes the activity of the accessory male sex organs and...

  • Clitoromegaly
    Clitoromegaly
    Clitoromegaly is an abnormal enlargement of the clitoris ....

  • Hirsutism
    Hirsutism
    Hirsutism is excessive and increased hair growth on female humans in locations where the occurrence of terminal hair normally is minimal or absent. For example, a beard, or chest hair. It refers to a male pattern of body hair and it is therefore primarily of cosmetic and psychological concern...