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For Hyperandrogenism Article Under Causes.

Hyperthecosis and Hyperinsulinemia

Hyperthecosis occurs when the cells of the ovarian stroma transition from interstitial cells, which are cells located in between other cells, into luteinizedtheca cells. Theca cells are located in the ovarian follicles and become luteinized when the ovarian follicle breaks and a new corpus luteum is formed. The dispersal of luteinized theca cells throughout the ovarian stroma, in contrast to PCOS where the luteinized theca cells are only around cystic follicles, causes women with hyperthecosis to have higher testosterone levels and male-attributed characteristics (virilization) than women with PCOS. Excess levels of insulin in the blood, known as hyperinsulinemia, is also a characteristic of hyperthecosis.^[8]  Hyperthecosis is mostly seen inpostmenopausal women and is linked to acne, hirsutism, growth of the clitoris, baldness, and voice deepening.^{[9] (citations 8 and 9 are made in Hyperandrogenism article)}

Low levels of insulin can also lead to hyperandrogenism. When the body’s insulin levels drop too low, it can force itself to produce too much in an effort to make up for the loss. The result of such an overproduction is a disorder called hyperinsulinemia. An effect of hyperinsulinemia is the body’s increased production of androgens in the ovaries.[1] This is all part of HAIR-AN syndrome, a multisystem disorder that involves increased insulin levels that prompt increased androgen levels.[2][3]

[1] RL, Barbieri and Hornstein MD. “Hyperinsulinemia and Ovarian Hyperandrogenism. Cause and Effect.” Endocrinology and Metabolism Clinics of North America 17.4 (1988): 685-703. Europe PMC Harvard Medical School, Boston, Massachusettes. Web. 10 Nov. 2016

[2] James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders.

[3] Somani N, Harrison S, Bergfeld WF (2008). "The clinical evaluation of hirsutism". Dermatol Ther. 21 (5): 376–91