The main androgens secreted physiologically by the adrenal cortex of adult subjects are Δ4-androstenedione and its 11-oxygenated derivatives along with dehydroisoandrosterone and its sulfate conjugate. These steroids have limited biologic activity. They can be metabolized to a small extent into potent androgens which contribute greatly to the physiologic level of androgenic activity in women but which are of little significance in men. Androgens from the fetal adrenal cortex play an important role in the over-all production of steroids by the maternal-placental-fetal unit. At birth, the levels of adrenal androgens are in the adult range but they fall to low values shortly thereafter. Then, they rise progressively over a period of several years at puberty contributing to the "adrenarche" (or "pubarche"). Pathologic hypersecretion of adrenal androgens can result in a series of well defined syndroms: congenital adrenal hyper-plasia with its various forms, virilizing and feminizing adrenal tumors, Cushing's syndrome. In addition, mild degrees of hyper-adrenocorticism can be the cause of female hirsutism.
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