CYP21A2 and hyperandrogenism: However, heterozygous carriers of CYP21A2 pathogenic variants seem to have an increased risk of hyperandrogenism, which may manifest as premature pubarche, accelerated growth, apocrine body odor, and seborrhea in childhood ( 5 – 8 ) and hirsutism, oligomenorrhoea, acne, and infertility in adolescence and adulthood ( 9 – 12 ).