High testosterone in women is a concern for a variety of reasons, with irregular periods and infertility being at the top of the list. In fact, the question shows up on my Instagram page about once per week. In this guide, we’ll look at how you can recognize if your testosterone levels are too high and if so, what you can do to tackle them.
Testosterone in Women
Testosterone is often thought of as a male sex hormone because it regulates fertility, muscle mass and fat distribution for men. It also exists in women to support sex drive, immune function and muscle density. However, in women, excess levels can suppress ovulation and lead to irregular periods or infertility.
It’s important to keep in mind as we dive into this topic that testosterone in women is good and healthy, as it is for all bodies. But like all hormones (and most things in life) too much of a good thing can be big trouble.
Normal Testosterone Levels in Women
Maintaining testosterone levels within range, as shown on this graph, can help ensure testosterone is working for your body without any of the unwanted symptoms. If you suspect your testosterone is too high, a simple blood test can tell you how much testosterone you have.
Be aware that your testosterone levels will fluctuate throughout the day and the best time to get tested is in the morning when testosterone levels are at their highest.
Symptoms of High Testosterone in Women
Signs of high testosterone in women include:
- Hair loss on the scalp
- Excess body hair (especially upper lip, chin, chest and abdomen)
- Acne
- Oily skin
- Increased body odor
- Sleep disturbance
- Irritability, aggression
- Decreased breast size
- Increased muscle mass
- Lowering of the voice
As well as this, elevations of testosterone may also lead to irregular menstrual cycles and even infertility.
These symptoms were some of the same symptoms that my 36-year-old patient Shannon was concerned about. “I can’t keep up with the amount of hair on my chin and I never know when my period is coming,” she explained in her first visit. In addition to hair on her chin, she was now shaving her belly, experiencing significantly oily skin and acne. Shannon’s symptoms pointed to high testosterone.
High Testosterone and Hirsutism
Excessive testosterone can lead to hirsutism, which is the medical term for thick, dark hair. If you notice excess hair on the back, face or chest, or abdomen, this can be a clear symptom of the condition which is cause by an imbalance of androgen hormones. It's important to understand that this can be a sign of an underlying medical condition and so should be taken seriously.
What Causes High Testosterone in Women?
There are several mechanisms at play that can lead to women with high testosterone. Mainly there are certain conditions that affect the ovaries, insulin levels or the adrenal glands, such as:
1. Polycystic Ovary Syndrome
One of the most common causes of high testosterone levels in women is Polycystic Ovarian Syndrome (PCOS). This is a hormonal condition that can affect as many as 1 in 10 women. If you have PCOS, you may notice excess body hair or infrequent periods. This condition can lead to certain complications such as infertility, cardiovascular disease, diabetes, and obesity.
2. Congenital Adrenal Hyperplasia (CAH)
This is a condition that directly affects the adrenal glands, which is where the body produces hormones, including testosterone in women. Due to CAH, the adrenal glands can overproduce testosterone, leading to severe acne and what is classified in medicine as “behavioral and physical masculinization,” which is the tissue's response to androgens. It is important to understand that this is a specific condition that can be tested for and the the physical and behavioral traits are part of the symptom picture. They would not be enough on their own to determine if someone has elevated androgens.
3. High Insulin & Blood Sugar Levels
Blood sugar dysregulation is at the crux of many hormone imbalances, with high testosterone being no exception. As insulin climbs it can stimulate the ovaries to produce testosterone, especially in women with PCOS. While many body tissues will begin ignoring insulin signals, your ovaries are among the few organs that will continue to remain sensitive to insulin.
This stimulation causes the ovary to produce testosterone. In women with PCOS (and the chronic insulin overstimulation that accompanies it), this can lead to the typical structural changes that are seen in PCOS.
This was true of Shannon. Shannon was an ‘eat on the run’ kind of girl and often ate a bag of gluten-free pretzels or fruit when feeling “desperately hungry.” It was these spikes and dips in blood sugar that were creating strain on Shannon’s hormones. Her insulin levels were mildly elevated, along with clear signs her blood sugar was often higher than it should be.
Read more: 5 Blood Sugar Balancing Strategies for PCOS
How to Lower Testosterone in Women
If you’re noticing the dreaded symptoms associated with this condition, don’t panic. High testosterone in women can be targeted in a number of ways. This includes hormone medication, or diet and supplements depending on your individual needs.
Medication to Lower Testosterone in Females
Metformin
This is a medicine used to treat type 2 diabetes and is commonly used in women with PCOS. It helps with high testosterone by lowering your blood sugar levels and helping your body regulate insulin. This is also often used for treating PCOS.
Glucocorticoids
These are a type of steroid hormone that help reduce inflammation in the body and may be used in cases of congenital adrenal hyperplasia. Glucocorticoids naturally exist within the body to help your cells use sugar and fat. However, in cases of high testosterone, additional glucocorticoids are needed.
Spironolactone
This is a diuretic that helps regulate water and salt levels in the body. It is often used to reduce excessive female hair growth. It does this by slowing down the production of androgen sex hormones, including testosterone. You can read more about Spironolactone here.
Oral contraceptives
Certain birth control pills are an effective treatment for blocking testosterone. According to the American Academy of Family Physicians, look for birth control that uses low levels of norgestimate, gestodene, and desogestrel. Bear in mind that this treatment can come with its own side effects, such as decreased libido and mood, which you should discuss with your provider.
Read more: Treating PCOS Symptoms With The Pill
How To Treat High Testosterone In A Woman Naturally
Simple diet changes can have effective results on your testosterone levels. For example, increasing the levels of fat and protein in meals, while reducing sugar can help optimize your blood sugar.
With Shannon, we swapped out her 3 cups of black coffee for green tea. Green tea increases Sex Hormone Binding Globulin (SHBG), a protein that grabs onto excess testosterone. We also got her going with fresh ground flax seed, which is a great source of anti-inflammatory omega-3 fatty acids and has been shown to also raise SHBG.
With the help of my clinical team, Shannon was able to bring her testosterone back into balance. Along with her other hormones, she was able to get clear, beautiful skin. With hirsutism it is important to understand that you cannot reverse the hair that is there, but can prevent new hair from growing. Shannon decided to have her removed and after having electrolysis she was happy to report there was no new growth.
Get the Meal Plan and Recipe Guide that helped Shannon get her hormones in check here!
@drjolenebrighten Body odor when you drop that egg? #hormones #hormonas #pcos #pcosawareness #pcosproblems ##testosterone #ovulation #ovulating #ovulationphase #hormonedoc #hormonedoctor ♬ BILLIE EILISH. – Armani White
Supplements to Lower Testosterone in Females
As well as diet, certain herbs such as Saw Palmetto, Vitex, and DIM help to support adrenal, testosterone, estrogen and progesterone production. I generally recommend women begin with 4 key supplements to get their intake: Balance, Adrenal Support, Saw Palemetto Plus, and N-Acetyl Cysteine because of their synergistic benefits.
1. DIM for High Testosterone
DIM is a nutrient derived from cruciferous vegetables like broccoli that can support healthy testosterone levels. Aim to eat cabbage, kale, cauliflower, Brussel sprouts, and other cruciferous vegetables three to four times weekly.
Balance Women's Hormone Support contains Vitex, in addition to green tea extract, DIM, and calcium d-glucarate to support estrogen and testosterone metabolism. Learn about Balance here.
3. Zinc & Saw Palmetto for High Testosterone
Zinc and Saw Palmetto are important for keeping high testosterone symptoms in check. Saw Palmetto is a herb that prevents the conversion of testosterone to DHT, a potent form that causes hair loss on the head and growth on the chin and chest.
4. N-Acetyl Cysteine for Clear Skin
N-Acetyl Cysteine is an important amino acid for optimizing weight, improving hair, and creating clear skin. Learn about N-Acetyl Cysteine here.
All of these supplements together support a healthy menstrual cycle, glowing skin, and easier to manage weight. I've bundled Balance, Adrenal Support, and Saw Palmetto Plus into one package called the PCOS Basic Kit, which is designed to help maintain a healthy hormone balance.
References
- Medical News Today. Why do we need testosterone?.
- Walker K. Low Testosterone Diagnosis. Endocrine Web.
- Healthline. High Testosterone Levels in Women.
- Hunter M, Carek P. Evaluation and Treatment of Women with Hirsutism. American Family Physician. 2003.
- NHS. Metformin.
- Web MD. What Are Glucocorticoids?.
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