Causes of High Testosterone in Women

Testosterone is considered a male sex hormone, but women produce small amounts of testosterone in their ovaries and adrenal glands.

Testosterone plays a role in the growth and maintenance of female reproductive tissue together with the female sex hormone, estrogen. These hormones also influence behavior.

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Normal testosterone levels

In men, normal testosterone levels in men are around 280 to 1,100 nanograms per deciliter (ng/dL).

Women secrete much lower amounts, with normal levels falling between 15 and 70 ng/dL.

Levels of testosterone are highest in the morning. The level of hormones produced in the body varies each day and throughout the day.

Symptoms of high testosterone in women

Testosterone imbalances in women can affect their physical appearance and general health. Symptoms of high testosterone in women include:

  • deep voice
  • acne
  • loss of libido
  • irregular periods
  • excess hair on the face and body
  • increased muscle mass
  • large clitoris
  • mood fluctuations
  • reduction in breast size
  • thinning hair

High levels of testosterone in women can cause infertility and obesity.

Causes

High testosterone in women is usually caused by an underlying medical condition, such as:

Congenital adrenal hyperplasia (CAH)

CAH is the term given to a group of inherited disorders that affect the adrenal glands. These glands secrete the hormones cortisol and aldosterone, which play a role in managing metabolism and blood pressure.

The adrenal glands also produce the male sex hormones DHEA and testosterone.

People with CAH lack one of the enzymes necessary to regulate the production of these hormones, so they secrete too little cortisol and too much testosterone.

CAH may be mild (nonclassic CAH) or severe (classic CAH).

Symptoms in women include:

  • deep voice
  • early appearance of pubic hair
  • enlarged clitoris
  • excess body hair
  • facial hair
  • irregular or absent menstrual periods
  • severe acne
  • short height as an adult but rapid childhood growth

Most people with the disorder can receive treatment that will reduce symptoms and improve their quality of life.

Hirsutism

Hirsutism is characterized by excess unwanted hair growth in women. It is a hormonal condition thought to be connected to genetics.

Symptoms include male-pattern hair growth that is dark and coarse. It typically affects the face, back, and chest.

In cases of excessively high testosterone, other symptoms will also be present, including:

  • balding
  • acne
  • deepening voice
  • enlarged clitoris
  • increased muscle mass
  • reduced breast size

Polycystic ovary syndrome (PCOS)

PCOS is a common hormonal disorder that affects women of reproductive age. PCOS affects between 8 and 20 percent of women globally.

Women are not usually diagnosed until they are in their 20s and 30s, but children as young as 11 years old can be affected.

Symptoms of PCOS include:

  • enlarged ovaries that develop follicles and do not release eggs regularly
  • excess body hair
  • irregular, infrequent, or long menstrual periods

PCOS may lead to several complications, including:

Doctors do not know what causes PCOS, although genetics and excess insulin may be responsible.

Diagnosis

A doctor can diagnose high testosterone in women based on the following:

Physical examination

During a physical examination, the doctor will look/ask questions on symptoms such as:

  • facial hair growth
  • acne
  • excess body hair

They will also inquire about:

  • libido
  • menstrual cycle abnormalities
  • mood changes

The doctor may visually survey the pelvic region to look for abnormalities if PCOS is suspected.

Blood test

If symptoms suggest high testosterone levels, the doctor will take a blood sample and have hormone levels tested. They may also check glucose and cholesterol levels. Usually, the blood will be drawn in the morning when testosterone levels are highest.

Ultrasound

To check for PCOS, the doctor may do an ultrasound of the ovaries and uterus.

Treatment

The treatment recommended for high testosterone will depend on its basic cause. A doctor will recommend both lifestyle changes and medication.

Medication

High testosterone in women and associated conditions can be treated with the following medications:

  • Eflornithine, a cream applied directly to the skin that slows the growth of new facial hair.
  • Glucocorticosteroids, a type of steroid hormone that reduces inflammation in the body.
  • Metformin, a treatment for type 2 diabetes.
  • Progestin, a hormone that may regulate periods and improve fertility.
  • Spironolactone, a diuretic that helps regulate water and salt levels and reduces excessive female hair growth.

Oral contraceptives may also be prescribed, as this treatment helps to block excess testosterone. Oral contraceptives for high testosterone and hirsutism are ones that contain low doses of norgestimate, gestodene, and desogestrel.

However, oral contraceptives may not be suitable for women who are trying to get pregnant, and they can also cause adverse side effects.

Hair removal treatments

Both electrolysis and laser therapy may be used to control unwanted hair. However, these treatments will not resolve an underlying hormonal imbalance.

  • Electrolysis. This involves inserting a tiny needle into each hair follicle. A pulseof electric current travels through the needle and damages the follicle so that it cannot grow new hair. Multiple treatments may be required.
  • Laser therapy. During this treatment, laser light is applied to the hair follicles to damage them. Again, multiple treatments may be required.

Note that these hair removal treatments can cause adverse reactions, and they may have other associated risks.

Anyone with a hormonal imbalance should speak to a doctor before trying medical treatments for excess hair growth.

Lifestyle changes

Some of the following lifestyle changes can reduce high testosterone in women, while others simply manage symptoms.

Manage unwanted hair

Some women choose to treat their facial and body hair growth by plucking, shaving, waxing, or using chemical depilatories. Others bleach their hair to make it less visible.

 

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