Men have testosterone and women have estrogen, but not all is black or white only, there are some shades in between. While women do have estrogen, they also have testosterone and vice versa.
This post focuses on the role of testosterone in women, normal levels of the hormone, and it also sheds light on the high concentration of testosterone in ladies.
Read on to learn the consequences of high testosterone in women, symptoms, causes, and how to manage this problem adequately.
Why women need testosterone?
Testosterone is a sex hormone produced by the human body. While it is a key hormone in men, it's also found in women. In females, testosterone is produced by ovaries and adrenal glands. The greatest portion of produced testosterone is converted to estradiol[i], though.
Although we don't look at it this way, testosterone is crucial for women's health, over the years there has been a significant amount of controversy regarding the role of androgen hormones in females.
Studies show that testosterone contributes to sexual desire, arousal, and orgasm[ii]. Healthy levels of testosterone benefit a woman’s general wellbeing in more ways than one. This important hormone regulates the production of red blood cells, and it also plays a role in brain function and cognitive health.
At the same time, testosterone plays a role in muscle mass and strength in addition to fat distribution. Testosterone contributes to a general sense of wellbeing and energy levels.
Together with estrogen, testosterone participates in growth, maintenance, and repair of reproductive tissues in women. The important hormone also influences behaviors and moods.
As you can see, testosterone is not just about libido and sex life, and it has a pivotal role in different aspects of your overall health and wellbeing.
Due to all these roles, it’s important to manage hormone levels adequately, but also to get informed about high testosterone and complications that come with it.
Normal levels of testosterone in women
Women do not need the same concentration of testosterone as men, but it's still important to learn about normal levels of this hormone.
Testosterone levels are measured in nanograms per deciliter (ng/dl), and they are different throughout your life.
Normal testosterone levels in women are as follows[iii]:
- 0-5 months – 20-80 ng/dl
- 6 months – 9 years - <7-20 ng/dl
- 10 to 11 years - <7-44 ng/dl
- 12 to 16 years - <7-75 ng/dl
- 17 to 18 years – 20-75 ng/dl
- Ages 19 and older – 8-60 ng/dl
Women produce about 100-400 µg (micrograms) a day. As seen above, testosterone levels lower than 7 ng/dl are considered to be low while concentration higher than 75 ng/dl is defined as high. It’s important to mention that the amount of testosterone produced during the day varies and the peak production usually occurs in the morning.
Keeping testosterone levels balanced is vital for sexual health and performance, but also for healthy bones, blood, you name it.
Causes of high testosterone in women
High levels of testosterone in women are usually a result of some underlying problem. Various diseases and health conditions can disrupt hormone balance, boost testosterone, and cause symptoms associated with it.
There is no specific cause that elevates testosterone in all women, in some cases, a combination of different causes and factors plays a role. Below, you can see some of the most common reasons behind the heightened concentration of this hormone in females.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects between 5% and 10% of women in reproductive age[iv].
The exact cause of this common condition is unknown, but it could be down to excess insulin, low-grade inflammation, but family history also plays a role. The most common signs and symptoms of PCOS include menstrual irregularities, polycystic ovaries, and increased concentration of testosterone hormone.
Women with PCOS can experience various complications such as infertility issues, sleep apnea, depression, miscarriage, type 2 diabetes, among others.
Hirsutism is an uncomfortable condition where women have unwanted male-pattern hair growth. The condition manifests itself through dark and pretty visible hair on areas where men usually grow hair, but women tend not to such as back, chest, and face. Hirsutism occurs due to an imbalance of estrogen and testosterone which can be a result of Cushing’s syndrome, tumors, medications, and even PCOS.
Besides excessive growth of hair on face, back, and chest, hirsutism can also be associated with other symptoms such as deepening of the voice, decreased breast size, increased muscle mass, high testosterone, balding, acne, and clitoris enlargement.
Risk factors associated with this condition are family history, obesity, and ancestry (women in the Mediterranean region, as well as Middle Eastern and South Asian women, are more likely to develop this condition).
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia is defined as a group of inherited genetic disorders which affect a patient’s adrenal glands. A patient with this condition does not have one of the enzymes that adrenal glands require to produce hormones.
In a vast majority of cases, patients lack an enzyme called 21-hydroxylase. Signs and symptoms of the condition vary based on the type, i.e. whether a person has classic or nonclassic congenital adrenal hyperplasia.
Classic type of the condition is indicated by excessive levels of testosterone, but also low cortisol and other hormonal imbalances.
Insulin resistance is a common problem where the body is resistant to hormone insulin which leads to increased blood sugar levels.
Since the body doesn't use insulin, this hormone remains in the bloodstream which may promote the production of testosterone in a woman’s ovaries.
The butterfly-shaped gland participates in a wide range of functions in your body, and it influences the production and concentration of hormones. Studies have confirmed that hypothyroidism can affect hormonal balance[v].
Hypothyroidism is linked to a decreased production of sex hormone binding globulin (SHBG) which is vital for the balance of sex hormones in your bloodstream. If SHBG levels are too low, it can lead to higher concentration of testosterone and symptoms associated with it.
Most people today have a sedentary lifestyle. We spend way too much time curled up on the sofa watching TV or Netflix and not enough time in the gym working out.
Humans are meant to be active so it’s not such a surprise that being sedentary can affect your body and health in more ways than one.
Sedentary lifestyle affects your hormones due to increased risk of insulin resistance, a high concentration of insulin, and the subsequent rise in testosterone.
Symptoms of high testosterone in women
Hormone imbalances are tricky, and they always induce a whole spectrum of symptoms that can be uncomfortable, frustrating to bear, have the potential to affect a person's quality of life. High testosterone in women is not the exception.
The exact signs and symptoms vary from one woman to another depending on the underlying cause that propelled a spike in testosterone production. Some of the most significant symptoms of high testosterone in women include:
- Balding or thinning hair
- Bigger muscle mass
- Deeper voice
- Excess body hair, particularly on the face
- Irregular menstrual periods
- Larger clitoris
- Low libido
- Mood changes
- Reduced breast size
It’s also important to mention that elevated testosterone concentration can lead to various complications including infertility and obesity, but it could also affect cardiovascular, cognitive, and sexual health.
That’s why it’s of huge importance to manage this problem properly.
How is high testosterone in women diagnosed?
Your menstrual cycle is irregular? Got excess body hair on your face, chest, or back? Experiencing other symptoms mentioned above? If so, then you may want to schedule an appointment to see a doctor.
The reality is that many women feel too embarrassed to see the doctor about these problems, but the longer you wait, the bigger the problem. When left unmanaged high testosterone can wreak havoc on your health and increase the risk of various health conditions. You don't want that. Mention all symptoms to your doctor who will also perform a physical exam and order a blood test to analyze hormone levels.
Based on symptoms described your doctor would suspect high testosterone could be the issue here, but testosterone test will help make an accurate diagnosis.
During the physical exam, the physician will look for acne, excess body hair, and facial hair growth. In addition, the doctor may use an ultrasound to check for PCOS which is also the most common cause of high testosterone in women.
Managing high testosterone in women
Hormones fluctuate, sometimes they go up or down, but there is a lot one can do to balance them. A proactive approach is vital for successful management of high testosterone. Ignoring the symptoms or avoiding listening to doctor’s orders is the last thing you want to do.
The exact treatment of high testosterone depends on the cause behind this problem. That being said, treatment usually revolves around lifestyle changes and the regular use of medications. Your doctor may prescribe some of the following drugs:
- Metformin – treats type 2 diabetes
- Eflornithine – topical product, a cream, that reduces the growth of facial hair
- Progestin – improves fertility and regulates periods
- Glucocorticosteroids – decreases inflammation
- Spironolactone – a diuretic that controls salt and water levels in the body to slow down hair growth
To manage symptoms associated with high testosterone your doctor may prescribe oral contraceptives. That being said, this is not a suitable treatment for women who are trying to get pregnant.
Besides medications, this problem also requires lifestyle changes which include:
- Weight loss
- Well-balanced diet particularly soy, low-fat foods, and flaxseed
- Reduce intake of refined carbs and junk food
- Regular exercise and increased physical activity levels
- Stress management
- Getting enough sleep
- Quit smoking
- Limit or avoid alcohol intake
How to balance your hormones
The problem here is not just about high testosterone, but the fact that imbalance in one hormone can cause problems with many others.
It’s a domino effect that you can tackle successfully. Here are some useful ways to balance your hormones and keep them in check, which can ultimately, lead to improved testosterone balance too:
- Consume enough protein
- Exercise regularly
- Avoid sugar
- Be proactive about underlying health problems and other hormone issues
- Find a unique way to manage stress, do what you find relaxing, and turn it into an important part of your lifestyle, e.g. reading, writing, bubble bath, yoga, meditation
- Avoid eating too much or not enough
- Drink green tea
Testosterone is a vital hormone that both men and women need for optimal health and sexual function. The levels of this hormone in women can increase due to a number of causes ranging from a sedentary lifestyle to PCOS.
Fortunately, it’s possible to balance testosterone and manage symptoms associated with its increased concentration. Make sure you see your doctor in order to receive an accurate diagnosis.
[i] Testosterone, You and Your Hormones http://www.yourhormones.info/hormones/testosterone/
[ii] Panay N, Fenton A. The role of testosterone in women. Climacteric 2009 Jul;12(3):185-7. Doi: 10.1080/13697130902973227 https://www.tandfonline.com/doi/abs/10.1080/13697130902973227?journalCode=icmt20
[iii] Test ID: TTFB, Testosterone, Total, Bioavailable, and Free, Serum, Mayo Clinic Laboratories https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/83686
[iv] Polycystic ovary syndrome (PCOS), My VMC https://www.myvmc.com/diseases/polycystic-ovarian-syndrome-pcos/
[v] Saran S, Gupta BS, Philip R, et al. Effect of hypothyroidism on female reproductive hormones. Indian J Endocrinol Metab. 2016;20(1):108-13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743370/