High Testosterone in women and Assigned Females at Birth (AFABs) is more common than most people realize. Testosterone is the male hormone mainly produced by the testes of males and Assigned Males at Birth (AMABs). But women’s ovaries also naturally make it in smaller amounts to support metabolism, muscle strength, and fertility. However, when these levels exceed the usual range, it can lead to extra facial hair, acne, irregular periods, weight gain, and infertility.
Polycystic Ovarian Syndrome (PCOS) is the most prevalent cause of higher levels of testosterone in women, but other medical conditions, such as adrenal gland abnormalities, can also contribute. Several treatment options, ranging from medications to natural remedies, can help control the symptoms.
This article will highlight the early signs, causes, and treatment options to help women effectively manage symptoms and maintain long-term hormonal balance.
What is High Testosterone in women and its symptoms?
High testosterone level in women is a condition where the ovaries or adrenal glands produce an excessive amount of testosterone. Excessive testosterone in women can disrupt the hormonal balance and appear in various symptoms such as:
- Excessive face or body hair (Hirsutism)
- Acne or oily skin
- Female-pattern hair loss (Androgenetic alopecia in women)
- Irregular or missed menstruation
- Unexplained weight gain, particularly in the abdomen
- Deepening of voice
- Increased muscle mass
- Mood swings and irritation
- Reduced fertility or trouble conceiving
- Enlarged clitoris (rare)
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What causes High Testosterone in women?
The cause of High Testosterone in women is often linked to the underlying medical disorders like PCOS and insulin resistance that disrupt the production of hormones by the ovaries and adrenal glands. Let’s have a look at the common factors that lead to a higher level of testosterone in women.
PCOS
PCOS is the primary cause of elevated testosterone in women. In this disorder, the ovaries fail to produce eggs regularly, disrupting the balance of female hormones, including estrogen and progesterone. As a result, the ovaries begin releasing an excessive amount of androgens (male hormones), including testosterone.
This hormonal imbalance causes symptoms such as irregular periods, ovarian cysts, acne, weight gain around the abdomen, excessive facial or body hair, and fertility issues.
Insulin resistance
Insulin resistance happens when the body’s cells stop responding effectively to insulin. This stimulates the pancreas to make more insulin to maintain normal blood sugar levels. High insulin levels trigger the ovaries to produce more testosterone, which can disrupt menstrual cycles and contribute to the development of acne and hair growth.
This condition is highly common among women with PCOS, Prediabetes, Type 2 Diabetes, and Obesity.
Congenital Adrenal Hyperplasia (CAH)
CAH is a hereditary disorder in which the adrenal glands are unable to produce certain hormones like cortisol and androgens effectively. To compensate, they produce excess androgens, including testosterone. Early puberty, excessive hair growth, severe acne, and irregular periods are all possible symptoms.
Adrenal gland disorders
The adrenal glands, located above the kidneys, naturally produce trace levels of testosterone. Adrenal tumors and Cushing’s disease (a condition where the adrenal glands produce too much cortisol) are two disorders that can cause these glands to produce abnormally high levels of testosterone.
These conditions often lead to rapid and severe symptoms, such as excessive hair growth, deepening of the voice, unexplained weight gain, and menstrual abnormalities.
Ovarian tumors
Although uncommon, some ovarian tumors, particularly androgen-secreting tumors, can release significant levels of testosterone. This produces major and unexpected changes, such as severe acne, rapid facial or body hair growth, hair loss, and a deeper voice.
Unlike PCOS, symptoms of ovarian tumors frequently arise suddenly rather than gradually, making early identification essential.
Medications or supplements
Certain medications and supplements, like steroids, testosterone boosters, and Dehydroepiandrosterone (DHEA) supplements, can directly or indirectly raise testosterone levels in women. This, in turn, results in symptoms such as voice deepening, acne, irregular periods, and increased body hair.
Stress
Chronic stress stimulates the adrenal glands to release additional stress hormones, particularly cortisol. This ongoing stimulation can eventually boost the synthesis of testosterone. Women who are stressed for an extended period of time may experience irregular cycles, mood swings, acne, sleep issues, and increased facial hair growth.
Diagnosing High Testosterone
Diagnosis of High Testosterone involves a thorough medical evaluation combining medical history, physical examination, and laboratory tests. These often involves:
- Blood tests that measure testosterone levels, insulin, and thyroid hormones, as these levels help identify hormonal imbalance or underlying endocrine issues.
- Review of medical history, including weight changes, acne, hair growth, fertility problems, and mood symptoms.
- Assessment of menstrual patterns to check for irregular, missed, or heavy periods, which often point to hormonal disruptions.
- A physical examination to check for excess facial or body hair, acne, scalp hair thinning, dark skin patches, and abdominal or pelvic tenderness.
- In some cases, doctors might recommend ultrasound imaging to observe ovarian size or cysts.
Together, these findings help create a clear picture of the hormonal health and guide proper treatment.
How to fix High Testosterone in women?
Treating high testosterone levels in women is crucial for overall health, fertility, and well-being. Treatment primarily involves medications, lifestyle changes, and natural remedies.
Medications
A doctor can prescribe the following medications that either limit the effects of testosterone or manage overall hormone levels.
- Oral contraceptives (birth control pills): These are usually the first-line treatment. They contain estrogen and progestin, which work together to reduce ovarian androgen production and boost Sex Hormone Binding Globulin (SHBG), a protein that binds to and deactivates testosterone. This regulates the menstrual cycle and helps inhibit acne and hair growth.
- Anti-androgen medications: Medicines such as Spironolactone help prevent the impact of testosterone on the hair follicles and skin, reducing Hirsutism and acne.
- Insulin-sensitizing agents: Metformin is a medication that is frequently used to treat women with PCOS who have insulin resistance. They can indirectly assist lower testosterone levels by enhancing the body’s reaction to insulin.
- Corticosteroids (glucocorticosteroids): These are used to treat excessive testosterone caused by an adrenal gland condition, such as CAH.
Lifestyle changes
Since elevated testosterone due to conditions like PCOS is directly connected to insulin resistance and weight, the following lifestyle adjustments can be quite beneficial:
- Weight management: Losing just 5-10% of body weight can considerably improve insulin resistance, regulate menstrual cycles, and lower circulating testosterone levels.
- Dietary changes: Opt for a balanced, low-glycemic diet that doesn’t rapidly spike blood sugar levels and maintains stable energy levels. Reduce your consumption of refined carbohydrates, processed foods, and added sugars. This helps to maintain blood sugar and insulin levels.
- Regular exercise: A combination of moderate-intensity cardio and resistance training can boost insulin sensitivity and support weight loss.
Natural remedies
While the following natural remedies cannot replace medical treatment, they can help improve hormonal balance and relieve symptoms:
- Spearmint tea: According to a randomized controlled trial published by the journal Phytotherapy Research in 2010, drinking spearmint tea twice a day can considerably reduce free testosterone levels while also improving symptoms such as Hirsutism.
- Inositol: Inositol, which is commonly used to treat PCOS, increases insulin sensitivity, enhances ovulation, and aids in natural hormone regulation.
- Flax seeds, cinnamon, and omega-3s: Foods like flax seeds contain lignans, which help lower free testosterone levels, while cinnamon helps with insulin sensitivity and blood glucose control. Also, omega-3 fatty acids aid in reducing inflammation and maintaining hormonal balance.
When to consult a doctor?
Women with High Testosterone levels should seek immediate medical assistance if they notice any of the following signs that persist or start bothering them:
- An abrupt increase in facial or body hair
- Irregular menstruation lasting around 2-3 cycles
- Severe acne flare-ups
- Hair loss, or bald patches
- Difficulty becoming pregnant
Early detection can help overcome High Testosterone symptoms and prevent long-term consequences.
Conclusion
High testosterone in women can affect reproductive health and overall well-being. It often leads to symptoms such as Hirsutism, acne, and menstrual irregularities. However, with the correct approach, it is possible to manage this condition effectively.
Whether the imbalance is caused by PCOS, insulin resistance, or adrenal difficulties, early treatment can help prevent long-term complications. With proper diagnosis, hormone-regulating medications like Spironolactone, healthier eating habits, weight management, and targeted natural therapies, many women can restore balance and improve their overall well-being.
Maintaining consistency in treatment and monitoring hormone levels helps women to reclaim control of their hormonal health and live a happier, more balanced life.
Frequently Asked Questions
When is testosterone highest in females?
Testosterone in females is highest in the morning, shortly after waking, and naturally peaks around mid-cycle during ovulation. These fluctuations support energy, mood, and libido throughout the menstrual cycle.
How long does it take to lower testosterone levels?
The treatment results of High Testosterone vary from woman to woman. Medications may show improvement in 4–8 weeks, while lifestyle and diet changes can take several months. Most women notice better hormone balance within three to six months with consistent care.
Can Menopause cause High Testosterone?
Yes, Menopause can lead to high testosterone levels. During Menopause, estrogen declines more sharply than testosterone, making androgen levels appear relatively higher. This hormonal shift can trigger acne, changes in hair growth, and metabolic alterations in some women.
Is it possible to have High Testosterone even without visible symptoms?
Yes, some women may have elevated testosterone levels with mild or non-specific symptoms. However, consistent monitoring is essential, as it still indicates an underlying hormonal imbalance or condition that requires attention.
Should I fast before getting my testosterone blood test done?
No, generally you do not need to fast before getting your testosterone blood tests done. However, doctors often recommend testing in the morning when testosterone levels are naturally highest. Fasting might be suggested if other tests (like glucose) are also being run.
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