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10 Signs of High Testosterone in Women (+ Causes and Treatment)

Medically Approved by Dr. Edward Salko

Table of Contents

Testosterone in women? It may come as a shock for some people because testosterone is primarily a male hormone, but women do produce testosterone in smaller amounts. Thus, it can be alarming to learn if you have elevated testosterone. 

In most cases, high testosterone in women is associated with a much-concerning disorder, which is why knowing the signs early on can help speed up treatment. Let’s dive into spotting high testosterone in women by understanding these signs.   

This article focuses on research specific to individuals assigned female at birth during the studies and may not be generalizable to the entire population.
  1. Acne
woman dealing with acne

Testosterone promotes increased production of sebum from the sebaceous glands. Sebum is an oily substance that preserves skin moisture. 

Excessive sebum combines with dead skin cells and dirt, clogging the hair follicles. As a result, it creates comedones, a plug in the pores that encourages bacteria to grow and cause inflammation as well as acne lesions(1)

  1. Hair Loss
Woman having hair loss

Women with high testosterone are at risk of developing androgenetic alopecia, a type of hair loss that starts with the thinning of the hair on top of the scalp. Androgenetic alopecia widens the part line. 

Not all women with elevated testosterone experience hair loss. Those who do often have a genetic sensitivity to DHT (dihydrotestosterone)(2), a more potent form of androgen resulting from the action of testosterone and an enzyme called 5-alpha reductase. 

DHT binds with the hair follicle receptors, shrinking the hair. Eventually, the hair becomes shorter and thinner so that it’s not easily visible on top of the head anymore. 

Also Read: What Blood Tests to Take for Sudden Hair Loss (Alopecia)?

  1. Excessive Male-Like Hair Growth
Emotional young woman doesnt want to shave, holds razor blades, wears bath cap and rubber goggles, being tired of hygienic procedures at home, closes eyes and shouts loudly, isolated on green wall

High testosterone in women can lead to hirsutism(3)(4), in which hair growth can be observed in areas similar to men. Mail-like hair growth can be visible on the face and chest, as testosterone stimulates the process in these areas. 

Similar to hair loss, genetics influences one’s inclination to hirsutism. If one is much more sensitive to androgens or has other underlying conditions that promote hair growth, they are likely to develop hirsutism.  

  1. Decreased Breast Size

If you have more testosterone than normal, chances are other reproductive hormones become repressed, including estrogen. Unlike testosterone, estrogen is produced in high levels during the menstrual cycle’s mid-follicular phase. 

Estrogen also plays a primary role in developing breast tissue(5), both the fatty and glandular types. With less estrogen, the fatty tissues can be overpowered by the glandular tissues, as testosterone leans toward its development more. As a result, the breasts may look smaller. 

  1. Deepened Voice

Testosterone thickens the vocal cords, deepening your voice(6). Among young males, they begin to notice this change during puberty when testosterone levels are surging(7). For women with high levels of testosterone, this is a possibility. It may not necessarily be as deep as that of many men, but the significant change in pitch will be hard not to notice. 

  1. More Muscle Mass

Testosterone, an anabolic hormone, drives muscle growth(8). It stimulates protein synthesis that makes new muscles. Plus, it prevents too much muscle breakdown and promotes repair and growth. 

Hence, if you’re a woman with elevated testosterone, you might have a higher proportion of fast-twitch muscle fibers that easily expand with strength training. 

  1. Irregular or Missing Period

Too much testosterone in women can interfere with ovulation(9), the process wherein the ovaries produce the egg cells. Without ovulation, there wouldn’t be menstruation. 

In addition, high testosterone can also stem from PCOS, which triggers hormone imbalance, causing fluctuating or irregular periods. On top of that, PCOS is also associated with insulin resistance that influences testosterone levels.  

  1. Infertility
Sad couple looking at pregnancy test

The hormonal disruption due to elevated testosterone that leads to irregular periods or its complete absence makes it difficult for women to conceive. 

High testosterone levels can also adversely impact egg quality(10) and the ability of the endometrium to receive the fertilized egg (zygote). As a result, even if you do conceive, the chances of the zygote surviving are diminished.

Also Read: Everything You Need To Know About the Anti-Mullerian Hormone Test for Ovarian Reserve

  1. Low Libido

Libido in women can be tricky as it requires a good balance between key hormones like estrogen and testosterone(11). For women with high levels of testosterone, the condition can decrease sexual desire as the delicate balance is disrupted. It’s also likely that excess testosterone gets converted to estrogen, which further restrains libido.   

  1. Mood Swings

Contrary to popular belief, hormones do not function in isolation. Any changes in one hormone can influence how the others work. That said, if women have above-normal testosterone levels, they can impact other hormones and neurotransmitters that regulate mood. 

The imbalance also disrupts sleep and triggers unpleasant symptoms that challenge a woman’s self-esteem, like excessive facial hair, acne, and hair loss. All these can cause depression, anxiety, and fluctuations in a woman’s mood(12)

What Causes High Testosterone in Women?

It’s unlikely that elevated testosterone in females is caused by factors other than an underlying medical condition. High testosterone is a symptom of a health problem that requires significant attention, including the following:

Polycystic ovary syndrome (PCOS)

Around five million women(13) suffer from polycystic ovary syndrome (PCOS) in the US. PCOS is a hormonal disorder in women that causes excess production of androgens, including testosterone. Women may develop fertility problems, but PCOS can be managed with proper lifestyle changes and treatment.   

Did You Know? Diagnosing PCOS requires several tests–not just a testosterone test. You will likely have to take a comprehensive female hormone blood test and a pelvic exam. Likewise, your gynecologist will look into your medical and family history on top of the symptoms you’re experiencing. 

Androgen-releasing tumors

Rare as it is, high testosterone in women can be linked to the formation of tumors that trigger the overproduction of testosterone. These androgen-releasing tumors(14) typically develop in the ovaries and adrenal glands, which are organs that secrete androgens. 

Congenital adrenal hyperplasia

Also known as CAH, congenital adrenal hyperplasia is a collective term for disorders affecting the adrenal glands. It’s a rare condition that inhibits the production of certain hormones but triggers excessive release of testosterone. 

Cushing disease

Cushing disease is typically caused by a tumor in the pituitary gland. As a result, it forces the body to produce more cortisol, a hormone secreted by the adrenal glands. Cortisol is a primary stress hormone that facilitates physiological responses during stressful conditions.  

Aside from cortisol, Cushing disease also leads to the overstimulation of adrenal glands, which also produces excessive amounts of other hormones. These include testosterone. 

How Elevated Testosterone in Women Is Treated

Treating high testosterone in women means uncovering the underlying medical disorder. By addressing the cause, this hormone will subsequently level to the normal range. In this process, the following treatment may be recommended:

  • Medications: For women with PCOS, your doctor may use medicines like anti-androgens and oral contraceptives. In other disorders, specific drugs will also be prescribed to limit extra hormone production that triggers elevated testosterone secretion. 
  • Surgery: Androgen-secreting tumors should be surgically removed, typically from ovaries and adrenal glands. 
  • Weight management: Losing weight the right way can help improve your hormone balance. In turn, it can significantly lower testosterone levels. Consider altering your diet and exercising 30 minutes a day. 
  • Sleep better and longer: If you’re always sleep-deprived, it’s time to improve your sleep hygiene. Aim for eight hours of quality sleep at night. If you’re riddled with anxiety, here are our science-backed tips to sleep better.     
  • Stress management: Stress can impact hormone production. Manage stress through relaxing activities like yoga, mindful meditation, arts and crafts, and so on. 

Much like self-diagnosis, treating high testosterone in women can harm your health, especially if medications are involved. Make sure to consult your doctor. 

Nevertheless, several suggestions above can be made as a general approach to good health, such as getting adequate quality sleep, exercising, stress management, etc. You can start with these actions and track the results. 

Frequently Asked Questions

What foods lower testosterone in females?

Fatty fish, flaxseeds, licorice roots, and red reishi mushrooms can help lower testosterone in women. Drinking peppermint or spearmint tea is also said to have the same effect. However, before increasing your intake of these foods, consult your doctor first to avoid any unwanted interactions with prescribed medications. 

Can too much testosterone in a woman cause anxiety?

Studies have shown that some women with higher testosterone than normal also have anxiety. This is likely due to the hormonal imbalance that impacts mood regulation. Still, it’s unlikely that elevated testosterone alone can heighten anxiety. Talk to your doctor to uncover other triggers and learn the best course of treatment. 

How do you treat high testosterone in women naturally?

You can supplement medical treatment for the underlying health problem that led to elevated testosterone. These include changing your diet, exercising regularly, getting enough sleep, and other lifestyle adjustment. However, the natural approach alone is less likely to treat high testosterone in women. 

The Bottom Line

High testosterone in women in itself is not necessarily alarming, especially if you can address the condition through lifestyle adjustments. However, since it is a critical symptom of PCOS and ovarian tumors, it shouldn’t be ignored. That said, it’s best to consult your doctor for proper diagnosis and corresponding treatment. 

Sources

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2 Grymowicz M, Rudnicka E, Podfigurna A, Napierala P, Smolarczyk R, Smolarczyk K, Meczekalski B. Hormonal Effects on Hair Follicles. Int J Mol Sci. 2020 Jul 28;21(15):5342. doi: 10.3390/ijms21155342. PMID: 32731328; PMCID: PMC7432488.

3 Yilmaz B, Yildiz BO. Endocrinology of Hirsutism: From Androgens to Androgen Excess Disorders. Front Horm Res. 2019;53:108-119. doi: 10.1159/000494907. Epub 2019 Sep 9. PMID: 31499500.

4 Hohl A, Ronsoni MF, Oliveira Md. Hirsutism: diagnosis and treatment. Arq Bras Endocrinol Metabol. 2014 Mar;58(2):97-107. doi: 10.1590/0004-2730000002923. PMID: 24830586.

5 Ekstrand J, Zemmler M, Abrahamsson A, Lundberg P, Forsgren M, Dabrosin C. Breast Density and Estradiol Are Major Determinants for Soluble TNF-TNF-R Proteins in vivo in Human Breast Tissue. Front Immunol. 2022 Mar 30;13:850240. doi: 10.3389/fimmu.2022.850240. PMID: 35432372; PMCID: PMC9005790.

6 Chadwick KA, Simpson CB, McGarey PO Jr, Estes CM, Nix J, Sulica L. Voice Change Following Testosterone Supplementation in Women: A Multi-Institutional Case Series. J Voice. 2021 Nov;35(6):936.e1-936.e7. doi: 10.1016/j.jvoice.2020.03.008. Epub 2020 May 5. PMID: 32386906.

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