High Testosterone in Women: Signs, Causes, and Treatment

Testosterone is primarily a male sex hormone (androgen), but it’s also found in a woman’s body. Under normal conditions, a woman’s ovaries produce a small amount of testosterone, which is responsible for the growth and maintenance of the female reproductive tissues while also maintaining their bone mass and behaviors.

What’s the normal range of testosterone in women?

Normally, a woman’s body secretes much lower levels of testosterone than a man’s, with the range being 15-70 nanograms per deciliter (ng/dL). In males, the normal range of testosterone is 280-1100 ng/dL, but for both genders, the hormone levels vary on a daily basis and even throughout the day.

Further, the testosterone levels in women vary with their age, the range being:

What are the signs of high testosterone should you be looking out for?

Higher levels of testosterone affect both a woman’s appearance and internal workings, and the symptoms include:

• Thinning of scalp hair
• Excess body hair, especially in the facial region
• Breasts becoming smaller
• More muscle mass
• Deepened voice
• Enlarged clitoris
• Acne
• Irregular periods
• Mood swings
• Lowered libido

In some cases, higher testosterone levels also cause obesity or infertility.

What are the probable causes of high levels of testosterone in women?

Several factors can contribute to heightened levels of testosterone, including:

• Polycystic ovary syndrome (PCOS) - In PCOS, an excess of androgens is produced in the ovaries, causing an excess of testosterone in the female body. The disease itself is an endocrine disorder that affects about 1 in every 10 people with ovaries and is known to cause irregular periods and fertility problems. PCOS also causes other problems like acne, obesity, enlarged ovaries, excessive body and facial hair, etc. in females. Further, people with PCOS are also at a higher risk of developing type 2 diabetes and endometrial cancer.

• Hirsutism - Caused by an imbalance of androgens, hirsutism is a hormonal condition known to cause excessive male-patterned hair growth in women. You may notice hair on the back, chest and face and the strands are usually coarse and dark. Sometimes, the hormonal imbalance can go beyond hirsutism to develop a process known as virilization which can include other symptoms of high testosterone, like an enlarged clitoris, acne, a deep voice, hair fall, muscle buildup and smaller breasts.

• Congenital adrenal hyperplasia (CAH) - CAH directly affects the adrenal glands, which are responsible for producing androgens and cortisol, the hormones that regulate metabolism and blood pressure, while also secreting the male sex hormones DHEA and testosterone. CAH makes the body produce a lot of testosterone and very little cortisol, causing problems like severe acne, early pubic hair appearance, infertility and some masculine traits in women.

• Insulin resistance - Insulin makes the body break down the glucose in the bloodstream, and sometimes your body may develop a resistance to it. This spikes your blood sugar level, and the unused insulin in the bloodstream promotes testosterone production in excess in the ovaries.

• Thyroid issues - The body’s metabolism and hormone production levels are monitored by the thyroid gland, and some studies have established an indirect link between lowered levels of thyroid hormones (hypothyroidism) and rising testosterone levels. The sex hormone-binding globulin (SHBG) plays an integral role in maintaining a balance in the sex hormone levels and if SHBG falls too low, your testosterone levels can rise.
  

How is high testosterone diagnosed?

If you notice any of the symptoms associated with high levels of testosterone, you should visit a doctor and get yourself formally diagnosed. The doctor can use the following methods to conduct a proper diagnosis:

• Blood tests - Your healthcare provider may conduct a few blood tests to check your hormone levels, which becomes even more crucial in case you have been diagnosed with PCOS or you are suffering from amenorrhea from anorexia nervosa or excessive physical training.

• A thorough check of medical history - A thorough physical checkup and questioning regarding your medical history can be used to understand if you have symptoms like excessive body and facial hair, acne, hair loss, etc. If you are suspected to have PCOS, an ultrasound (USG) may be required to get a formal diagnosis.

• Imaging tests - In the case of PCOS, an ultrasound is enough to check the ovaries and the uterus to determine if you have the disease or not. But, if you are suspected to have an adrenal disease, you may need a CT scan or an MRI.
  

What are your treatment options?

If you are suffering from high testosterone, your healthcare specialist will most likely prescribe a holistic approach for regulating your hormone levels which will include medication and lifestyle changes.

• Medications - You may be prescribed anything from hormonal birth control pills, anti-androgen medicines to surgery and hormone therapy, depending on your level of testosterone imbalance. You should always consider sharing your reproductive plans with your doctor so that they can treat you accordingly since birth control pills are not an option in this circumstance.
  
  
• Lifestyle changes - If you have a testosterone imbalance, chances are that your doctor will ask you to manage your lifestyle accordingly to improve your symptoms, apart from prescribing medications. You may be asked to lose bodyweight or engage in exercise daily along with diet restrictions. Usually, the imbalance is caused by an underlying condition like PCOS, which needs to be treated first in order to bring the hormone levels back to normal. If you are experiencing unwanted symptoms, contact a gynecologist immediately to start your treatment plan as soon as possible.