What causes high testosterone in women?

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

Testosterone plays a part in the development and maintenance of female reproductive tissue and bone mass along with the female sex hormone oestrogen. Such hormones affect behaviour, as well.

Read about disorders in women that cause high testosterone, and about symptoms and treatment in this article.

Normal testosterone levels

Standard levels of testosterone in men range from 280 to 1100 nanograms per deciliter (ng / dL).

Women secrete significantly lower quantities, with typical levels estimated to range from 15 to 70 ng / dL.

The amount of hormones released in the body varies every day, and all day long. During the morning, testosterone levels are highest.

Symptoms of high testosterone in women

Symptoms of high testosterone in women
Symptoms of high testosterone in women may include mood changes, a deep voice, thinning hair, and acne.

Women with testosterone imbalances can affect their physical appearance and overall health.

Symptoms for women with elevated testosterone include:

  • acne
  • deep voice
  • excess hair on the face and body
  • increased muscle mass
  • irregular periods
  • larger-than-normal clitoris
  • loss of libido
  • mood changes
  • reduction in breast size
  • thinning hair

Severely high levels of testosterone in women can cause obesity and infertility.

Causes

High testosterone in females is typically triggered by an underlying medical condition, like:

Congenital adrenal hyperplasia (CAH)

CAH is the name for a group of hereditary disorders involving the adrenal glands. This glands secrete the cortisol and aldosterone hormones which play a role in the management of metabolism and blood pressure.

The adrenal glands also contain DHEA and testosterone, which are male sex hormones.

People with CAH lack one of the enzymes required to control the development of these hormones, so too little cortisol and too much testosterone is secreted.

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

Although there is no cure for CAH, medication that will minimize symptoms and improve their quality of life can be provided to most people with the condition.

Hirsutism

Unwanted hair growth in women is characterized by hirsutism. It is a hormonal disorder which is thought to be associated with genetics.

Symptoms include dark and coarsely male-pattern hair growth. Usually it affects:

  • back
  • chest
  • face

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

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

Home remedies and medical procedures help a number of people handle hirsutism symptoms.

Polycystic ovary syndrome (PCOS)

PCOS is a common hormonal disorder which affects reproductive-age women. Several reports say that 8 to 20 per cent of women worldwide are affected by PCOS.

People are typically not diagnosed until they are in their twenties and thirties but it can affect girls as young as 11 years old.

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 play a role.

Diagnosis

Blood test
A doctor may order a blood sample to diagnose high testosterone in women.

In women, a doctor can diagnose high testosterone on the basis of:

Physical examination

The doctor will check for signs such as, during a physical examination:

  • acne
  • excess body hair
  • facial hair growth

They will also inquire about:

  • libido
  • menstrual cycle abnormalities
  • mood changes

If PCOS is suspected, the physician can examine the pelvic region visually and manually to look for abnormalities.

Blood test

If signs indicate high levels of testosterone, the doctor should take a sample of the blood to check the hormone levels. They can also test the cholesterol and glucose levels.

Generally when testosterone levels are strongest the blood should be drawn in the morning.

Ultrasound

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

Treatment

Effective treatment for high testosterone may depend upon its underlying cause.

A doctor will usually prescribe changes to both the lifestyle and medicine. Some therapies may also be used to regulate excess hair.

Medication

The following drugs can be used to treat high testosterone in females and associated conditions:

  • 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 contraception can also be recommended as this treatment helps to prevent excess testosterone from developing. The safest forms of oral contraceptives are those that contain small doses of norgestimate, gestodene, and desogestrel for high testosterone and hirsutism.

Oral contraception, however, may not be appropriate for women attempting to get pregnant, and they can also cause adverse side effects.

Hair removal treatments

Laser therapy may help to control unwanted hair.
Laser therapy may help to control unwanted hair.

Unwanted hair can be controlled by both electrolysis and laser therapy. Such therapies, however, do not resolve an underlying hormonal imbalance.

  • Electrolysis. This involves inserting a tiny needle into each hair follicle. A pulse of 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.

Remember that such treatments for hair removal may cause adverse reactions, and can pose other related risks.

Someone with a hormonal imbalance should speak to a doctor before carrying out unnecessary hair growth medical treatments.

Lifestyle changes

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

Achieve and maintain a healthy weight

Achieving a healthy weight may help with the symptoms of a hormonal balance. Losing even 5 to 10 percent body weight may improve PCOS symptoms, reduce testosterone levels, and help prevent complications, including infertility.

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.

Takeaway

High testosterone in women can cause a variety of symptoms, ranging from excess facial hair to infertility and is typically caused by an underlying disorder. Treatment of the underlying condition also reduces symptoms and improves the quality of life for a person.

People who are or think they may have high symptoms of testosterone should contact their physician to assess the cause and gain access to treatment.

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