How to tell if your testosterone levels are too high for a woman
- Women with high testosterone may have symptoms like acne and facial hair growth.
- You may also experience thinning hair, a deepening voice, irregular periods, and more.
Testosterone is a sex hormone that's primarily associated with men — but it's found in women, too.
Women's ovaries and adrenal glands are responsible for producing small amounts of male hormones known as androgens, so it is completely normal and expected for women to have some testosterone in their blood.
However, if you're a woman with higher testosterone levels than normal due to an underlying condition, this can result in various symptoms that affect both your appearance and how you physically feel.
Here's what you need to know about the symptoms, causes, and treatments for high testosterone.
The symptoms of high testosterone in women
Two of the most common and obvious symptoms of high testosterone in women are acne and increased hair growth, says Dr. Pinar Kodaman, a reproductive endocrinologist and infertility expert at Yale Medicine.
The acne is due to increased sebum (oil) production, which is stimulated by elevated testosterone levels, Kodaman says. As for the increased hair growth, she says this occurs in a "male pattern," meaning it may grow on the jawline, chest, back, and lower abdomen.
However, it's possible for high testosterone to result in even more changes to how a woman looks and feels, depending on how much extra of the hormone there is, says Dr. Jane L. Frederick, a reproductive endocrinologist and infertility expert at HRC Fertility, an affiliate of Keck Medicine of USC.
Frederick says you may also have the following symptoms:
- Balding/hair thinning
- Enlarged clitoris
- Decreased breast size
- Increased muscle mass
- Deeper voice
- Irregular periods
Causes of high testosterone in women
Multiple conditions are linked with high testosterone. Some examples include:
1. Polycystic Ovary Syndrome (PCOS)
"PCOS is by far the most common cause of elevated testosterone levels among women of reproductive age," Kodaman says.
For a doctor to diagnose you with PCOS, you need to meet at least two of the following three criteria:
- Elevated levels of male hormones, including testosterone
- Irregular periods
- Polycystic ovaries, which means that there are multiple small egg-containing follicles around the ovary, due to the lack of regular ovulation, says Kodaman.
Other PCOS symptoms include:
- Excessive hair growth on the face and chin
- Thinning hair on the scalp
- Darkened skin in the groin, under breasts, and neck creases
- Weight gain and trouble losing weight
Treatment: One of the most common treatments, for women with PCOS who are not trying to get pregnant, is birth control pills. This helps regulate your menstrual cycle and decrease elevated testosterone levels, Kodaman says.
Depending on the situation, your doctor may prescribe other medications such as spironolactone or metformin, Frederick says.
- Spironolactone: This is a medication that blocks the effects of androgen on your skin,, so it can help improve your acne and excess hair growth. However, you shouldn't take spironolactone if you're planning on getting pregnant or are already pregnant, due to birth defect risks.
- Metformin: For people with PCOS who are trying to get pregnant, metformin is actually a type 2 diabetes medication, but it can help you ovulate if you are trying to get pregnant and experiencing infertility due to PCOS.
Furthermore, Kodaman says lifestyle modifications like eating a healthy diet, exercising, and losing weight (if necessary) can help, too.
Hirsutism is directly linked to high levels of testosterone.
"This is a hormonal condition in women that causes growth of unwanted hair, especially on the back, face, and chest," Frederick says. The hair is typically dark and coarse.
Overtime, the high androgen levels tied to hirsutism can cause the other tell-tale high testosterone symptoms listed above.
Treatments: The goal is to reduce androgen levels, so like with PCOS treatment, options include birth control pills or anti-androgen medications.
For excess hair on the face, a topical prescription can help to slow the growth of hair. Additionally, laser hair removal or electrolysis can help with long-term hair removal.
3. Congenital Adrenal Hyperplasia (CAH)
CAH is a genetic disorder. This condition directly affects the adrenal glands and the production of hormones such as androgens, says Frederick.
In more severe cases, this condition gets diagnosed in infancy. Other times it's not diagnosed until later in life, especially in mild cases.
Besides the symptoms of excess testosterone, the general symptoms of CAH include:
- Low levels of cortisol
- Genitals that develop atypically
- Quick growth during childhood, but a short final height
Treatment: The main treatment is medications to replace the low hormones. These meds may include corticosteroids and mineralocorticoids.
Then, to deal with excess male hormones, treatment is similar to PCOS treatment — including birth control or androgen receptor blockers, Frederick says.
4. Ovarian tumors
It's possible for an ovarian tumor to cause androgen production to increase.
"This is a much rarer cause of androgen excess in women that is characterized by significantly higher male hormone levels and as a result, more severe symptoms of androgen excess," Kodaman says.
Treatment: In most cases, ovarian tumors are not cancerous. Treatment involves surgical removal of the tumor, Frederick says. In cases where a tumor is cancerous, on top of surgery, you may need to undergo chemotherapy.
Everyone is unique and may experience varying levels of severity of symptoms or different combinations of symptoms. In order to know for sure if high testosterone is causing your symptoms, blood tests are necessary.
"The best way to get help is to meet with your doctor, find the cause, and come up with a treatment plan that is specific for each patient," Frederick says.
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