Testosterone, the male hormone, plays a crucial role in both male and female anatomy and bodily functions. Without it, a lot of systems would be impaired, and the body wouldn't carry out a number of essential processes.
Therefore, regardless of whether you, as a woman, have it in high or low concentrations, you must address the problem as soon as possible.
Don't be surprised; there is such a thing as high testosterone in women. You can see it in freakishly strong and muscular females and women with manly features. Women who have high testosterone levels may have a number of health issues and other unpleasant side effects.
If you're interested in learning more about this issue, read ahead. We'll explain the biology behind testosterone, the different health problems that arise from a high dose, its causes, and the necessary treatments.
Testosterone is naturally present in the female body
While it is common to think of testosterone as a male hormone, it is also present in the female body, although in lower concentrations. Despite that, the amount of testosterone produced over a woman's lifespan is higher than that of estrogen.
That's because testosterone is the pro-hormone from which the major estrogen, estradiol, is synthesized. The ovary cells make testosterone first, and then it's converted into estrogen.
The ovaries aren't the only organ that produces testosterone, though. Testosterone from the ovaries comprises about a fourth of the total synthesized testosterone in women. Another fourth is produced by the adrenal glands, and about half is secreted from peripheral tissues.
The cells of a woman's body can certainly respond to testosterone given that they possess androgen receptors in breast cells, the vagina, the ovaries, and the uterus, in addition to other systems such as cardiovascular, digestive, respiratory, and integumentary systems.
What are normal T levels in women?
Normal testosterone levels in women range from:
That’s a drop of about 50%, which makes sense since women’s ovaries stop working, but the adrenal glands and adipose tissue continue to produce testosterone.
If your test results show numbers outside of these readings, then you’re dealing with either low or high testosterone levels, and you should immediately consult with your doctor.
Consequences of high testosterone
A woman's health and sex drive may suffer from an imbalance of testosterone in her body.
In combination with the effect provided by estrogen, testosterone is responsible for:
- Maintaining women’s bone health (bone density),
- Reproductive health (ovaries, uterus, etc.), and
- Keeping their behavior/mood balanced.
A woman’s appearance is the first thing to change when her body is exposed to high testosterone levels. It can cause:
High testosterone levels can also cause menstrual cycles to become irregular. Furthermore, It negatively impacts women’s libido and may even cause depression and other behavioral issues.
Further research has shown that high testosterone levels in women increase the risk of cancer, type 2 diabetes, and metabolic syndrome, which is the opposite case for men.
The idea of forgoing treatment and simply dealing with it may have entered your mind if your testosterone levels are high. It can be frightening to handle medical issues properly, but it's strongly advised that you don't sacrifice your long-term health for the momentary annoyance.
Causes of high testosterone in women
A number of illnesses or hormonal conditions can lead to hormonal imbalances in women. More often than not, these imbalances happen due to damage to one of the organs that produce testosterone in women. That means damage either to the ovaries, adrenal glands, or adipose tissue.
- Polycystic ovary disease,
- Congenital adrenal hyperplasia
are the most typical reasons for elevated testosterone levels in women.
Let’s address them.
Affecting primarily women, Hirsutism is a medical condition that results in excessive hair growth on specific body areas.
It has non-androgenic and androgenic causes. Non-androgenic causes include acromegaly (a rare condition where the body secretes too much growth hormone), certain medications, and skin irritation caused by retinoic acid.
Androgenic causes include Polycystic Ovary Syndrome (damage to the ovaries), HAIR-AN syndrome (a combination of hyperandrogenism, insulin resistance, and acanthosis nigricans — a skin condition causing dark discolorations), non-classical congenital adrenal hyperplasia, among other causes.
The way to recognize if you have Hirsutism or not is through a combination of symptoms that include:
To find out whether you have Hirsutism or not, you should undergo a 24-hour urinary cortisol test. Several tests might be necessary to get an accurate reading.
2. Polycystic ovary disease
As the name suggests, Polycystic Ovary Syndrome affects women's ovaries by creating tiny cysts within them that look like black holes on an ultrasound.
It's one of the most common endocrinopathies in women, with 6-12% of women being affected. It's also the leading cause of female infertility in the US.
Women with PCOS frequently have insulin resistance. Insulin resistance is a condition where the body can produce enough insulin, yet its cells are no longer responding to it. Insulin resistance increases the risk of type 2 diabetes.
Women with PCOS also have higher levels of androgens that can inhibit ovulation.
Insulin resistance and a higher level of androgens cause an array of secondary conditions. These include Dyslipidemia (lipids imbalance), Obstructive Sleep Apnea, Anovulatory, Infertility (prolonged release of the egg), Endometrial Hyperplasia (thickening of the uterus), Endometrial Cancer, Depression, and Anxiety.
The causes of PCOS aren't fully understood by the scientific community. However, there are correlations suggesting that obesity, insulin resistance, and family history can cause PCOS.
PCOS symptoms are:
3. Congenital adrenal hyperplasia
Being a group of genetic disorders, more often than not, Congenital Adrenal Hyperplasia (CAH) involves a deficiency in a specific hormone called 21-hydroxylase. This enzyme is responsible for transforming certain precursors (progesterone and 17-Hydroxyprogesterone) into aldosterone (a hormone that's necessary for the diuretic system) and cortisol.
When there's a deficiency of 21-hydroxylase, there's a build-up of the precursors. These precursors are then used in the androgen-production pathway, and that's how some women with CAH end up with high testosterone.
CAH comes in two types: classical and non-classical, with classical CAH having more health repercussions.
Women with CAH are deficient in aldosterone and cortisol. Aldosterone deficiency causes Hyponatremia (lack of sodium in the bloodstream) and hyperkalemia (too much calcium in the bloodstream). Without enough sodium to cause water retention, blood pressure drops, causing hypotension.
On the other hand, cortisol deficiency causes hypoglycemia (low blood sugar) and elevated Acetylcholine (ACTH), which can cause Cushing Syndrome.
Symptoms of CAH include:
Testing your testosterone
If you have some of the symptoms listed above, you might be dealing with high testosterone levels. Therefore, it’s recommended that you take a testosterone test.
Women’s testing is different from men’s. For instance, the method used to test testosterone levels for women is called liquid chromatography/tandem mass spectrometry, while testosterone levels in men are measured via Immunoassays.
This test gives an accurate estimate of serum testosterone. However, the test may not be as accurate if testosterone levels are moderately high instead of excessively high.
Either way, a total testosterone test will usually be used for screening. You will then need a free testosterone test to diagnose certain medical conditions.
The best time to conduct this test is in the morning as testosterone levels tend to be highest then.
Here’s how the test goes: Blood will be drawn using a tube from a vein in your arm or possibly a finger. If you use any medications or herbal supplements, let your doctor know. Your test results may be skewed by active ingredients in some medications.
Due to the fluctuating nature of testosterone levels, you will need to repeat the test a few times to get an accurate read.
An underlying medical issue typically brings on high testosterone in females, and it can result in a variety of symptoms, from excessive facial hair to infertility.
Often, treating the illness will help women feel better and have fewer symptoms. In order to identify the root of the problem and select the best course of treatment, women who are or believe they may be having high testosterone symptoms should speak with a doctor.
Treatment of high testosterone in women comes down to medication, lifestyle changes, and, rarely, surgery. This is the list of the most common medications:
- Oral contraceptives;
Hormonal therapy and contraceptives are also an option. Contraceptives block the production of testosterone; however, it would put any pregnancy attempts on hold.
Women looking to lower their testosterone naturally need to manage their weight, their diets, and their lifestyle choices.
As discussed above, obesity is correlated with PCOS. Obesity is also correlated with insulin resistance, the latter being correlated with PCOS.
By managing your diet and picking up exercise as a healthy habit, you should drop to a manageable weight (usually a BMI between 18-25).