What Causes High Testosterone in Women?

By Dr. Kenosha Gleaton, OBGYN

Testosterone, while often connected to men’s health, is an essential hormone for both men and women. In women, testosterone is primarily made in the ovaries and much of the hormone is converted to estrogen. [1] The body uses this converted testosterone to regulate menstruation, aid in conception and pregnancy, minimize bone loss, stimulate hair growth, and more. [2] Unfortunately, having low or high levels of testosterone can lead to some negative health effects. Let’s learn more about high testosterone levels in women. 

What Is Hyperandrogenism?

Testosterone is a sex hormone, the most common androgen. [2] Androgens (groups of sex hormones) are important for puberty, reproductive health, and general body development. Everyone makes androgens, but generally, people assigned male at birth (AMAB) make more. [3] When someone has a higher-than-normal amount of androgens in their body, they may be diagnosed with hyperandrogenism. [3] Hyperandrogenism can impact anyone but is most commonly seen in people assigned female at birth (AFAB) of reproductive age. Hyperandrogenism affects up to 10% of this population and can lead to health complications and uncomfortable symptoms. [3] Test your androgen levels → 

What Causes High Testosterone in Women? 

In many cases, there is an underlying health condition that may result in high testosterone levels. These conditions include PCOS, CAH, Cushing disease, and others. 

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders seen in people AFAB and a leading cause of infertility. [4] Oftentimes, symptoms of hyperandrogenism are indicative of PCOS. In fact, some of the criteria to diagnose PCOS include signs of excess androgens. [4] If someone does have PCOS, they may also experience irregular periods, obesity, darkened skin, cystic ovaries, and other symptoms. There is no way to cure PCOS, but there are many ways to manage the condition. [4] Learn more about PCOS. 

Congenital Adrenal Hyperplasia (CAH)

CAH refers to a group of different genetic disorders that influence the adrenal glands. [3] The adrenal glands are responsible for producing many different hormones, including testosterone. Those with CAH have genetic mutations that lead to the overproduction of hormones, which can result in high testosterone levels. [3] Read about CAH vs PCOS. 

Cushing Disease

Cushing disease, a form of Cushing syndrome, is related to high levels of adrenocorticotropic hormone, a hormone that increases cortisol and may also lead to excess androgens in the body. [3] Those with Cushing syndrome may also notice purple stretch marks on the stomach, rapid weight gain, and high blood pressure. 

There are other potential causes of high testosterone levels, including medications, tumors, other hormone imbalances, and more. If you have high testosterone, you should speak with a healthcare provider to pinpoint the exact cause. [3] 

Symptoms of High Testosterone in Women

High levels of testosterone in women and others AFAB can lead to many different symptoms [1,3]: 

• Acne and oily skin
• Hirsutism (excess body hair, especially on the face, chest, abdomen, and back)
• Infertility
• Male pattern baldness
• Abnormal menstruation

While these symptoms are commonly associated with high testosterone levels, there may be other conditions causing your symptoms. You should always speak to a healthcare provider directly for help assessing and managing your health. 

How to Lower Testosterone Levels

Managing high testosterone can be difficult, but there are ways to promote healthy hormone levels. 

Medications

There are a handful of medications that can improve symptoms and slow the release of certain androgens. Medications include corticosteroids,  hormonal birth control methods, spironolactone, cyproterone, and others. [3] Your provider may recommend a certain medication for you based on your fertility goals and symptoms. 

Surgery

Surgical intervention may be necessary to remove tumors or the ovaries in severe cases. [3] Surgery is not something that should be considered or recommended lightly, so be sure to speak to multiple healthcare providers if surgery is something that you are considering. 

Lifestyle Changes

Depending on the cause of your high testosterone, certain lifestyle changes may improve testosterone levels and related symptoms. For example, minor weight loss has been shown to greatly improve PCOS symptoms. [5] Speak with your provider about your current lifestyle habits and what changes you can make to improve your overall health. A few options may include increasing physical activity, eating a more balanced diet, drinking more water, etc. 

Supplements

In some cases, dietary supplements may be useful for promoting hormone balance, endocrine function, ovarian health, and more. You should speak with a healthcare provider if you are considering taking any supplements, especially if you’re pregnant, breastfeeding, or hoping to conceive soon. Research shows that some nutrients, like Inositol, may be useful for promoting ovulation in those with PCOS as well as reducing levels of total testosterone. [6] Similar effects have been reported from CoQ10 and vitamin E supplementation, decreasing testosterone levels and improving insulin resistance. [7] While more research is needed, there is also some data that suggests Vitamin D levels are associated with sex hormones, including testosterone levels.  [8] Omega-3 fatty acids are also thought to play an important role in menstrual cycle regulation and reducing serum testosterone in those with PCOS. [9] Lastly, some research suggests that zinc supplementation has positive effects on endometriosis symptoms, menstruation pain, PCOS symptoms, and more. Data shows that zinc helps to maintain normal levels of important sex hormones, including testosterone. [10] Find vitamins and supplements here. 

Treating Symptoms

In addition to promoting healthy hormone levels, there are ways to manage the symptoms of high testosterone. If someone is experiencing excess hair growth, they may opt for waxing, shaving, or using certain medications that can slow the growth of body hair. Various creams and medications may also be helpful for reducing acne and oily skin. Those who are not trying to conceive may benefit from taking hormonal birth control to better manage symptoms. Lastly, fertility treatments and supplements may be useful for those having difficulty conceiving. Learn about different fertility treatment options, including ovulation induction, IUI, IVF, and others. 

Support Hormone Levels and Fertility with Natalist

Hormone levels can be difficult to understand and manage. Our hormones play important roles in most of our body processes, including digestion, pregnancy, breastfeeding, sleep, and more. Whether you’re concerned about your hormone health in regards to fertility, or you’re just wanting to better understand your body, Natalist has many resources and products that may help. Test your hormones with the Fertility Test Bundle, read up more on conception, or browse supplements to support hormone health and fertility. 

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University.  She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women. 

References:

1. Davis SR, Wahlin-Jacobsen S. Testosterone in women--the clinical significance. Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi:10.1016/S2213-8587(15)00284-3
2. Androgens. Cleveland Clinic. October 2021. https://my.clevelandclinic.org/health/articles/22002-androgens
3. Hyperandrogenism. Cleveland Clinic. January 2023. https://my.clevelandclinic.org/health/diseases/24639-hyperandrogenism
4. Polycystic Ovary Syndrome (PCOS). Cleveland Clinic. February 2023. https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos
5. Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019;3(3):CD007506. Published 2019 Mar 28. doi:10.1002/14651858.CD007506.pub4
6. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009;13(2):105-110.
7. Izadi A, Ebrahimi S, Shirazi S, et al. Hormonal and Metabolic Effects of Coenzyme Q10 and/or Vitamin E in Patients With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2019;104(2):319-327. doi:10.1210/jc.2018-01221
8. Kuhr DL, Sjaarda LA, Alkhalaf Z, et al. Vitamin D is associated with bioavailability of androgens in eumenorrheic women with prior pregnancy loss. Am J Obstet Gynecol. 2018;218(6):608.e1-608.e6. doi:10.1016/j.ajog.2018.03.012
9. Nadjarzadeh A, Dehghani Firouzabadi R, Vaziri N, Daneshbodi H, Lotfi MH, Mozaffari-Khosravi H. The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iran J Reprod Med. 2013;11(8):665-672.
10. Nasiadek M, Stragierowicz J, Klimczak M, Kilanowicz A. The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients. 2020;12(8):2464. Published 2020 Aug 16. doi:10.3390/nu12082464