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What Causes High Testosterone in Women?
Updated on January 31, 2024
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What Causes High Testosterone in Women?
Updated on January 31, 2024
7 min read

What Causes High Testosterone in Women?

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Key Takeaways

While testosterone is often associated with men, women also produce the hormone testosterone but in very low amounts compared to men. High testosterone levels in women are not typical and signify a hormonal imbalance. It may cause excess hair growth or hair loss, mood changes, and other undesirable symptoms.

It can be caused by many things that either directly cause a hormonal imbalance or contribute to abnormal hormone levels.

“These conditions may be present at birth or may slowly progress over time. If this was present upon birth, the most common symptom is ambiguous genitalia,” says our in-house medical expert, Dr. Rizza Mira.

This symptom isn’t always present, however, and may vary.

The Most Common Causes of High Testosterone in Women

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (or Polycystic Ovarian Disease) is linked to excess testosterone or hormonal imbalance in general.1

PCOS specifically causes an overproduction of male sex hormones in the ovaries. This causes several health-related concerns, such as irregular menstrual periods, possible infertility, and cysts forming in the ovaries.2

“PCOS is diagnosed by health professionals by a combination of hormonal tests, ultrasound, and metabolic function tests,” says Dr. Mira.

PCOS has many other high testosterone symptoms, such as body hair growth, male pattern baldness, acne, and weight gain. As many as 6% to 12% of women are affected with PCOS with a varying range of severity.3

Congenital Adrenal Hyperplasia (CAH)

Congenital Adrenal Hyperplasia is a genetic disease of the adrenal glands, which are hormone-producing glands found near the kidneys.

The adrenal gland produces cortisol, aldosterone, and the primary sex hormone estrogen, as well as androgens. Androgens is the collective term for each male sex hormone, including testosterone.

CAH causes your adrenal gland to produce less cortisol (or aldosterone) and more testosterone simultaneously. Classic or severe CAH affects 1 in every 10,000 people.4 Congenital Adrenal Hyperplasia is typically diagnosed in infancy as part of normal newborn screening.

Insulin Resistance and Blood Sugar Imbalances

High insulin levels may cause the ovaries to produce testosterone beyond the norm for women.1 

High insulin levels can be caused by insulin resistance, where insulin is not as effective as it should be in transferring sugar from the bloodstream to cells and organs. As a result, the body produces higher amounts of insulin.

This insulin resistance can be a sign of type 2 diabetes, but a high-sugar diet can also cause high levels of insulin. PCOS can also cause a higher resistance to insulin, which may lead to type 2 diabetes.1

Consequently, insulin resistance is linked with lower testosterone in men in some studies.5 

Other Potential Causes

High testosterone levels may also be the result of masculinization hormone therapy rather than an underlying medical condition. Testosterone therapy may also be considered as a treatment to address low sexual desire in postmenopausal women.

What Is the Normal Testosterone Level for a Woman?

The normal range of testosterone levels for average adult women is within 15 to 70 nanograms per deciliter of blood.

Men have twenty times as much testosterone at 300 to 1000 nanograms per deciliter of blood.6

Understanding Testosterone Ranges

Testosterone levels are measured by detecting the amount of sex hormone-binding globulin (SHBG) in the blood.

Testosterone levels can vary within a range from person to person. It is possible to be on the low or high end of the normal range. This means that there is no hormone imbalance yet, though being at the extremes of the range may still produce mild symptoms.

“Age also plays a factor in fluctuating levels of testosterone. Infants have higher testosterone levels, and this slowly decreases over time,” adds Dr. Mira.

Factors Affecting Testosterone Levels in Women

Aside from the aforementioned causes of high testosterone in women, other lifestyle factors can affect testosterone levels.

Steroid usage for muscle training can increase testosterone levels beyond normal levels. 

Steroids used in weight training are usually anabolic steroids or synthetic steroid hormones that imitate testosterone. Their use is typically intended for increased muscle mass. Even this form of testosterone can produce unwanted symptoms of high testosterone in women.

On the other hand, low testosterone can result from taking birth control pills. Regular oral contraceptives inhibit the production of all sex hormones by decreasing ovarian activity.

When to Test for Testosterone Levels

“The ‘right time’ to test your hormone levels will depend on one’s symptoms. We also take note of age, medication use, and other medical conditions,” answers Dr. Mira.

Testosterone testing is recommended for women who suffer from high or low testosterone symptoms. High testosterone in women includes excessive facial hair or excessive female hair growth, irregular menstruation, and other symptoms.

You should take the blood test from 7 AM to 10 AM when testosterone levels are highest throughout the day. Some doctors may recommend fasting, while others may not.

What Are the Signs of High Testosterone in Females?

Since women are meant to have low normal testosterone levels, high testosterone levels can create a lot of unwanted changes in the body.

Hirsutism and Hair Growth Patterns

As a male sex hormone, testosterone plays a part in the body hair patterns of men. When women have high testosterone levels, it can result in excess facial hair growth and unwanted hair in other parts of the body, such as the chest, back, and armpits.

This male pattern of coarse dark hair in women is called hirsutism and is an effect of high testosterone.

High testosterone levels can also cause male pattern baldness in both men and women. This is because of a version of testosterone called dihydrotestosterone (DHT) that can shrink hair follicles, causing hair loss.7

Acne and Skin Changes

Androgens like testosterone and DHT, in particular, have an effect on the sebaceous glands in your skin. Increased testosterone concentrations in the blood can cause these glands to produce more oils and sebum, resulting in acne.8,9

Voice Deepening and Other Masculine Features

Testosterone and DHT are heavily involved in the development of masculine features in men. When these are high in women, this can cause similar effects as when boys go through puberty.

Apart from the aforementioned effects on body hair and acne, women experiencing high testosterone symptoms may see other effects. 

Increased muscle mass and voice deepening are possible symptoms. A larger-than-average clitoris mirrors the penile growth in men undergoing puberty. Some women also experience a reduced breast size.

“Doctors may also conduct an ultrasound to see if all body organs traditionally in a female are present in the patient and normal,” says Dr. Mira.

Irregular Periods and Menstrual Cycle Changes

Testosterone imbalance can have an effect on the menstrual cycle. High levels of testosterone are linked with irregular periods, longer cycles, and even missed periods.10

These are also common symptoms of PCOS and CAH.

How Does High Testosterone Affect Women?

Impact on Fertility and Reproductive Health

Any form of abnormal hormone levels for sex hormones such as estrogen and androgens can have an effect on reproductive health.

Polycystic ovary syndrome’s effects on the menstrual cycle are just one of many ways high testosterone can inhibit female fertility.

Weight Gain and Metabolic Changes

Just like how high insulin can cause higher testosterone in women, the reverse is also true. As testosterone levels rise, so may insulin resistance which can cause a sharp increase in body weight.11

This can result in obesity which further leads to other health complications, such as diabetes and high cholesterol.

Emotional and Mental Health Effects

Abnormal testosterone levels have also been linked to depression. In addition to this, other symptoms of testosterone imbalance may contribute to self-esteem and body image issues in women.

How to Treat High Testosterone in Women

There are various ways to address abnormal testosterone levels in women, here are a few:

  • Diabetes medications that help to control insulin or blood sugar levels may have an effect (note: remember to consult with your healthcare provider first to check if it’s conclusively an insulin problem and can be addressed by medication)
  • Some oral contraceptives inhibit the production of testosterone
  • Reducing alcohol intake decreases testosterone in women12
  • Exercise may not produce long-term effects on testosterone production, but it can contribute to addressing related health concerns such as maintaining a healthy weight, improvement of mood, and managing blood sugar levels

Please remember to always check with your doctor or healthcare provider first before taking any kind of medication or making major lifestyle changes.

When to Seek Professional Help

Many women may have testosterone levels on the high end of the normal range. Other women may have symptoms of high testosterone that are still within manageable levels.

Consult your doctor if the effects listed in this article begin to severely impact your lifestyle or mental health. Because of the prevalence of PCOS, taking a test when possible is also recommended. Early detection of PCOS or abnormal testosterone levels may help in preventing diabetes and other complications.

Updated on January 31, 2024
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12 sources cited
Updated on January 31, 2024
  1. Polycystic ovary syndrome” United Kingdom National Health Service
  2. Polycystic Ovary Syndrome (PCOS)” JOhn Hopkins Medicine
  3. PCOS (Polycystic Ovary Syndrome) and Diabetes” Centers for Disease Control and Prevention
  4. Congenital Adrenal Hyperplasia” Cleveland Clinic
  5. The association between serum testosterone and insulin resistance: a longitudinal study” National Library of Medicine
  6. Testosterone” Mount Sinai Hospital
  7. DHT (Dihydrotestosterone)” Cleveland Clinic
  8. Serum levels of androgens in acne & their role in acne severity” National Library of Medicine
  9. Sex hormones and acne” National Library of Medicine
  10. Menstrual Cycle Irregularities Are Associated With Testosterone Levels in Healthy Premenopausal Women” American Journal of Human Biology
  11. Hyperandrogenemia is Common in Asymptomatic Women and is Associated with Increased Metabolic Risk” National Library of Medicine
  12. A Review on the Sex Differences in Organ and System Pathology with Alcohol Drinking” National Library of Medicine
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