What causes high testosterone in women?

Many people consider testosterone a “male” sex hormone, but females produce small amounts in the ovaries and adrenal glands. Higher testosterone levels can increase the risk of acne, body hair, and other features. They may indicate an underlying health condition.
Together with the female sex hormone estrogen, testosterone plays a role in the growth and maintenance of female reproductive tissue and bone mass. These hormones also influence behavior.
estrogen
testosterone
In this article, learn about conditions that cause high testosterone in females and about symptoms and treatment.
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
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Typical testosterone levels
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According to the American Urology Association, typical blood levels of testosterone in males are at least 300 nanograms per deciliter (ng/dL).
at least 300 nanograms per deciliter (ng/dL)
Females secrete much lower levels — about one-tenth of those in males.
one-tenth
The level of hormones the body produces varies daily and throughout the day. However, testosterone levels are generally highest in the morning.
are generally highest
Symptoms of high testosterone in females
Testosterone imbalances in females can affect their physical appearance and overall health.
Symptoms of high testosterone in females include:
include
acne
acne
deep voice
excess hair on the face and body
excess hair on the face and body
irregular periods
irregular periods
larger than average clitoris
reduction in breast size
thinning hair
thinning hair
deep voice
increased muscle mass
Severely high levels of testosterone in females can cause infertility.
infertility
Causes of high testosterone in females
High testosterone in females is usually due to an underlying medical condition, such as:
CAH is the term that refers to a group of inherited disorders that affect the adrenal glands. These glands secrete the hormones cortisol and aldosterone, which play a role in managing metabolism and blood pressure.
CAH
adrenal glands
secrete
blood pressure
The adrenal glands also produce the male sex hormones dehydroepiandrosterone and testosterone.
dehydroepiandrosterone
People with CAH lack one of the enzymes necessary to regulate the production of these hormones, so they secrete too little cortisol and too much testosterone.
CAH may be mild, which is nonclassic CAH, or severe, which is classic CAH.
Symptoms in females include:
include
deep voice
early appearance of pubic hair
enlarged clitoris
excess body hair
facial hair
irregular or absent menstrual periods
absent menstrual periods
severe acne
shorter height as an adult after rapid childhood growth
While there is no cure for CAH, most people with the condition can receive treatment that will reduce symptoms and improve their quality of life.
Hirsutism involves unwanted hair growth in females. It is a hormonal condition that healthcare professionals believe has links to genetics.
Hirsutism
Symptoms include male-pattern hair growth that is dark and coarse. It typically affects the:
typically affects
lower back
chest
face
In cases of excessively high testosterone, other symptoms will also be present, including:
including
acne
balding
deepening voice
enlarged clitoris
increased muscle mass
reduced breast size
Home remedies and medical treatments help many people control the symptoms of hirsutism.
PCOS is a common hormonal disorder that affects females of reproductive age. Health experts estimate that PCOS affects 6–12% of United States females.
PCOS
6–12%
People do not usually receive a diagnosis until they are in their 20s and 30s. However, the condition can affect children as young as 11 years old.
Symptoms of PCOS include:
include
weight gain
difficulty getting pregnant
acne or oily skin
PCOS may lead to several health complications, including:
may lead
depression
depression
heart disease
heart disease
infertility
infertility
miscarriage
miscarriage
obesity
obesity
sleep apnea
sleep apnea
type 2 diabetes
type 2 diabetes
Doctors do not know what causes PCOS, although excess insulin and genetics may play a role.
insulin
may play
Diagnosis of high testosterone in females
A doctor can diagnose high testosterone in females according to the following.
During a physical examination, the doctor will look for symptoms such as:
physical examination
acne
acne
excess body hair
excess body hair
facial hair growth
They will also inquire about menstrual cycle abnormalities and attempts at pregnancy.
menstrual cycle abnormalities
If doctors suspect PCOS, they may visually and manually examine the pelvic region to look for abnormalities.
they may
If symptoms suggest high testosterone levels, the doctor will take a blood sample and test hormone levels. They may also check glucose and cholesterol levels.
blood sample
glucose
cholesterol
Usually, a healthcare professional will take a person’s blood sample in the morning when testosterone levels are highest.
are highest
To check for PCOS, the doctor may perform an ultrasound of the ovaries and uterus.
may perform
ultrasound
Treatment of high testosterone in females
The recommended treatment for high testosterone will depend on its underlying cause.
Typically, a doctor will recommend both lifestyle changes and medication. Doctors may also use some treatments to control unwanted hair.
High testosterone and associated conditions are treatable with the following medications:
Eflornithine: This is a cream that a person applies directly to the skin that slows the growth of new facial hair.
slows
Glucocorticosteroids: This is a type of steroid hormone that doctors recommend if there is evidence of inadequate steroid production by the adrenal glands. It regulates metabolism and immune response.
regulates
Metformin: This is a treatment for type 2 diabetes, which doctors sometimes use to decrease insulin resistance and address metabolic abnormalities in people with PCOS.
doctors sometimes use
Progestin: This is a hormone that may regulate periods and improve fertility.
may regulate
improve fertility
Spironolactone: This is a diuretic that helps balance water and salt levels and reduces excessive female hair growth.
helps balance
Doctors may also prescribe oral contraceptives, as this treatment helps block excess testosterone.
According to a 2019 review, pairing oral contraceptives that contain estrogen and progestin with antiandrogens and metformin may be most effective for the treatment of hirsutism.
2019 review
However, oral contraceptives may be unsuitable for people trying to get pregnant. They can also cause adverse side effects.
Both electrolysis and laser therapy may help control unwanted hair. However, these treatments will not resolve an underlying hormonal imbalance.
may help
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 necessary.
Laser therapy: During this treatment, a healthcare professional applies a laser to the hair follicles to damage them. Multiple treatments may be necessary.
These hair removal treatments can cause adverse reactions and may have other associated risks.
Anyone with a hormonal imbalance needs to speak with a doctor before trying medical treatments for excess hair growth.
Some lifestyle changes can reduce high testosterone in females, while others simply manage symptoms.
Here are a few lifestyle changes that may be beneficial:
Reach and maintain a moderate weight: Some research shows that losing even 5–10% of body weight can improve fertility, help balance menstrual cycles, and reduce symptoms in people with PCOS.
5–10%
Follow a balanced diet: A person can improve symptoms of PCOS by following a nutritious, well-rounded diet and limiting their intake of foods high in sugar, refined carbs, saturated fat, and trans fat.
can improve
well-rounded diet
Manage unwanted hair growth: A person can 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.
Frequently asked questions
Below are answers to common questions about high testosterone in females.
Some symptoms of high testosterone in females include:
include
acne
acne
deep voice
excess hair on the face and body
excess hair on the face and body
increased muscle mass
irregular periods
irregular periods
a larger than average clitoris
A woman’s testosterone levels may be high due to congenital adrenal hyperplasia (CAH) or polycystic ovary syndrome (PCOS).
Summary
High testosterone in females can cause a range of symptoms, from excess facial hair to infertility. It is usually due to an underlying medical condition.
infertility
Treating the underlying disorder will often reduce symptoms and improve a person’s quality of life.
People who are or think they may be experiencing high testosterone symptoms should consult a doctor to determine the cause and determine the best course of treatment.