Causes of High Testosterone in Women and How to Recognize the Symptoms

The nature and effects of a hormonal imbalance is something women are perhaps much more familiar with than men. But as a woman, when you are contemplating hormonal fluctuation, it is usually in the context of estrogen and progesterone. Nothing wrong with that since these are the primary female sex hormones. Yet, you could have a testosterone imbalance too. Shocked? Don’t be. I will tell you why and how women could have high testosterone.

Quick facts overview

Do women have testosterone?

Before you throw your basic knowledge of biology out the window, let’s get one fact out of the way – testosterone is the primary male sex hormone. That notwithstanding, women do have testosterone too – just not in the same quantity as men (15-70 nanograms per deciliter compared to 270-1,070 ng/dL). By the way, men have estrogen but that’s a different conversation. While testosterone in men is made in the testes, the production occurs in the ovaries and adrenal glands in women.

Since testosterone is naturally present in women, there is a range within which it is deemed normal. Women with testosterone that significantly exceeds this band are deemed as having high testosterone. Aside from undergoing a blood test, high testosterone in females does lead to some physiological changes that should serve as symptoms.

What are the symptoms of high testosterone in females?

In mild to moderate instances of high testosterone, you could see the following.

In severe instances, expect the following.

Common causes of high testosterone in women

High testosterone could be caused by dozens of factors. Most times though, either one (or a combination) of the following is the culprit.

Diabetes

Type 3 diabetes means having high blood sugar levels. This can stimulate testosterone production in the ovaries especially among women that have PCOS.

Hirsutism

A condition affecting nearly 8 percent of women, Hirsutism is a condition that leads to the growth of excess hair on the face, chest and back. How much growth you experience is partly dependent on genetic predisposition. Most times though, hirsutism is the result of androgen hormone imbalance.

Insulin resistance

Insulin resistance is a condition where the body does not recognize the hormone insulin. This results in an increase in blood sugar. As the insulin remaining in the bloodstream is unutilized, it stimulates increased production of testosterone by the ovaries.

Polycystic ovary syndrome (PCOS)

PCOS is a hormonal disorder affecting 6-12 percent of women of reproductive age. It is caused by a surge in androgen hormones. Telltale signs of PCOS include prolonged or irregular periods, excess body hair and enlarged ovaries. In severe instances, it may lead to miscarriage, infertility, obesity, diabetes, heart disease, endometrial cancer and depression.

Congenital Adrenal Hyperplasia (CAH)

CAH is a hormonal genetic disorder affecting the production of hormones by the adrenal glands. Most times, CAH causes an overproduction of androgen hormones like testosterone. Symptoms of this condition include severe acne, early onset of pubic hair, masculine features and infertility.

Thyroid issues

The thyroid gland regulates numerous body functions including hormone production, concentration and metabolism. Studies have shown a link between an underactive thyroid and free testosterone. Hypothyroidism may curtail the production of sex hormone binding globulin (SHBG) thereby increasing the amount of free testosterone.

Gigantism and dwarfism

Gigantism and dwarfism are caused by too much or too little production of the growth hormone. Both gigantism and dwarfism are associated with causing an imbalance of other hormones including testosterone.

When should you see a doctor?

High testosterone may have a substantial impact on your health, self-confidence and overall quality of life. So if you suspect you have it, the best time to set an appointment with your doctor is now. Treatment options will vary depending on their gauge of the severity and their determination of the root cause. The doctor will assess your physical symptoms, run a blood test or, in the case of PCOS, perform an ultrasound of your uterus.

Oral contraceptives have proven effective in blocking testosterone but will probably not be the best path to take if you are planning to get pregnant soon. If you have to use birth control, low doses should do. Either way, treatment is by prescription only. You could aid the process by making lifestyle changes including switching to a healthier diet and scheduling regular exercise.

Conclusion

High testosterone in women is not the most pleasant experience. The unwanted masculine features that can make for an uncomfortable everyday life. Yet, aside from this blow to your self-confidence, high testosterone poses grave, life-altering health risks if left untreated. We are talking about infertility, cancer, cardiovascular illness and more. Don’t take chances. The faster you address it, the better the treatment outcomes.

Endocrine Abstracts

A surprising diagnosis in a man with high testosterone levels

L. Srbova

The Institute of Endocrinology, Prague, Czech Republic.

Introduction: Marked elevation of testosterone levels can be caused by tumors with hormonal hypersecretion. However, we should be aware of the relationship between thyroid and sexual hormones, including changes of SHBG.

Case report: A 48-year-old man was recommended by an urologist to endocrinological examination due to high levels of total testosterone.

CT scan of abdomen, pelvis and the pituitary did not show any abnormalities.

The patient did not complain of any problems, but after inquiry he admitted a weight loss of 15 kg during last year which he related to his effort of eating less because of obesity. Apart of that we did not find any deviations from physical normal status including thyroid palpation, skin temperature and heart rate. Laboratory tests revealed the following results: fT₄ 48 pmol/l, fT₃ 16 pmol/l, TSH 0.005 mIU/l, total testosterone 59 nmol/l and SHBG 190 nmol/l (34–66). Free androgen index was still within the normal range 31 (30–152).

Within four months of therapy by antithyroid drugs, both the levels of thyroid hormones and total testosterone returned to norm.

Conclusions: Hyperthyroidism may lead to an elevation of total testosterone in males due to an increase of hepatic synthesis of SHBG. The metabolic clearance of testosterone is also decreased and the peripheral conversion of androstendion to testosterone is increased. Despite this, the levels of free testosterone are usually normal.

The restoration of all these parameters is in most cases achieved after euthyroidism is established.

This report shows the need of judging the levels of sexual hormones in connection with the levels of thyroid hormones (and SHBG) with respect to the fact that thyroid disorders may be clinically silent.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

What causes high testosterone in women?

Although testosterone is often thought of as a male-specific hormone, testing testosterone levels is in fact an important part of assessing fertility in both men and women. High testosterone levels in women (15 – 70 ng/dL) not only affect a woman’s appearance, but also pose a potential risk to her reproductive function as well as her general health. Conversely, there are cases of low testosterone levels in women as well, but this usually happens after they have gone through menopause and is not a major obstacle for those who are planning a pregnancy.
Manifestations of abnormally high testosterone levels in women include:
Irregular menstrual cycles Menstrual periods but no ovulation (non-ovulatory cycles) Acne breakouts Hirsutism or mustache Hair thin, sparse or bald voice Deep voice Strong muscle growth Mood swings, low sex drive Sex organs (clitoris) are large but breasts are small High testosterone levels also make women more susceptible obesity and risk of infertility.

2. Causes of abnormally high testosterone levels in women

2.1. Polycystic ovary syndrome (PCOS) This is a common hormonal disorder affecting 8-20% of women of reproductive age worldwide. Polycystic ovary syndrome is also a leading cause of infertility in women, as well as being linked to obesity and insulin resistance (type 2 diabetes). The disease is usually detected in women between the ages of 20 and 30 through blood tests and an ultrasound of the ovaries, despite the fact that girls as young as 11 years old can already have PCOS. Currently, experts still do not know the cause of polycystic ovary syndrome, but genetic factors and insulin levels in a woman’s body are thought to play a role in this disease.

2.2. Congenital adrenal hyperplasia (CAH) The adrenal glands are responsible for the production of the hormones cortisol and aldosterone, which are necessary for metabolism and blood pressure regulation. The genetic disorder CAH causes this gland to become weak and can lead to infertility in both men and women. Congenital adrenal hyperplasia can be diagnosed at any age. For girls with this disease, the usual sign is early growth and superior height growth in childhood, but stops in adulthood and is shorter than girls of the same age. Until now, there is no cure for CAH syndrome, the therapies are applied only to relieve symptoms and improve the patient’s quality of life.
2.3. Other reasons Adrenal or ovarian cancer: Doctors have found extremely high testosterone levels, specifically greater than 200 ng/dL, in women with two types of cancer. above. Anabolic Steroid Use: Anabolic steroids are man-made hormones used by athletes to improve performance. If women abuse anabolic steroids, it will cause abnormally high testosterone levels in the body. Hirsutism: This is an overproduction of male hormones (androgens) that is genetically linked. Women’s hair will grow unusually thick, black, and stiff when hirsutism is present.

3. Treatment of high testosterone levels in women

3.1. For women who do not want to become pregnant When treating high testosterone levels, the doctor will consider the symptoms as well as the wishes of the woman. For women who are trying to get pregnant, the treatment method will be different from the rest of the group.
In those who do not want to have children, the treatment that can be applied is the use of oral contraceptives containing the female sex hormones estrogen and progesterone – two active ingredients that can regulate menstruation and enhance femininity. . In addition, the androgenic diuretic spironolactone (trade name Aldactone) is also an option to help regulate water and salt levels, also reducing excessive hair growth in women. It should be noted that the spironolactone contained in this medicine is not safe for pregnant women.
3.2. For women who are hoping to give birth

Other measures that women who are planning a pregnancy can choose from include:
Exercise and weight loss: Regular exercise and significant weight loss can help lower testosterone levels, especially in women with polycystic ovary syndrome. This method even works to regulate the ovulation cycle. Metformin: The treatment of insulin resistance with the drug metformin for diabetics is seen as an aid in weight loss and is as effective as attempted exercise. Ovulation-stimulating drugs: In addition to lifestyle changes, women who want to have a baby need to take fertility drugs to increase their chances of conceiving. Clomid and letrozole are the first two fertility treatments for women with PCOS. Cosmetic interventions: Cosmetic treatments such as waxing or plucking are both possible solutions to unwanted hair growth and safe for women trying to conceive. High levels of testosterone in women can cause a range of symptoms that affect their appearance and fertility and are a potential risk factor for certain health problems. If you think you have high testosterone levels, consult your doctor to determine the cause and access appropriate treatments to relieve symptoms and improve quality. life.

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Treating low testosterone levels

Testosterone is a hormone that plays a role in puberty, fertility, and libido. Low levels may cause physical symptoms or mood changes. Treatment options, such as increased exercise or medication, could help boost your levels.

Language matters

In this article, we use “assigned male at birth” and “assigned female at birth” to refer to someone’s sex as determined by their chromosomes, and “men” and “women” when referring to their gender (unless quoting from sources using nonspecific language).

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

In people assigned male at birth, most testosterone is made in the testes. In people assigned female at birth, most testosterone is made in the ovaries.

People assigned male at birth have higher levels of testosterone than people assigned female at birth. Testosterone influences the development of many physical characteristics. It helps increase muscle bulk, bone mass, physical strength, and body hair.

The levels of testosterone in your body are constantly changing in response to your body’s needs. However, the overall level of testosterone in your body changes throughout your lifetime as well.

Typically, testosterone decreases as you age — particularly in people assigned male at birth. For some people, these levels can become too low and cause unwanted effects that have them looking for ways to increase their testosterone levels.

In order to know whether testosterone levels are too low, a normal level has to be established. This has been a challenge for clinicians. However, according to a press release from the Endocrine Society in January 2017, results from a recent study have helped to define the normal ranges for testosterone levels in those assigned male at birth: 264–916 nanograms per deciliter (ng/dL). This range is for those assigned male at birth between the ages of 19 and 39 years who don’t have obesity.

A testosterone test measures the amount of testosterone in your blood. If a doctor wants to test the hormone levels in your blood, they’ll most likely specify a time of day for your test. Hormone levels are highest in the morning, so this test is often performed in the morning between 7:00 a.m. and 10:00 a.m. Your doctor may have your levels tested more than once.

Your doctor may ask you to stop taking certain drugs before your test, as they could affect your testosterone levels. It’s important to tell your doctor about all medications you’re taking. Include both over-the-counter and prescription drugs.

Testosterone home-testing kits are also available from companies such as LetsGetChecked. They use your saliva to test your hormone levels. After taking the test, you’ll send your sample to a lab for testing.

There may be certain lifestyle changes to help increase testosterone levels, such as adding resistance exercise and losing weight.

Research indicates that resistance exercise, such as lifting weights, is related to temporary increases in testosterone levels.

An older 1999 study suggests that testosterone increases after heavy resistance training are typically much higher in younger than older people assigned male at birth — and overall don’t appear to greatly increase your overall testosterone levels.

Exercise, especially cardiovascular exercise, can contribute to weight loss, which can help to increase levels of testosterone.

In addition to lifestyle changes and increased exercise, there are a few other options available to you that can help boost the amount of testosterone in your body. A few of these options have been proven in clinical trials. Others may claim to increase testosterone level but don’t always provide substantial evidence to back up their claims.

Of course, if you’re concerned about you testosterone levels, it’s a good idea to share your concerns with a doctor. They’ll be able to verify your T levels and help build a treatment plan. Here are just a few of the most common ways to treat low testosterone levels.

Some types of herbal supplements claim to be “testosterone boosters.” The makers of these products claim that the ingredients help to increase levels of testosterone.

However, there isn’t enough research to support their effectiveness, and these products may not actually have ingredients that support their claims.

In fact, a 2020 study tested 50 supplements advertised as “testosterone boosting” and “libido improving.” The researchers found that less than 25 percent of them had data to support their claims, based on their ingredients. Moreover, 10 percent of the supplements tested contained ingredients that have a negative effect on testosterone, according to the study.

Additionally, these products aren’t closely regulated by the Food and Drug Administration (FDA). This means that they aren’t tested or evaluated for their effectiveness and could contain undisclosed ingredients or have unexpected side effects. Consider talking with a doctor before taking a “testosterone booster” and discuss with them alternative treatments that are FDA-approved and clinically proven to work.

You may find there are more natural steps that may help to boost your testosterone level.

Some foods may play a role in helping your body moderate your testosterone levels.

Making sure you get enough foods that are rich in zinc and vitamin D may help to keep your testosterone at a normal level.

Here are seven testosterone-boosting foods that could help you get the vitamins and minerals you need to keep your testosterone levels healthy.

A 2018 animal study suggests that zinc supplementation increases testosterone and fertility in those with marginal zinc deficiency.

Testosterone replacement therapy is used to help treat people with abnormally low levels of testosterone.

Abnormally low levels of testosterone can affect normal body functions. They may contribute to decreased muscle mass, a lowered sex drive, erectile dysfunction (ED), and mood changes such as irritability and depression.

Testosterone replacement therapy involves taking prescribed testosterone medication in the form of pills, patches, and gel that you apply to your skin. Testosterone therapy can also come in the form of injections.

Testosterone injections are one of the more common forms of testosterone replacement therapy. They’re typically given by a doctor. You need them less frequently than other forms.

Testosterone replacement therapy has many risks. If you have testosterone replacement therapy, you’ll need frequent blood tests to check your testosterone levels and to monitor potential side effects, including:

• fluid retainment
• acne
• prostate enlargement
• lowered fertility
• sleep apnea
• blood clots
• increased red blood cells

Side effects may vary based on the type of testosterone therapy you use.

Symptoms of abnormally low testosterone can be bothersome and may impact your quality of life. These symptoms can include:

If you’re experiencing one or more of these symptoms and don’t believe they’re caused by something else, talk with a doctor. If your doctor thinks your symptoms are related to abnormally low testosterone levels, they can test your levels.

Low testosterone causes in people assigned male at birth

Testosterone levels in people assigned male at birth remain fairly constant from the start of puberty — when levels spike — until a person’s 30s, when they slowly begin to decline.

For some people, testosterone levels may become abnormally low.

• aging
• delayed puberty
• testicular damage (caused by trauma, alcoholism, or mumps)
• hypothalamic disease
• pituitary disease
• noncancerous pituitary tumor
• chemotherapy

A number of genetic diseases can also affect testosterone levels, including:

Low testosterone in people assigned female at birth

Testosterone plays an important role in people assigned female at birth. However, testosterone levels are naturally lower in these individuals than in people assigned male at birth.

Usually, low levels of testosterone in people assigned female at birth aren’t problematic. However, levels that are too high may cause unwanted symptoms. These include:

High testosterone levels in people assigned female at birth may be caused by:

According to the American Urological Association, you should see a healthcare professional if you have any of the following symptoms of low testosterone, including:

• lowered sex drive
• lowered erectile function
• fatigue
• lowered lean muscle mass
• irritability
• symptoms of depression

It’s worth noting that ED can be a symptom of low T levels, but there isn’t a strong correlation showing that testosterone replacement can also treat ED. If you’re experiencing ED, it’s worth talking with a doctor. They can confirm if low T levels are the cause of your ED symptoms or help you explore other alternative treatments that might work better for you.

What happens if low testosterone goes untreated?

It’s common for people assigned male at birth to experience drops in their testosterone levels as they age. However, if these levels are significantly low, there can be a number of short-term and long-term symptoms that someone might experience.

Some of the most apparent symptoms of low testosterone could include ED, lowered sex drive, depression, difficulties focusing on tasks, and an increase in body weight. More long-term symptoms that might develop from untreated low testosterone levels could be a loss of muscle mass and a condition that weakens your bones known as osteoporosis.

What are the potential benefits of testosterone replacement therapy for people with low testosterone?

Potential benefits of testosterone therapy for people with low testosterone include:

• increased libido
• improved sexual function
• improved mood and well-being
• increased muscle mass
• increased bone density

Does testosterone replacement therapy work?

There’s conflicting evidence regarding the benefits of male testosterone therapy for age-related declines in testosterone, according to a 2017 clinical review.

Some studies show improvement in ED in older men, while others don’t. There’s no evidence that testosterone therapy improves ED in men with normal testosterone levels.

Testosterone therapy does appear to increase bone density in the lumbar spine in middle-aged men with testosterone deficiency.

It also consistently increases lean mass while decreasing fat mass, but the effect sizes are small.

Are there different adverse effects of testosterone replacement therapy for people assigned male at birth versus people assigned female at birth?

Side effects of testosterone therapy can vary for people based on their sex assigned at birth. Adverse effects of testosterone replacement therapy in people assigned male at birth may include:

• acne
• erythrocytosis (when you have more red blood cells than normal)
• lowered sperm production
• increased risk of subclinical prostate cancer

Adverse effects of testosterone therapy in people assigned female at birth may include:

In rare circumstances, adverse effects may include:

Are there cardiovascular risks to testosterone therapy?

In a 2015 advisory, the FDA warned that testosterone use is possibly associated with increased cardiovascular risk. However, other reviews of studies didn’t find an increased risk. For now, the effects of testosterone therapy on cardiovascular health remain unclear, but studies are ongoing.

Will I be able to fully replenish my testosterone?

Fully replenishing your testosterone level depends largely on what treatments you explore a your doctor. If you choose to go a more natural route with changes to your diet and exercise routine, you may see an increase in your T levels, but it’s highly unlikely that you’ll be able to get back to the levels you were at in your 20s with diet, exercise, and supplements alone.

Testosterone creams and injections can replace a significant amount of lost testosterone, but since each person reacts differently to these treatments, it’s possible that your T levels won’t be fully replenished.

More importantly, it’s worth discussing the side effects and results of overusing these replacement therapies. You should never increase your dose or the frequency of use without talking with a doctor first. Severe side effects from misusing these treatments can include stroke, heart attack, a higher risk of prostate cancer, liver conditions, and an enlarged prostate.

Testosterone levels in people assigned male at birth decrease a little naturally with age. However, in some people, these levels can be too low and cause unwanted symptoms. Treatment is available, but it’s important for your doctor to confirm your low testosterone levels with one or more blood tests. Your doctor may also do other tests to help determine what’s causing your low testosterone.

For people assigned female at birth, levels of testosterone that are too high, rather than too low, are more concerning. Symptoms of high testosterone may be an indication of an underlying condition that needs to be treated.

Last medically reviewed on July 8, 2022

Test ID: TTBS Testosterone, Total and Bioavailable, Serum

Recommended second-level test for suspected increases or decreases in physiologically active testosterone:

-Assessment of androgen status in cases with suspected or known sex hormone-binding globulin binding abnormalities

-Assessment of functional circulating testosterone in early pubertal boys and older men

-Assessment of functional circulating testosterone in women with symptoms or signs of hyperandrogenism but normal total testosterone levels

-Monitoring of testosterone therapy or antiandrogen therapy in older men and in females

Clinical Information

Testosterone is the major androgenic hormone. It is responsible for the development of the male external genitalia and secondary sexual characteristics. In female patients, its main role is as an estrogen precursor. In both sexes, it also exerts anabolic effects and influences behavior.

In men, testosterone is secreted by the testicular Leydig cells and, to a minor extent, by the adrenal cortex. In premenopausal women, the ovaries are the main source of testosterone, with minor contributions by the adrenals and peripheral tissues. After menopause, ovarian testosterone production is significantly diminished. Testosterone production in testes and ovaries is regulated via pituitary-gonadal feedback involving luteinizing hormone (LH) and, to a lesser degree, inhibins and activins.

Most circulating testosterone is bound to sex hormone-binding globulin (SHBG), which, in men, also is called testosterone-binding globulin. A lesser fraction is albumin bound and a small proportion exists as free hormone. Historically, only free testosterone was thought to be the biologically active component. However, testosterone is weakly bound to serum albumin and dissociates freely in the capillary bed, thereby becoming readily available for tissue uptake. All non-SHBG bound testosterone is therefore considered bioavailable.

During childhood, excessive production of testosterone induces premature puberty in boys and masculinization in girls. In women, excess testosterone production results in varying degrees of virilization, including hirsutism, acne, oligo-amenorrhea, or infertility. Mild-to-moderate testosterone elevations are usually asymptomatic in male individuals but can cause distressing symptoms in female patients. The exact causes for mild-to-moderate elevations in testosterone often remain obscure. Common causes of pronounced elevations of testosterone include genetic conditions (eg, congenital adrenal hyperplasia), adrenal, testicular, and ovarian tumors, and abuse of testosterone or gonadotrophins by athletes.

Decreased testosterone in female individuals causes subtle symptoms. These may include some decline in libido and nonspecific mood changes. In male patients, it results in partial or complete degrees of hypogonadism. This is characterized by changes in male secondary sexual characteristics and reproductive function. The cause is either primary or secondary/tertiary (pituitary/hypothalamic) testicular failure. In men, there also is a gradual, modest but progressive, decline in testosterone production starting between the 4th and 6th decade of life. Since this is associated with a simultaneous increase of SHBG levels, bioavailable testosterone may decline more significantly than apparent total testosterone, causing nonspecific symptoms similar to those observed in testosterone-deficient women. However, severe hypogonadism, consequent to aging, alone is rare.

Measurement of total testosterone (TTST / Testosterone, Total, Mass Spectrometry, Serum) is often sufficient for diagnosis, particularly if it is combined with measurements of LH (LH / Luteinizing Hormone [LH], Serum) and follicle stimulating hormone (FSH / Follicle-Stimulating Hormone [FSH], Serum). However, these tests may be insufficient for diagnosis of mild abnormalities of testosterone homeostasis, particular if abnormalities in SHBG (SHBG1 / Sex Hormone-Binding Globulin [SHBG], Serum) function or levels are present. Additional measurements of bioavailable (this test) or free testosterone (TGRP / Testosterone, Total and Free, Serum) are recommended in this situation. While both bioavailable and free testosterone can be used for the same indications, determination of bioavailable testosterone levels may be superior to free testosterone measurement in most situations.

Interpretation

Total testosterone and general interpretation of testosterone abnormalities:

Decreased testosterone levels indicate partial or complete hypogonadism. In hypogonadism, serum testosterone levels are usually below the reference range. The cause is either primary or secondary/tertiary (pituitary/hypothalamic) testicular failure.

Primary testicular failure is associated with increased luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and decreased total, bioavailable, and free testosterone levels. Causes include:

-Genetic causes (eg, Klinefelter syndrome, XXY males)

-Developmental causes (eg, testicular maldescent)

-Testicular trauma or ischemia (eg, testicular torsion, surgical mishap during hernia operations)

-Autoimmune diseases (eg, autoimmune polyglandular endocrine failure)

-Metabolic disorders (eg, hemochromatosis, liver failure)

Secondary/tertiary hypogonadism, also known as hypogonadotrophic hypogonadism, shows low testosterone and low, or inappropriately “normal,” LH/FSH levels. Causes include:

-Inherited or developmental disorders of hypothalamus and pituitary (eg, Kallmann syndrome, congenital hypopituitarism)

-Medical or recreational drugs (eg, estrogens, gonadotropin releasing hormone [GnRH] analogs, cannabis)

-In prepubertal boys, increased levels of testosterone are seen in precocious puberty. Further work-up is necessary to determine the cause of precocious puberty.

-In men, testicular or adrenal tumors or androgen abuse might be suspected if testosterone levels exceed the upper limit of the normal range by more than 50%.

Monitoring of testosterone replacement therapy:

Aim of treatment is normalization of serum testosterone and LH. During treatment with depot-testosterone preparations, trough levels of serum testosterone should still be within the normal range, while peak levels should not be significantly above the normal young adult range.

Aim is usually to suppress testosterone levels to castrate levels or below (no more than 25% of the lower reference range value).

Decreased testosterone levels may be observed in primary or secondary ovarian failure, analogous to the situation in men, alongside the more prominent changes in female hormone levels. Most women with oophorectomy have a significant decrease in testosterone levels.

Increased testosterone levels may be seen in:

-Congenital adrenal hyperplasia: Non-classical (mild) variants may not present in childhood but during or after puberty. In addition to testosterone, multiple other androgens or androgen precursors, such as 17 hydroxyprogesterone (OHPG / 17-Hydroxyprogesterone, Serum), are elevated, often to a greater degree than testosterone.

– Prepubertal girls: analogous to boys, but at lower levels, increased levels of testosterone are seen in precocious puberty.

-Ovarian or adrenal neoplasms: High estrogen values also may be observed and LH and FSH are low or “normal.” Testosterone-producing ovarian or adrenal neoplasms often produce total testosterone values above 200 ng/dL.

-Polycystic ovarian syndrome: Hirsutism, acne, menstrual disturbances, insulin resistance, and, frequently, obesity form part of this syndrome. Total testosterone levels may be normal or mildly elevated and uncommonly exceed 200 ng/dL.

Monitoring of testosterone replacement therapy:

The efficacy of testosterone replacement in females is under study. If it is used, then levels should always be kept within the normal female range. Bioavailable (this test) or free testosterone (TGRP / Testosterone, Total and Free, Serum) levels should also be monitored to avoid overtreatment.

Antiandrogen therapy is most frequently employed in the management of mild-to-moderate idiopathic female hyperandrogenism, as seen in polycystic ovarian syndrome. Total testosterone levels are a relatively crude guideline for therapy and can be misleading. Therefore, bioavailable (this test) or free testosterone (TGRP / Testosterone, Total and Free, Serum) also should be monitored to ensure treatment adequacy. However, there are no universally agreed biochemical end points and the primary treatment end point is the clinical response.

Usually, bioavailable (and free testosterone) levels parallel the total testosterone levels. However, a number of conditions and medications are known to increase or decrease the sex hormone-binding globulin (SHBG) concentration, which may cause total testosterone concentration to change without necessarily influencing the bioavailable or free testosterone concentration, or vice versa:

-Treatment with corticosteroids and sex steroids (particularly oral conjugated estrogen) can result in changes in SHBG levels and availability of sex-steroid binding sites on SHBG. This may make diagnosis of subtle testosterone abnormalities difficult.

-Inherited abnormalities in SHBG binding.

-Liver disease and severe systemic illness.

-In pubertal boys and adult men, mild decreases of total testosterone without LH abnormalities can be associated with delayed puberty or mild hypogonadism. In this case, either bioavailable or free testosterone measurements are better indicators of mild hypogonadism than determination of total testosterone levels.

-In polycystic ovarian syndrome and related conditions, there is often significant insulin resistance, which is associated with low SHBG levels. Consequently, bioavailable or free testosterone levels may be more significantly elevated.

Either bioavailable (this test) or free testosterone (TGRP / Testosterone, Total and Free, Serum) should be used as supplemental tests to total testosterone in the above situations. The correlation coefficient between bioavailable and free testosterone (by equilibrium dialysis) is 0.9606. However, bioavailable testosterone is usually the preferred test, as it more closely reflects total bioactive testosterone, particularly in older men. Men at this agehave elevated SHBG levels and may also have varying albumin levels due to coexisting illnesses.

Profile Information

In men, high testosterone can mean weakened immune response, study finds

Scientists at the Stanford University School of Medicine have linked high testosterone levels in men to a poor immune response to an influenza vaccine.

In a study published online Dec. 23 in the Proceedings of the National Academy of Sciences, the investigators show that men with relatively high amounts of circulating testosterone benefit less, as measured by a boost in protective antibodies after vaccination against influenza, than do men with lower testosterone levels and women.

In the study, women had a generally stronger antibody response to the vaccine than men. But the average response mounted by men with relatively low testosterone levels was more or less equivalent to that of women.

It has long been known that, for reasons that are not clear, men are more susceptible to bacterial, viral, fungal and parasitic infection than women are, and that men’s immune systems don’t respond as strongly as women’s to vaccinations against influenza, yellow fever, measles, hepatitis and many other diseases. The new study may explain why this is the case.

Women are known to have, on average, higher blood levels of signaling proteins that immune cells pass back and forth to jump-start inflammation, a key component of immune-system activation. Furthermore, previous research in animals and in cell-culture experiments has established that testosterone has anti-inflammatory properties, suggesting a possible interaction between the male sex hormone and immune response.

However, the new study found no connection between circulating levels of pro-inflammatory proteins and responsiveness to the flu vaccine. Nor does testosterone appear to directly chill immune response; rather, it seems to interact with a set of genes in a way that damps that response, said the study’s senior author, Mark Davis, PhD, professor of microbiology and immunology and director of Stanford’s Institute for Immunity, Transplantation and Infection

“This is the first study to show an explicit correlation between testosterone levels, gene expression and immune responsiveness in humans,” said Davis, who is also the Burt and Marion Avery Family Professor of Immunology and a Howard Hughes Medical Institute investigator. “It could be food for thought to all the testosterone-supplement takers out there.”

The scientists took advantage of ongoing longitudinal research at Stanford. Since 2008, the research participants, who span a broad range of ages, have been getting blood drawn before and after receiving annual influenza vaccines. Many have returned year after year for their annual flu shots and associated blood draws. The participants’ samples are analyzed at Stanford’s Human Immune Monitoring Core, a distributed center deploying state-of-the-art instrumentation and expertise, for tens of thousands of variables, including circulating levels of numerous immune-signaling proteins; counts of various blood-cell subtypes; and the degree to which each of the roughly 22,000 genes in a participant’s circulating immune cells is active or inactive.

Sex differences

“Most studies don’t report on sex differences, a major determinant of variation in immune response,” said the study’s lead author, David Furman, PhD, a research associate in Davis’ group. The Stanford team, in collaboration with researchers at the French governmental research organization INSERM, aimed at probing those differences.

Analysis of samples from 53 women and 34 men showed that, on average, women had significantly stronger antibody responses to the influenza vaccine, consistent with other studies. “This was not surprising,” Furman said. The women also showed higher average pre-vaccination blood levels of pro-inflammatory immune-signaling proteins, as earlier studies have found. But pre-vaccination levels of those proteins in a particular woman’s blood didn’t significantly predict the degree of her post-vaccination antibody response.

The analysis also showed that, in men, elevated activity of a particular set of genes that tend to turn on and off at the same time was associated with a weakened antibody response to the vaccine. The same gene cluster’s activity levels didn’t track closely with antibody response in women.

This piqued the interest of Furman. Previous studies have shown that some of the constituent genes of this multi-gene cluster (known as Module 52) are involved in immune regulation — and that activation of the module is somehow boosted by testosterone.

So he, Davis and their colleagues looked directly at testosterone levels in their male subjects. They separated the 34 men into two groups — those whose circulating levels of testosterone in its bioactive form were above the median level, and those with below-median levels of the hormone. They found that, in the high-testosterone men, high-activation levels of Module 52 genes correlated with reduced post-vaccination antibody levels. In the low-testosterone men — as in women — activation levels of Module 52 genes bore no significant relationship to the amount of antibodies produced as a result of the influenza vaccine.

Testosterone effects

Additional analyses showed that testosterone reduces levels of certain transcription factors (regulatory proteins) that ordinarily prevent Module 52 genes from “turning on.” In other words, higher testosterone levels result in more Module 52 expression. Several Module 52 genes have known immune-system connections; activation of one of these genes, for example, results in the accelerated differentiation of cells whose job it is to suppress, rather than foster, immune response. These connections make the interactions of the genes with testosterone an intriguing target of further exploration by immunologists, physiologists and drug researchers, Davis said.

But perhaps more intriguing, to many, is this: Why would evolution have designed a hormone that on the one hand enhances classic male secondary sexual characteristics, such as muscle strength, beard growth and risk-taking propensity, and on the other hand wussifies men’s immune systems?

The evolutionary selection pressure for male characteristics ranging from peacocks’ plumage to deer’s antlers to fighter pilots’ heroism is pretty obvious: Females, especially at mating-cycle peaks, prefer males with prodigious testosterone-driven traits.

Davis speculates that high testosterone may provide another, less obvious evolutionary advantage. “Ask yourself which sex is more likely to clash violently with, and do grievous bodily harm to, others of their own sex,” he said. Men are prone to suffer wounds from their competitive encounters, not to mention from their traditional roles in hunting, defending kin and hauling things around, increasing their infection risk.

While it’s good to have a decent immune response to pathogens, an overreaction to them — as occurs in highly virulent influenza strains, SARS, dengue and many other diseases — can be more damaging than the pathogen itself. Women, with their robust immune responses, are twice as susceptible as men to death from the systemic inflammatory overdrive called sepsis. So perhaps, Davis suggests, having a somewhat weakened (but not too weak) immune system can prove more lifesaving than life-threatening for a dominant male in the prime of life.

Other Stanford co-authors were Cornelia Dekker, MD, professor of pediatrics and medical director of the Stanford-LPCH Vaccine Program; Robert Tibshirani, PhD, professor of statistics and of health research and policy; and Noah Simon, PhD, a former postdoctoral scholar in Tibshirani’s group, now on the faculty of the University of Washington.

Why do Gen Z and millennial men have lower testosterone levels?

Odds are your grandad had higher testosterone levels than you — but why?

Author: Dr Joshua Smith – Research Scientist, MBBS, BMedSci, PGCertMedEd

Reviewed by: Dr Sam Rodgers – Chief Medical Officer, MBBS, MRCGP

For decades, testosterone levels have been declining. Your grandad may not have been quite as swift with Excel, but he probably one-upped you where T levels are concerned.

It’s normal for testosterone levels to decline as you get older, but for some reason, there’s been a population-level drop with each generation, at least since the 70s [1–4]. This means, on average, Gen Zers and millennials have significantly lower testosterone levels compared to their predecessors.

But what is it about younger generations that has caused this trend?

The generational decline in testosterone

The average testosterone level of a 60-year-old man in 1987 was around 17.5nmol/L, according to a 2007 study in Massachusetts [5]. Compare that to a 60-year-old man in 2002 — his testosterone level was closer to 15nmol/L.

Based on this, average testosterone levels in men are declining by 1% every year, give or take.

Research carried out on Finnish and Danish populations has shown the same trend [1,6]. And even more recently, a large-scale study of Israeli men has shown how average testosterone levels have dropped between 2006 and 2019 [7] — by over 10% across almost every age category.

Of course, we can’t know for certain that 60-year-old millennials and Gen Zers will have lower testosterone levels, at least not for a few decades, but it’s looking very likely.

What’s concerning is testosterone levels aren’t the only problem. Sperm counts are dropping significantly [8] and some reproductive disorders, like testicular cancer, are on the rise (9). Even men’s grip strength has declined [10]. So, what’s going on?

Why are testosterone levels falling?

This is a complicated question. The truth is, it’s not entirely clear, and it likely comes down to a combination of factors.

1. Obesity and sedentary lifestyles

Rising rates of obesity almost certainly play a role in declining testosterone levels. Being overweight can push the body’s hormone axis out of balance and affect how the body responds to insulin, both of which can lower testosterone levels [11]. One study found that an increase in BMI by four to five points was associated with a testosterone level of someone ten years older [2].

These days, most of us eat too much and don’t move enough. Much of this has been sparked by the digital revolution; ecommerce, tech, and entertainment industries have boomed, which makes it easy to prioritise convenience over health. You can now order a Big Mac from your phone to be delivered to your house while you finish binge-watching your favourite Netflix series. It’s something Baby Boomers wouldn’t have dreamed of and something Gen Zers can’t imagine a world without.

The digital age has transformed how we work too. We favour machinery and automation over manual labour, which likely explains the drop in men’s grip strength over time. Many jobs are now office-based and some of us don’t even need to leave the house to work. Modern-day careers tend to be much less active than our grandfathers’, and people who lead sedentary lifestyles tend to have lower testosterone [12].

But even after taking obesity into account, most studies still show a downward trend in testosterone, which means it can’t be the only culprit.

2. External toxins

The annual global production of plastics has grown from 50 million to 300 million tons since the 70s [13]. Science is now seeing the connection between this and changes to our hormone health.

Many plastics contain endocrine-disrupting chemicals (EDCs). EDCs, as their name suggests, are chemicals that interfere with the body’s hormones and may be natural or man-made. Some EDCs are slow to break down and accumulate which makes them potentially hazardous over time, even in low doses.

EDCs are found in everyday products, including:

Research has found links between EDC exposure and effects on attention (ADHD), immunity, metabolism, puberty, and reproduction [14]. Several EDCs have been associated with lower semen quality and testosterone levels [15], so there’s a possibility they may be partly to blame for this population-level decline.

3. Fewer smokers

This might surprise you, but some data shows that smoking marginally increases testosterone levels [16,17], though not all studies agree with this. Nicotine is metabolised by the body into cotinine; it’s possible this may prevent testosterone breakdown [17].

In the 70s, half of men smoked [18], but since then there’s been a significant decrease. Now in the UK, only around 15% of men smoke [18]. This may play a part in falling testosterone levels.

But that’s not a good reason to light up. Smoking is extremely harmful to many systems in the body and its dangers massively outweigh any potential effect it may have on testosterone. There are safe and natural ways to boost your testosterone — and smoking isn’t one of them.

4. Stress and mental health problems

Acute stress may cause testosterone levels to spike. But both physical and psychological long-term stress is likely to lead to reduced testosterone levels [19,20].

Some say that, as a society, we’re more stressed than ever before. This one is up for debate. After all, a lot of modern-day problems are nothing new: recessions, political upheavals, and the demands of work and family.

One big difference is that we’re now constantly plugged in. We have phones in our pockets that ping with newsflashes and notifications watches that buzz when a friend tries to make contact and headphones that silence the real world around us. Everything is immediate: we just need to press a button and we have access to any information we please. This constant stimulation can make it hard to switch off. And one of the biggest distractors is mobile phones.

Most children are phone owners by the age of seven, a report from Childwise showed [21], and it comes with implications.

Smartphone use has been linked to difficulties regulating emotions, impulsivity, addiction to social networking, shyness, low self-esteem, and FOMO (fear of missing out) [22]. From the physical aspect, it can also lead to sleep problems, reduced physical activity, and migraines [22]. Apps like TikTok and Instagram use algorithms to feed us content we like, which makes it even more difficult to separate ourselves.

There are, of course, upsides to smartphones and social media. Some argue that digital communication can improve friendships and connections [23], or that it may inspire, motivate, and give us new knowledge [24]. Might this just be a new normal that we’re adjusting to? Gen Zers could represent the start of a new wave of how we connect with one another. They’re the first generation to use smartphones, tablets, and social media from such a young age – and we’re still not entirely sure what the lifelong effects of this might be.

5. Other causes

Above are just a few reasons that might explain declining testosterone levels.

Other more off-the-wall theories have been put forward too, like tighter-fitting underwear and warmer temperatures in homes and offices [25]. (There’s a reason your crown jewels hang away from your body.)

Conditions like diabetes have also become much more common. People with diabetes tend to have lower testosterone, though it’s not entirely clear which causes which (26).

But one thing we can be sure of — there’s no single cause for these downward trends. It likely comes down to a combination of changes in our lifestyles, environment, and behaviours.

How important is testosterone for men?

Testosterone is a sex hormone produced mainly in the testes. It plays an essential role in developing and maintaining typical male characteristics, including:

A lack of testosterone can lead to a variety of symptoms from fatigue to reduced sex drive.

Should I be worried?

Are we heading towards an impending Spermageddon?

While there’s a downward trend in sperm counts and testosterone levels, averages haven’t yet fallen to the point where they’re considered low for the overall population. The decline is gradual, so it’s not something you need to worry about specifically. But from an evolutionary and ecological perspective, it does raise interesting questions about the future of men’s health and reproductivity.

Testosterone replacement therapy (TRT) prescriptions have rocketed in recent years (29). While this is mainly due to changes in our approaches to management and media influences, there has been a genuine increase in the number of men with testosterone deficiency (30).

Measuring your testosterone levels

There’s no need to measure your testosterone levels routinely unless you have signs or symptoms of low testosterone. If this is the case, it’s best to let a doctor know exactly what you’re experiencing so they can interpret your results alongside your symptoms.

Alternatively, you can check your levels from home with our Testosterone Blood Test — it’s a simple finger-prick test you can take yourself. You’ll receive a report from one of our doctors with your result and you can then see how your testosterone levels compare to other men your age.

Want the full picture? Our male hormone panel blood test measures your testosterone levels alongside other hormones and proteins which are essential in maintaining a healthy male reproductive system, mood, muscle mass and energy.

References

1. Andersson AM, Jensen TK, Juul A, Petersen JH, Jørgensen T, Skakkebaek NE. Secular decline in male testosterone and sex hormone binding globulin serum levels in Danish population surveys. J Clin Endocrinol Metab. 2007 Dec;92(12):4696–705.
2. Travison TG, Araujo AB, Kupelian V, O’Donnell AB, McKinlay JB. The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab. 2007 Feb;92(2):549–55.
3. Nyante SJ, Graubard BI, Li Y, McQuillan GM, Platz EA, Rohrmann S, et al. Trends in sex hormone concentrations in US males: 1988-1991 to 1999-2004. Int J Androl. 2012 Jun;35(3):456–66.
4. Lokeshwar SD, Patel P, Fantus RJ, Halpern J, Chang C, Kargi AY, et al. Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA. Eur Urol Focus. 2021 Jul;7(4):886–9.
5. Population-Level Decline in Serum Testosterone Levels in American Men | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic [Internet]. [cited 2022 Nov 21]. Available from: https://academic.oup.com/jcem/article/92/1/196/2598434?login=false
6. Perheentupa A, Mäkinen J, Laatikainen T, Vierula M, Skakkebaek NE, Andersson AM, et al. A cohort effect on serum testosterone levels in Finnish men. European Journal of Endocrinology. 2013 Feb 1;168(2):227–33.
7. Chodick G, Epstein S, Shalev V. Secular trends in testosterone- findings from a large state-mandate care provider. Reprod Biol Endocrinol. 2020 Mar 9;18:19.
8. Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update. 2017 Nov;23(6):646–59.
9. Testicular cancer statistics [Internet]. Cancer Research UK. 2015 [cited 2022 Nov 21]. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/testicular-cancer
10. Fain E, Weatherford C. Comparative study of millennials’ (age 20-34 years) grip and lateral pinch with the norms. Journal of Hand Therapy. 2016 Oct 1;29(4):483–8.
11. Lowered testosterone in male obesity: mechanisms, morbidity and management – PMC [Internet]. [cited 2022 Nov 21]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955331/
12. Hayes LD, Herbert P, Sculthorpe NF, Grace FM. Exercise training improves free testosterone in lifelong sedentary aging men. Endocrine Connections. 2017 Jul 1;6(5):306–10.
13. Impact of EDCs on Reproductive Systems [Internet]. [cited 2022 Nov 22]. Available from: https://www.endocrine.org/topics/edc/what-edcs-are/common-edcs/reproduction
14. Endocrine Disruptors [Internet]. National Institute of Environmental Health Sciences. [cited 2022 Nov 22]. Available from: https://www.niehs.nih.gov/health/topics/agents/endocrine/index.cfm
15. Exposure to Endocrine Disrupting Chemicals and Male Reproductive Health – PMC [Internet]. [cited 2022 Nov 22]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046332/
16. Wang W, Yang X, Liang J, Liao M, Zhang H, Qin X, et al. Cigarette smoking has a positive and independent effect on testosterone levels. Hormones (Athens). 2013 Dec;12(4):567–77.
17. Zhao J, Leung JYY, Lin SL, Mary Schooling C. Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies. Preventive Medicine. 2016 Apr 1;85:1–10.
18. ASH. Smoking Statistics [Internet]. ASH. [cited 2022 Nov 22]. Available from: https://ash.org.uk/resources/view/smoking-statistics
19. Afrisham R, Sadegh-Nejadi S, SoliemaniFar O, Kooti W, Ashtary-Larky D, Alamiri F, et al. Salivary Testosterone Levels Under Psychological Stress and Its Relationship with Rumination and Five Personality Traits in Medical Students. Psychiatry Investig. 2016 Nov;13(6):637–43.
20. Choi JC, Chung MI, Lee YD. Modulation of pain sensation by stress-related testosterone and cortisol. Anaesthesia. 2012 Oct;67(10):1146–51.
21. Media PA. Most children own mobile phone by age of seven, study finds. The Guardian [Internet]. 2020 Jan 30 [cited 2022 Nov 23]; Available from: https://www.theguardian.com/society/2020/jan/30/most-children-own-mobile-phone-by-age-of-seven-study-finds
22. Wacks Y, Weinstein AM. Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults. Frontiers in Psychiatry [Internet]. 2021 [cited 2022 Nov 23];12. Available from: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.669042
23. Lapierre MA, Zhao P. Smartphones and Social Support: Longitudinal Associations Between Smartphone Use and Types of Support. Social Science Computer Review. 2022 Jun 1;40(3):831–43.
24. Wilson C, Stock J. ‘Social media comes with good and bad sides, doesn’t it?’ A balancing act of the benefits and risks of social media use by young adults with long-term conditions. Health (London). 2021 Sep;25(5):515–34.
25. Bhasin S. Secular Decline in Male Reproductive Function: Is Manliness Threatened? The Journal of Clinical Endocrinology & Metabolism. 2007 Jan 1;92(1):44–5.
26. Type 2 diabetes risk linked to low testosterone levels [Internet]. Diabetes UK. [cited 2022 Nov 23]. Available from: https://www.diabetes.org.uk/about_us/news_landing_page/type-2-diabetes-risk-linked-to-low-testosterone-levels
27. Gan EH, Pattman S, H S Pearce S, Quinton R. A UK epidemic of testosterone prescribing, 2001-2010. Clin Endocrinol (Oxf). 2013 Oct;79(4):564–70.
28. Carnegie C. Diagnosis of Hypogonadism: Clinical Assessments and Laboratory Tests. Rev Urol. 2004;6(Suppl 6):S3–8.

What causes high testosterone in women?

Testosterone is 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.

In this article, learn about conditions that cause high testosterone in females, as well as about symptoms and treatment.

A note about sex and gender

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.

According to the American Urology Association, average blood levels of testosterone in males are at least 300 nanograms per deciliter (ng/dL).

Females secrete much lower amounts, with average levels considered to be between 15 and 70 ng/dL.

The level of hormones produced in the body varies each day and throughout the day. However, testosterone levels are generally highest in the morning.

Share on Pinterest Symptoms of high testosterone in females may include mood changes, a deep voice, thinning hair, and acne. Image credit: iStock

Testosterone imbalances in females can affect their physical appearance and overall health.

Symptoms of high testosterone in females include :

• acne
• deep voice
• excess hair on the face and body
• increased muscle mass
• irregular periods
• larger-than-average clitoris
• loss of libido
• mood changes
• reduction in breast size
• thinning hair

Severely high levels of testosterone in females can cause obesity and infertility.

High testosterone in females is usually caused by an underlying medical condition, such as:

Congenital adrenal hyperplasia (CAH)

CAH is the term given 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.

The adrenal glands also produce the male sex hormones DHEA and testosterone.

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 (nonclassic CAH) or severe (classic CAH).

• deep voice
• early appearance of pubic hair
• enlarged clitoris
• excess body hair
• facial hair
• irregular or 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

Hirsutism is characterized by unwanted hair growth in females. It is a hormonal condition thought to be linked to genetics.

Symptoms include male-pattern hair growth that is dark and coarse. It typically affects the:

In cases of excessively high testosterone, other symptoms will also be present, including :

Home remedies and medical treatments help many people control the symptoms of hirsutism.

Polycystic ovary syndrome (PCOS)

PCOS is a common hormonal disorder that affects females of reproductive age. It is estimated that PCOS affects between 6–12% of people in the United States.

People are not usually diagnosed until they are in their 20s and 30s. However, children as young as 11 years old can be affected.

• enlarged ovaries that develop follicles and do not release eggs regularly
• excess body hair
• irregular, infrequent, or long menstrual periods

PCOS may lead to several health complications, including:

Doctors do not know what causes PCOS, although excess insulin and genetics may play a role.

Share on Pinterest A doctor may order a blood sample to diagnose high testosterone in females. Image credit: Shutterstock

A doctor can diagnose high testosterone in females based on the following:

Physical examination

During a physical examination, the doctor will look for symptoms such as:

If PCOS is suspected, the doctor may visually and manually examine the pelvic region to look for abnormalities.

Blood test

If symptoms suggest high testosterone levels, the doctor will take a blood sample and have hormone levels tested. They may also check glucose and cholesterol levels.

Usually, the blood will be drawn in the morning when testosterone levels are highest.

Ultrasound

To check for PCOS, the doctor may perform an ultrasound of the ovaries and uterus.

The treatment recommended for high testosterone will depend on its underlying cause.

Typically, a doctor will recommend both lifestyle changes and medication. Some treatments may also be used to control unwanted hair.

Medication

High testosterone and associated conditions can be treated with the following medications:

• Eflornithine: This is a cream applied directly to the skin that slows the growth of new facial hair.
• Glucocorticosteroids: This is a type of steroid hormone that reducesinflammation in the body.
• Metformin: This is a treatment for type 2 diabetes, which is sometimes used to lower blood sugar and insulin levels in people with PCOS.
• Progestin: This is a hormone that may regulate periods and improve fertility.
• Spironolactone: This is a diuretic that helps balance water and salt levels and reduces excessive female hair growth.

Oral contraceptives may also be prescribed, as this treatment helps to 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.

However, keep in mind that oral contraceptives may not be suitable for people who are trying to get pregnant, and they can also cause adverse side effects.

Hair removal treatments

Both electrolysis and laser therapy may be used to control unwanted hair. However, these treatments will not resolve an underlying hormonal imbalance.

• 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 required.
• Laser therapy: During this treatment, laser light is applied to the hair follicles to damage them. Again, multiple treatments may be required.

Note that these hair removal treatments can cause adverse reactions and may have other associated risks.

Anyone with a hormonal imbalance should speak with a doctor before trying medical treatments for excess hair growth.

Lifestyle changes

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 to balance menstrual cycles, and reduce symptoms in people with PCOS.
• 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.
• 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.

High testosterone in females can cause a range of symptoms, from excess facial hair to infertility, and is usually caused by an underlying medical condition.

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 to determine the best course of treatment.

Last medically reviewed on August 29, 2022

EU Pharma Test Cypionate 250

Testosterone is a hormone produced by all human beings and is the primary male sex hormone. Through our discussion, well take a look at Testosterone Cypionate, and examine the pros and cons of its use to improve performance in athletics and bodybuilding. Before we dive in, lets clear up a common misconception. Testosterone Cypionate is no more or less powerful or effective than its counterpart Testosterone Enanthate. The two compounds are virtually identical in every way.

Testosterone Cypionate Traits

Testosterone Cypionate is a synthetic version of the naturally produced testosterone hormone. This hormone is responsible for many different physical and mental characteristics in males. It promotes sex drive, fat loss, helps with gaining and maintaining lean muscle mass, increases bone density, and may even protect against heart disease. Whether it is naturally produced or through the use of Testosterone Cypionate, these traits do not change. All other steroids are actually the testosterone molecule that has been altered to change the properties of the hormone. Testosterone Cypionate carries a rating of 100 when measuring its anabolic/androgenic structure and this rating is used to measure all other steroids. This would make testosterone the “father” of all anabolic steroids used by athletes today. It should be noted; all testosterone compounds, including Testosterone Cypionate carry this anabolic/androgenic score of 100, as they are all merely testosterone.

Testosterone Cypionate is a highly anabolic and androgenic hormone making it a great steroid to use if one is in pursuit of more size and strength. Testosterone Cypionate promotes nitrogen retention in the muscle and the more nitrogen the muscles hold the more protein the muscles store. Testosterone Cypionate can also increase the levels of another anabolic hormone, IGF-1 in muscle tissue providing even more anabolic activity. Testosterone Cypionate also has the amazing ability to increase the activity of satellite cells. These cells play an active role in repairing damaged muscle. Testosterone also binds to the androgen receptor to promote androgen receptor dependent mechanisms for muscle gain and fat loss.

Testosterone Cypionate induces changes in shape, size and can also change the appearance and the number of muscle fibers. Androgens like testosterone can protect your hard earned muscle from the catabolic (muscle wasting) glucocorticoid hormones, in-turn inhibiting the related adverse reactions. In addition, Testosterone Cypionate has the ability to increase red blood cell production and a higher red blood cell count will improve endurance through increased oxygenation in the blood. More red blood cells can also improve recovery from strenuous physical activity. Even so, Testosterones anabolic/androgenic effects are dose dependent; the higher the dose the higher the muscle building effect.

Many athletes display massive strength gains while using Testosterone Cypionate as the hormone improves muscle contraction by increasing the number of motor neutrons in muscle and improves neuromuscular transmission. It also promotes glycogen synthesis providing more fuel for intense workouts thereby increasing endurance and strength.

Testosterone Cypionate also has the ability to promote fat loss through an enhancement of metabolic activity. Testosterone binds to the androgen receptor fairly well resulting in fat breakdown, and further prevents new fat cell formation. Another indirect action of fat loss that testosterone produces is the nutrient portioning effect it has on muscle and fat. Since the body is building muscle at an accelerated rate more of the food you eat is shuttled to muscle tissue instead of being stored as fat; nutrient efficiency is enhanced.

Testosterone Cypionate will also play a crucial role revolving around creatine. Creatine is essential to adenosine triphosphate (ATP), the source of energy for our muscles and when the muscles are stimulated ATP is broken down into adenosine diphosphate (ADP) and this is what releases energy. Unfortunately, the process is often too slow during strenuous activity but through the use of Testosterone Cypionate, this demand is met as ATP is replenished at a much faster rate.

Effects of Testosterone Cypionate

With a well-planned Testosterone Cypionate cycle, nearly every anabolic steroid benefit can be obtained. For the off-season athlete, more lean muscle mass can be built with less body fat gain. In-order to grow, you must consume enough calories and fat gain will occur, but Testosterone Cypionate will ensure the brunt of your weight gain is the weight you want.

While off-season bulking use is the most common, the effects of Testosterone Cypionate can be tremendously beneficial during the cutting phase too. During this period of use, we are able to preserve far more lean muscle tissue that would otherwise be lost. In-order to lose body fat, we must burn more calories than we consume and this can and often does lead to muscle and strength loss. Further, the longer and harder you diet the more muscle and strength will be at risk, but due to the traits of Testosterone Cypionate muscle tissue and strength are protected.

Regardless of the purpose of use, Testosterone Cypionate defines performance enhancement by its ability to promote recovery and endurance. With a performance level dose of Testosterone Cypionate your body can recover faster and you wont tire out as quickly. This will allow you to workout longer and harder, and more progress can be made. This is performance enhancement at its best!

Testosterone Cypionate Administration

Testosterone Cypionate is only available in an injectable form and is regularly used to treat conditions such as low testosterone. More than twenty million men in the U.S. alone suffer from some form of low testosterone, and such a condition can severely diminish ones quality of life. Symptoms such as loss of muscle mass and strength, a decrease in libido and sexual performance, an increase in body fat, and low energy levels are all common characteristics of low testosterone. Further, when ignored low testosterone can be a gateway to Alzheimers, diabetes, osteoporosis and many other serious conditions. Most men will find one injection every seven to ten days at 100mg to 200mg per injection to completely eradicate such a problem.

For performance enhancement, one injection per week is often enough; however, in many cases two smaller yet equal sized injections will prove to be far more efficient. The reason for multiple injections is to keep blood levels peaked; further, it is often needed to control side effects that may occur with performance level dosing. Like most anabolic steroids, the more you take the greater the reward, but the more you take the greater the risk. By splitting the injections up into smaller more frequent injections, you are introducing smaller amounts of the hormone for your body to deal with all at once. As for the actual performance doses, this can range anywhere from 200mg per week all the way to 1,000mg per week depending on needs and desires.

The typical dose for those who are using Cypionate to counteract the lowering of testosterone due to the use of other steroids is normally 200mg. If it is being used for direct performance purposes, most will find 400mg to 600mg per week will be effective, but it is important to note that higher doses will greatly increase the risk.

Regardless of the total dose, most steroid users will find this to be an extremely well-tolerated anabolic steroid and one that can be used for long periods of time. 12 weeks of total use is quite commonplace, as is 16 weeks. There’s nothing magical about these numbers, but they are solid guidelines in-order for the individual to plan out his desired goals.

Regardless of the total dosing or the cycles length, you will need to design a post cycle therapy (PCT) plan once your Testosterone Cypionate use comes to an end. For most men, if you are discontinuing the use of anabolic steroids for more than ten weeks, you will need PCT but if your off period is less then it can be skipped. For full post cycle information and planning, please see the Post Cycle Therapy page on Steroid.com.

It should be noted; when it comes to performance enhancement, Testosterone Cypionate for women is not recommended. This is a steroid that carries far too much androgenic activity; after all, it is the primary male androgen. Women can suffer from low testosterone and there can be therapeutic benefits from the use of Testosterone Cypionate; however such treatment plans will be tremendously low dosed and should be watched closely for virilization symptoms.

The Side Effects of Testosterone Cypionate

As an extremely well-tolerated hormone for most men, the side effects of Testosterone Cypionate are in many ways easy to control. When it comes to such adverse reactions, keep in mind they largely fall into the realm of possible and are by no means guaranteed. Even so, total dosing, genetic predispositions and your overall state of health will play a role.

As for the side effects themselves, Testosterone Cypionate like all testosterone compounds carries a high level of aromatase activity; aromatization referring to the conversion of testosterone into estrogen. As estrogen levels rise, this can lead to gynecomastia (male breast enlargement) and excess water retention. This excess water retention can even negatively affect blood pressure. In-order to combat such effects, especially gynecomastia, many turn to Selective Estrogen Receptor Modulators (SERMs) such as Tamoxifen Citrate (Nolvadex) and for more serious protection Aromatase Inhibitors (AIs) such as Anastrozole (Arimidex). Without question, AIs are the most effective; however, they can also prove to be problematic when it comes to cholesterol and caution is advised.

Beyond these effects, Testosterone Cypionate can promote dihydrotestosterone (DHT) related side effects such as acne, hair loss and prostate enlargement; however, it should go without saying DHT steroids will be the prime culprits. In-order to provide protection, a 5-alpha reductase inhibitor such as Finasteride can be useful as it is an androgen suppressor and the androgen DHT is causing the problem. It must be noted; hair loss is only possible in men predisposed to male pattern baldness.

Availability of Testosterone Cypionate

If you live in the U.S. you will not find Testosterone Cypionate for sale on the black market as commonly as you will many other testosterone forms; especially when it comes to pharmaceutical grade. The vast majority of Testosterone Cypionate is manufactured in the U.S. by Upjohn and Watson, and very little ever finds its way to black market suppliers. Of course, outside the U.S. things begin to change as there are quite a few pharmaceutical companies that make it. Further, numerous underground labs across the globe manufacture the product.

Regardless of the brand you choose, most Testosterone Cypionate comes dosed at 200mg/ml or 250mg/ml. There are a few exceptions; however, most high dosed Testosterone Cypionate normally falls under the category of buyer beware. Such products are commonly under-dosed and are only provided by low-grade underground labs. Of course, regardless of the dosing, you must be very careful when making any anabolic steroid purchase. Contaminated products are not uncommon, and when it comes to human grade Testosterone Cypionate this is one of the most commonly counterfeited testosterones.

Cypionate Reviews

With many anabolic steroids to choose from, very few carry such a high level of versatility and toleration as Testosterone Cypionate. Perfect for beginners and long time steroid users in any cycle, it is impossible to go wrong with this steroid. If youre new to anabolic steroids and youve maxed out your natural potential, this is the perfect steroid to see your progress continue once again. If you are an advanced steroid user and have used Cypionate in past cycles, it will continue to be just as effective each and every time. This is not an anabolic steroid reserved for a particular group of people, or one that is only useful at one specific time but rather a solid foundational steroid that is perfect for any cycle.

Testosterone Cypionate Profile

• 17b-hydroxy-4-androsten-3-one
• Testosterone base + cypionate ester
• Formula: C27 H40 O3
• Molecular Weight: 412.6112
• Molecular Weight (base): 288.429
• Molecular Weight (ester): 132.1184
• Formula (base): C19 H28 O2
• Formula (ester): C8 H14 O2
• Melting Point (base): 155
• Melting Point (ester): 98 – 104 C
• Manufacturer: Various
• Effective Dose (Men): 300-2000mg+ week
• Effective Dose (Women): Not recommended
• Active life: 8 days
• Detection Time: 3 months
• Anabolic/Androgenic ratio: 100/100.

Investigating the Pros and Cons of High Testosterone Levels in Women: A Complete Guide

Testosterone is an androgen hormone that plays a crucial role in the development and maintenance of male reproductive tissues and secondary sexual characteristics. However, it is also present in women in smaller amounts and is vital for their health and well-being. When testosterone levels rise above the normal range in women, it can have both beneficial and harmful effects on their body and mind.

The Benefits of High Testosterone Levels in Women

While testosterone is often associated with men, it is essential for women’s health as well. High testosterone levels in women can help regulate their menstrual cycle, enhance libido, increase muscle mass, and boost bone density. Studies have also linked high testosterone levels to better cognitive function and mood, improved cardiovascular health, and a reduced risk of breast cancer.

The Risks of High Testosterone Levels in Women

While testosterone has many benefits, excessive levels can also cause adverse effects. High testosterone levels in women can lead to acne, hair loss, hirsutism (excessive hair growth), and virilization (masculinization). It can also disrupt the menstrual cycle, decrease fertility, and increase the risk of polycystic ovary syndrome (PCOS) and ovarian cancer.

Conclusion

While testosterone is crucial for women’s health, it is essential to maintain it at healthy levels. High testosterone levels can have both positive and negative effects on women’s body and mind. It is crucial to understand the benefits and risks associated with high testosterone levels and make informed decisions to maintain hormonal balance. This comprehensive guide will explore in detail the benefits and risks of high testosterone levels in women and provide actionable insights on how to maintain healthy testosterone levels.

🔔 The Role of Testosterone in Women’s Health

Testosterone is often thought of as the male hormone, but it also plays an important role in women’s health. Women naturally produce testosterone in their ovaries and adrenal glands, although in much smaller amounts than men.

Testosterone is essential for the development of bones and muscles, as well as maintaining a healthy libido. It also plays a role in regulating insulin and glucose metabolism, which can affect weight and energy levels.

Women with low levels of testosterone may experience a decrease in muscle mass, bone density, and libido, as well as fatigue and depression. However, too much testosterone can also have negative effects on women’s health.

High levels of testosterone in women can lead to acne, excess body hair growth, and irregular menstrual cycles. It can also increase the risk of developing polycystic ovary syndrome (PCOS), a hormonal disorder that can cause infertility and other health problems.

Overall, testosterone plays an important role in women’s health, but it’s important to maintain a healthy balance to avoid negative effects on both physical and mental health.

🔔 Benefits of High Testosterone Levels in Women

While traditionally associated with men, testosterone also plays a vital role in women’s health. Here are some of the benefits of high testosterone levels in women:

• Increased Muscle Mass: Testosterone helps women build lean muscle mass, which can improve physical performance and overall strength.
• Improved Bone Health: High testosterone levels can also help women maintain healthy bone density and reduce the risk of osteoporosis.
• Enhanced Libido: Testosterone is known to play a role in sexual desire and arousal in both men and women. Increased testosterone levels in women can improve libido and sexual satisfaction.
• Boosted Mood and Mental Health: Testosterone has been shown to have an impact on mood and cognitive function, with higher levels associated with improved mood and a decreased risk of depression.
• Increase in Energy and Stamina: High testosterone levels can lead to an increase in energy and stamina, helping women to perform better physically and mentally.

It’s important to note that while high levels of testosterone can provide these benefits, they can also come with risks. It’s essential for women to work with their healthcare provider to monitor their testosterone levels and ensure they remain within a healthy range.

🔔 Risks of High Testosterone Levels in Women

• Polycystic Ovary Syndrome (PCOS): PCOS is a condition that affects a woman’s hormone levels, leading to a range of symptoms such as irregular periods, acne, and excessive hair growth. Women with PCOS often have higher than normal levels of testosterone in their bodies.
• Increased Risk of Infertility: High levels of testosterone can interfere with ovulation, making it difficult for women to conceive.
• Increased Risk of Cardiovascular Disease: High testosterone levels have been linked to an increased risk of cardiovascular disease, including heart attacks and strokes.
• Acne and Skin Problems: High levels of testosterone can stimulate the production of sebum, leading to acne and other skin problems.
• Mood Changes: Women with high testosterone levels may experience mood changes such as mood swings and irritability.
• Increased Risk of Cancer: High levels of testosterone have been associated with an increased risk of breast and ovarian cancer in women.

If you experience any of these symptoms or are concerned about your testosterone levels, it’s important to speak to your healthcare provider who can provide further guidance on how to manage your hormone levels.

🔔 Treatment Options and Management of High Testosterone Levels

Medical Treatment

If your testosterone levels are significantly high, your doctor may prescribe medication to help lower them. Some medications commonly used to treat high testosterone levels in women include:

• Birth control pills: These can help regulate hormone production and reduce excess testosterone.
• Anti-androgen drugs: These medications block the effects of androgens like testosterone, making them useful for conditions like polycystic ovary syndrome (PCOS).
• Gonadotropin-releasing hormone (GnRH) agonists: These drugs suppress the production of testosterone and other hormones by the ovaries.

Lifestyle Changes

• Weight loss: If you are overweight or obese, losing weight can help reduce testosterone levels.
• Dietary changes: Eating a balanced diet that includes plenty of fruits, vegetables, lean protein, and whole grains may also help lower testosterone levels.
• Exercise: Regular physical activity can help regulate hormone levels and promote overall health.

Natural Remedies

There is some evidence that certain natural remedies may help manage high testosterone levels in women. These might include:

• Saw palmetto: This herb may help reduce excess testosterone in women with PCOS.
• Spearmint tea: Some studies suggest that drinking spearmint tea may lower testosterone levels in women with PCOS.
• Green tea: Green tea contains compounds that may help regulate hormone levels and reduce the production of androgens like testosterone.

It is important to note that natural remedies should not be used in place of medical treatment without first consulting with your doctor.

🔔 Questions & Answers:

What are the symptoms of high testosterone in women?

High testosterone levels in women can cause a range of symptoms, including acne, facial hair growth, increased muscle mass, irregular periods, and infertility. Women with high testosterone may also experience mood swings, aggression, and a decreased sex drive.

What causes high testosterone levels in women?

High testosterone levels in women can be caused by a variety of factors, including ovarian tumors, adrenal gland disorders, polycystic ovary syndrome (PCOS), and certain medications. In some cases, high testosterone levels may be a result of a genetic condition.

Can high testosterone levels in women be treated?

Yes, high testosterone levels in women can be treated. Treatment options may include medications to reduce testosterone levels, such as birth control pills or anti-androgen drugs. Lifestyle changes, such as weight loss and exercise, may also help to reduce testosterone levels. In some cases, surgery may be required to remove a tumor causing high testosterone levels.

🔔 Reviews:

Wow, this article was eye-opening. As a man, I always thought testosterone was a male hormone, but it turns out that women can have high levels of it too. I appreciated the explanation of how high testosterone can affect women’s fertility and menstrual cycles. However, I would have liked to see more information on the different causes of high testosterone in women and the potential treatments available.

As a man, I found this article fascinating. I couldn’t believe that women could have high levels of testosterone, which I always thought was a male hormone. The article’s explanation of the different symptoms women with high levels of testosterone may experience, such as acne, hair loss, and irregular menstrual cycles, was illuminating. I was also surprised to learn that high levels of testosterone can lead to infertility in women. However, I would have liked to see more information on the potential causes of high testosterone in women. Are some women simply genetically predisposed to it, or can certain behaviors or lifestyles contribute to higher levels? Additionally, while the article mentioned that treatments are available for women with high testosterone levels, I was curious to learn more about what these treatments can entail and how effective they are. Overall, this article opened my eyes and taught me something new, but I wish it had delved deeper into the topic to provide a more comprehensive understanding of the issue.

Wow, this article on high testosterone in women was a real eye-opener. As a man, I never really thought too much about the hormone levels in women, but it’s clear that they play a critical role in overall health and well-being. I was particularly fascinated by the potential negative effects of high testosterone levels in women, such as increased aggression and a higher risk for polycystic ovary syndrome. It’s important to be aware of these risks and take steps to address them when necessary, whether through lifestyle changes or medical intervention. Overall, this article has given me a greater appreciation for the complexities of the human body and how hormones can impact our physical and emotional health.

Interesting article, never knew that women could have high levels of testosterone. However, I wish they had included more information on the symptoms and treatments for women with high testosterone levels.

As a man, I found this article on high testosterone in women to be interesting. It’s so fascinating to learn about the different hormone levels between men and women, and this article shed some light on the topic. I was surprised to hear that high testosterone levels in women can lead to increased muscle mass and a higher sex drive. It just goes to show that there is still so much we have to learn about the human body.

This article on high testosterone in women has been informative! I had no idea that women could have high levels of testosterone like men do. I definitely learned something new today.

✒ Last Updated: August 3, 2023
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