Did you know that hormonal imbalances can impact your reproductive health? From ovulatory dysfunction to infertility, hormones have the power to derail your family-building plans.
This article provides an overview of how too much testosterone can affect a woman’s body, including its causes, symptoms, and fertility implications.
Understanding Testosterone and Its Role in the Female Body
Testosterone isn’t just a male hormone — women produce it too, just in smaller amounts. It’s one of several androgens, a group of hormones that help regulate various bodily functions in both sexes.
In women, testosterone is involved in the development of sex organs, pubic hair growth, and sex drive regulation. It also contributes to muscle and bone health.
Most women have testosterone levels between 15 and 70 nanograms per deciliter (ng/dL) of blood, but some may have higher levels due to certain medical conditions or genetic factors.
What is hyperandrogenism?
While it’s normal for a woman’s testosterone levels to fluctuate throughout the day and across her lifespan, an abnormally high level (hyperandrogenism) may indicate an underlying health issue.
Hyperandrogenism can lead to a variety of symptoms, including acne, hirsutism (unwanted hair growth), irregular menstrual cycles, and infertility.
Common causes of high testosterone in women include:
- Polycystic ovary syndrome (PCOS): The most common cause of hyperandrogenism is Polycystic ovary syndrome (PCOS). Women with PCOS produce higher-than-normal amounts of luteinizing hormone (LH) and not enough follicle-stimulating hormone (FSH). This hormonal imbalance triggers the ovaries to produce excessive amounts of testosterone, leading to symptoms like weight gain, ovarian cysts, irregular periods, and acne and/or facial hair.
- Congenital adrenal hyperplasia (CAH): Congenital adrenal hyperplasia (CAH) is a group of inherited disorders that affect the adrenal glands. These glands produce several essential hormones, including cortisol (the “stress hormone”), mineralocorticoids like aldosterone (which regulates salt and water balance), and androgens like testosterone.
- Ovarian or adrenal tumors: While rare, tumors on the ovaries or adrenal glands can sometimes produce excess hormones (testosterone, estrogen, or both, depending on the tumor). These tumors are typically benign (non-cancerous).
- Insulin resistance: When the body’s insulin levels get too high, it causes the ovaries to make more testosterone than usual. This happens a lot in women who have PCOS or Cushing’s syndrome.
- Cushing’s syndrome: Cushing’s syndrome is a rare and chronic condition that occurs when the body produces too much cortisol, which can indirectly increase testosterone production.
- Certain medications: Some hormone treatments, like anabolic steroids or certain meds like danazol and spironolactone, can cause a temporary spike in testosterone.
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Hyperandrogenism Symptoms
Women with high testosterone levels may experience one or more of the following symptoms:
Hirsutism
Excessive hair growth on the face, chest, abdomen, or back is a common sign of high testosterone in women. While it can run in families, hirsutism is often a symptom of an underlying condition like PCOS. Less common culprits include hormonal issues like hyperthecosis (a more severe form of PCOS), thyroid problems, or even certain medications like anabolic steroids.
Menstrual Cycle Irregularities
High testosterone levels can disrupt a woman’s menstrual cycle, causing irregular or missed periods (also known as amenorrhea). This hormonal imbalance can sometimes make it harder to get pregnant, especially for women with PCOS.
PCOS is the most common cause of ovulatory dysfunction (anovulation) and the leading cause of infertility. PCOS can also increase the risk of obesity, high blood pressure, and insulin resistance, which is a major risk factor for type 2 diabetes.
Changes in Behavior and Mood
High testosterone levels can also affect mood and behavior. Since testosterone influences the brain chemicals that control these things, having too much may cause mood swings, irritability, depression, anxiety, or even aggression.
It can also impact a woman’s sex drive or libido, which can either increase or decrease depending on the individual.
Anxiety and Depression
While the exact relationship between high testosterone levels and mental health isn’t fully understood, research suggests that testosterone can influence neurotransmitters in the brain, which play a role in mood regulation. Additionally, certain conditions associated with elevated testosterone, such as PCOS, are also linked to an increased risk of anxiety and depression.
Other Symptoms
Some women with hyperandrogenism may also experience:
- Acne
- Baldness or thinning hair
- Deepening of the voice
- Increased muscle mass
- Enlarged clitoris
- Reduced breast size
Diagnosis and Management
Diagnosing hyperandrogenism involves a physical exam, medical history, and blood tests to measure hormone levels, including testosterone, estrogen, and sex hormone-binding globulin (SHBG).
During the physical examination, the doctor may look for symptoms like excess facial/body hair, acne, and signs of insulin resistance, such as dark, discolored skin patches.
They’ll also ask about menstrual history, fertility issues, family history, and other related symptoms. If the doctor suspects an underlying condition, they may order additional tests like an ultrasound to check the ovaries and uterus.
Treatment Strategies
Treatment for high testosterone in women isn’t one-size-fits-all. Doctors personalize treatment plans based on the specific cause of the hormonal imbalance and the individual’s symptoms.
The main goal is to tackle the root of the problem, improve quality of life, and manage any unwanted side effects.
Treatment options may include:
Oral Contraceptives
Birth control pills with estrogen and progestin can help regulate menstrual cycles, reduce acne, and decrease unwanted hair growth. However, this may not be suitable for women who are trying to conceive.
Anti-Androgens
Medications like spironolactone can block the effects of androgens like testosterone, helping to alleviate symptoms such as acne, hirsutism, and baldness.
Hair Removal
Although removing excess hair doesn’t address the underlying cause, cosmetic treatments like laser hair removal or electrolysis can provide a temporary solution for managing issues like unwanted facial or body hair.
Women who prefer a more natural approach may shave, wax, or use hair removal creams, while others may bleach dark hair to make it less noticeable.
Acne Treatments
Over-the-counter or prescription creams, gels, or washes containing benzoyl peroxide, salicylic acid, or retinoids can help control breakouts and manage oily skin.
If the acne is more severe or persistent, a doctor may prescribe oral medications like antibiotics or certain birth control pills.
Lifestyle Changes
Sometimes, simple lifestyle adjustments can make a big difference.
- Weight Loss: Even a modest weight loss of 5% or more can often help restore hormonal balance and reduce symptoms, especially for women with PCOS.
- Diet: A low glycemic index (GI) diet can be beneficial for managing hyperandrogenic conditions like PCOS. It may also offer broader health benefits, potentially reducing the risk of heart disease and other chronic health conditions.
- Supplements: Certain supplements, like inositol or N-acetylcysteine (NAC), have shown some potential in improving hormonal regulation and insulin sensitivity in some studies, but it’s important to talk to a healthcare professional before starting any new supplements.
- Exercise: Regular physical activity improves insulin sensitivity, helps with weight management, and may even lower androgen levels.
Medical Interventions
For cases of severe hyperandrogenism or when lifestyle changes aren’t enough, additional medical options may include:
- Surgery: In rare cases, if a tumor is causing high testosterone, surgery might be an option to remove it and restore hormonal balance.
- Additional medications: Metformin (often used for type 2 diabetes) can sometimes lower testosterone in women with PCOS. In some cases, glucocorticosteroids (a type of steroid hormone) might be prescribed to help dial down androgen production.
Takeaway
Managing high testosterone isn’t just about addressing annoying symptoms like unwanted hair or acne. It’s about taking charge of your health and feeling your best. By addressing the root cause and working with your doctor, you can regain control of your menstrual cycle, fertility, and overall health and well-being.
A Word From RMA
We’re no strangers to hormonal imbalances at RMA Network. Our specialists have met with countless women who’ve struggled with irregular periods and fertility challenges due excess testosterone or other hormonal issues.
If you’re dealing with one or more of these concerns, we’re here to provide compassionate, personalized care to help you find the right treatment approach and get your health back on track.
We offer comprehensive diagnostic services, a wide range of treatment options, and all the support you need to achieve your family-building goals.
To learn more, schedule an appointment or visit us at one of our convenient locations across the country or reach out to our friendly staff.
