Testosterone in Women: Symptoms of High and Low Testosterone Levels

Low testosterone in women

Introduction

There’s a common misconception that only men have testosterone and only women produce oestrogen. While it’s true that the two hormones vary greatly between the sexes, it’s also the case that females need some level of testosterone for their bodies to function properly. 

So how much testosterone do women produce compared to men? Well, according to Healthline, it’s not very much at all. In fact, the female body contains as little as 5% of the amount a male body produces. However, one little known fact is that women produce more testosterone than they do oestrogen, despite oestrogen being thought of as the ‘female hormone’!

So why do women need testosterone? And what happens when testosterone levels in the female body become too high or low? Let’s explore everything you need to know about the causes, symptoms, and treatment of high and low testosterone levels in women.

What does testosterone do for women?

testosterone in women

Healthline states that testosterone plays an integral role in the female body. The hormone is produced in various organs, including the ovaries, adrenal glands, and fat and skin cells. While testosterone in men helps regulate things like muscle growth, sex drive, hair growth, and body fat, testosterone in women helps with:

  • Bone health 
  • Breast health
  • Fertility
  • Menstrual health
  • Vaginal health

Just as the male body needs testosterone to function, the female body also needs testosterone to remain healthy– particularly to keep bones strong, promote good cognitive health, and maintain sex drive. 

According to Everydayhealth, women need small amounts of testosterone as part of their healthy mix of androgen hormones that keep the bodily functions running smoothly, and with too little or too much, a woman will start to notice certain signs and symptoms that something isn’t right. 

What are the normal testosterone levels in females?

The British Menopause Society states that a healthy young woman produces around 100-400 mcg of testosterone per day. Healthline expands on this further, suggesting normal female testosterone levels can range from 15 to 70 ng/dL (nanograms per deciliter) or 0.5 to 2.4 nmol/l. Anything significantly above or below this standard rate might be considered as a high or low level of testosterone in females. 

If you are concerned about your testosterone levels, speak to a doctor to get a blood test. Alternatively, there are DIY tests you can do from the comfort of your own home too. 

Low testosterone in women

It’s perfectly normal for a woman’s testosterone levels to fluctuate up and down throughout her life. In fact, scientific research has shown that it’s common for testosterone levels to start to decrease between the ages of 20 and 40. However, this reduction shouldn’t be abrupt or profound. A natural decrease in testosterone should be slow and gradual.

So what happens when the female body suddenly stops producing enough testosterone? What problems might a woman face if their testosterone levels fall lower than the minimum healthy rate of 0.5nmol/l (15 ng/dL)?

Causes of low testosterone levels

Like most medical conditions, there are various reasons that lie behind women having significantly low testosterone levels. According to Medical News Today, there are three main causes:

  • A natural diminishing of hormones

The most common cause of low testosterone is the natural diminishing of hormones due to menopause or ageing. When a woman reaches menopause, her ovaries will start to produce fewer hormones, including both oestrogen and testosterone.

  • Medical problems with ovaries 

A woman may also experience low testosterone if she has problems with her ovaries, most commonly ovarian failure (caused by a number of medical factors including chemotherapy or eating disorders).   

  • Medical problems with adrenal/pituitary glands

Medical problems with your adrenal or pituitary glands can also cause testosterone levels to decrease. Adrenal insufficiency will likely cause an imbalance of various androgen hormones.

Everlywell also states that certain medications can cause a decrease of testosterone, including anti-hypertensives, opiates, and various methods of birth control (oral pills and contraceptive patches).  

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Signs and symptoms of low testosterone levels

According to Women’s Care, the symptoms of low testosterone in women are subtle when compared to those in men. Mostly, females will experience a decreased sex drive, fatigue, and general low energy. However, Medical News Today suggests there’s an even bigger list of common symptoms, most notably including:

  • Muscle weakness
  • Loss of bone density
  • Sleep disturbances
  • Unexplained weight gain
  • Vaginal dryness

It’s important to point out that these symptoms are common signs for a broad range of hormonal medical conditions. Therefore, low testosterone in women is often hard to diagnose. Usually, a doctor will look for a cause, including the transition to menopause, ovarian failure, or adrenal insufficiency.

Treatment of Low Testosterone

With research surrounding low testosterone in women scarce, the treatment options available are debated and often ineffective in seeing improvements. However, there are various solutions that can be prescribed to females depending on the cause of their low testosterone. Healthline points out 3 main treatment options that are available:

  • DHEA supplements

DHEA is an over-the-counter option that acts as a precursor to testosterone. The purpose of taking DHEA supplements is to promote a natural increase in the production of testosterone. This is often very effective in women.

  • Estratest 

A doctor may also prescribe a patient with Estratest, a medication used in post-menopausal women to boost oestrogen levels, which also contains small amounts of testosterone. However, the testosterone in Estratest is synthetically made, so it may not be as effective as naturally-produced testosterone.

  • Prescription testosterone (testosterone therapy)

Prescription testosterone, often referred to as Testosterone Replacement Therapy (TRT), may be prescribed in the form of testosterone injections, oral pills, skin-implanted pellets, or gel creams. TRT is the most effective solution to low testosterone in women.

These methods are more commonly used in the treatment of males with low testosterone. This is because a sudden and rapid increase in testosterone can cause abnormal side effects in females. 

According to Medical News Today, the side effects include but are not limited to:

  • Hair loss (male pattern baldness)
  • Acne 
  • Excessive facial hair
  • A deepened voice
  • An enlarged clitoris. 

Currently, there are no licensed female-specific testosterone products available in the UK. However, the one doctor-recommended exception is treating women with Female Androgen Deficiency Syndrome, a medical condition described by the NHS as a sexual dysfunction that results in low libido, increased tiredness, and difficulty concentrating.

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High testosterone in women

Women producing too much testosterone is also a recognised medical condition. Although testosterone does play a vital role in the healthy functioning of a woman’s body, testosterone is primarily a male-driven sex hormone. Therefore, when a female has excessive testosterone levels higher than 2.4nmol/l (70 ng/dL), the unwanted symptoms she faces will often be troubling.

So what causes high levels of testosterone in women? And what are the signs and symptoms of high testosterone in women to look out for?

testosterone levels in women

Causes of high testosterone levels

It’s perfectly normal for a woman’s testosterone to fluctuate, but sometimes the hormone will begin to rise to abnormally high levels. Usually, this increase will be the result of an underlying medical condition. There are 2 common medical causes for high testosterone in women:

  • Congenital adrenal hyperplasia (CAH)

CAH is a medical disorder that directly affects the body’s normal function of the adrenal glands which produce and secrete a variety of hormones including cortisol, aldosterone, and testosterone. Women with CAH lack a specific enzyme that regulates the production of these hormones, often resulting in a decrease in cortisol levels and an increase in testosterone levels. 

  • Polycystic ovary syndrome (PCOS)

PCOS is a hormonal disorder that’s caused by the excessive production of androgen hormones, including testosterone. PCOS is a common disorder that’s thought to affect 1 in 10 women in the UK. According to the NHS, there are 3 main symptoms of PCOS:

  • Irregular or prolonged periods 
  • Physical signs of increased androgen hormones (excess body hair, etc.).
  • Polycystic ovaries (enlarged ovaries or fluid-filled sacs that surround the eggs).

Unfortunately, there are other medical complications that come with PCOS too, including infertility, obesity, type 2 diabetes, and endometrial cancer.

Signs and symptoms of high testosterone levels

The symptoms of high testosterone levels will depend on the medical cause, such as those already mentioned. However, Medical News Today states that there are general signs of too much testosterone in women that you can look out for, including but not limited to: 

  • Excessive male-patterned hair growth
  • Increased muscle mass
  • A larger-than-normal clitoris
  • Mood changes
  • Thinning hair
  • Reduction in breast size

It’s important to point out that the severity of these symptoms will depend on the severity of the medical condition causing the increase of testosterone. 

Treatment of High Testosterone

According to Medical News Today, a doctor will diagnose high testosterone in women based upon a physical examination and a general inquiry into the symptoms. Most importantly, they will also carry out vital blood tests or an ultrasound to see if the cause is an underlying medical condition. As a result, treatments for high testosterone vary greatly depending on the cause.  

However, there is a range of general treatment options that a doctor may recommend to control the symptoms:

  • Medication

High testosterone levels in women can be treated with various medications depending on the associated condition and the main symptoms that have arisen, including topical creams and oral pills:

  1. Eflornithine (a skin cream that slows the growth of facial hair).
  2. Glucocorticosteroids (a steroid that reduces inflammation in the body).
  3. Progestin (a hormone that regulates periods and improves fertility).
  4. Spironolactone (a diuretic that helps regulate water and salt levels and reduces excessive female hair growth).

Heatlhline also suggests that oral contraceptives can be effective for blocking testosterone, but these medications should only be taken by women looking to also use it as purposeful birth control. 

  • Hair removal treatments 

Hair removal treatments are an effective way of controlling the growth of unwanted hair. However, these procedures are only a superficial solution to the problem. They do not resolve the underlying medical conditions causing the hair to grow. 

Nonetheless, women often benefit greatly from using hair removal treatments alongside medications. The two main types of hair removal treatments are:

  1. Electrolysis (using a pulse of electric currents to damage the unwanted hair follicles).
  2. Laser therapy (using a laser light to damage the unwanted hair follicles).
  • Lifestyle changes 

Like a lot of medical conditions, having a healthy lifestyle can vastly improve the symptoms of hormone imbalance and high testosterone levels. In fact, the NHS suggests that weight loss of just 5% can lead to significant improvements in PCOS symptoms, including the prevention of further complications.

Weight loss can be achieved through both regular exercise and a healthy balanced diet. The Fork Clinic advises women to make certain changes to their eating habits, most notably by consuming foods that balance their sugar levels and increase their intake of zinc. According to Very Well Health, some of the foods thought to naturally decrease testosterone levels include:

  • Nuts – The monounsaturated fatty acids and polyunsaturated fatty acids are thought to improve insulin and cholesterol levels in women with PCOS.
  • Herbal Teas – Spearmint tea is thought to have anti-androgen effects.
  • Fish – There’s evidence that suggests the intake of omega-3 helps regulate a healthy menstruation cycle. 

Final thoughts

There are numerous reasons why a female might have low or high testosterone levels, and these causes are usually a result of an associated medical condition. If you are concerned about your own testosterone levels or are experiencing symptoms, it’s important you seek medical advice from a doctor. Don’t worry unnecessarily in silence. You’re not the only woman to experience a testosterone imbalance.

Rest assured there are various treatment options available to both help ease the symptoms and treat the underlying medical problem. The main thing is that you find out the cause of your high or testosterone levels. That way the problem can be dealt with at the source.

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