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High Testosterone In Women: Symptoms, Causes + Treatment

Although testosterone is the primary male sex hormone, biological females also naturally produce testosterone. 

Women need a certain level of testosterone to support metabolism, muscle mass, growth, and other functions, but higher testosterone in women can lead to unwanted side effects and various problems.

So, what are the signs of high testosterone in women? How do you fix low testosterone in women or high testosterone in women?

In this guide, we will discuss why the female body produces testosterone, what is considered low testosterone in women versus high testosterone in women, signs and symptoms of high testosterone in women, and various treatment options.

We will cover: 

  • Do Women Have Testosterone?
  • What Are the Signs of High Testosterone In Women and What Are the Signs of Low Testosterone In Women?
  • What Causes High Testosterone in Women?
  • How Is High Testosterone In Women Treated?

Let’s get started!

The formula for testosterone.

Do Women Have Testosterone?

Because testosterone is the primary male sex hormone, also referred to as an androgen hormone, some people are unsure whether the female body naturally produces testosterone.

So, do females have testosterone? Are there women with higher testosterone than others?

Yes, biological females (females assigned at birth) should produce testosterone naturally, just as the male body produces this sex hormone.

In fact, female and male testosterone is biologically identical in terms of what the molecule looks like, but the levels of testosterone in women are much lower than in men, and the functions of testosterone in the female body are somewhat different than testosterone functions in the male body.

Studies suggest that the male body (males assigned at birth) produces about 15 times more testosterone than females assigned at birth.

A person with acne on their face.

What Are the Signs of High Testosterone In Women and What Are the Signs of Low Testosterone In Women?

In the female body, testosterone is produced in the ovaries as well as the adrenal glands, which are small glands that sit on top of the kidneys.

There are numerous roles or functions of testosterone in the female body, including regulating bone mass, supporting reproductive organs and function, promoting muscle growth and lean body mass, and increasing libido.

Thus, low testosterone in women and high testosterone in women are both associated with adverse effects such as:

  • Changes in body fat distribution
  • Bone mineral density issues
  • Changes in sex drive
  • Infertility or menstrual irregularities
  • Vaginal dryness
  • Thinning of hair
  • Depression
  • Fatigue
  • Mood disturbances
A person who looks depressed with her hands on her face.

The main symptom of low testosterone in women is hypoactive sexual desire disorder, HSDD, which refers to a low libido or loss of sex drive.

Fatigue, depression, low muscle tone, weakness, hair thinning, and vaginal dryness are other symptoms of low testosterone in women.

Additionally, because testosterone is an androgen hormone responsible for secondary sex characteristics in males, such as the production of body hair and a deepening of the voice, women with higher testosterone can experience:

  • Excessive body hair
  • Growth of facial hair or body hair in areas where women normally do not have hair growth or have only fine hair rather than coarse dark hair
  • Male pattern baldness
  • A deepening of the voice
  • Excessive oil production in the face and/or acne
  • Changes in breast tissue
A person who looks depressed with her hands on her face.

What Causes High Testosterone in Women?

Higher testosterone in women is generally due to the presence of one or multiple underlying conditions or disorders that affect the hormonal balance in the affected woman’s body.

In this way, higher testosterone levels in women are generally a symptom of another disorder or condition rather than a primary condition or primary diagnosis in and of itself.

Some of the most common underlying conditions that can increase testosterone in women include the following:

#1: Polycystic Ovarian Syndrome (PCOS)

One of the most common causes of elevated testosterone in women is polycystic ovarian syndrome, more commonly referred to as PCOS.

In fact, PCOS is thought to affect about 5 million women worldwide and is generally considered to be the most common cause of high testosterone in women.

The hallmark sign of PCOS is termed hirsutism, which refers to abnormal or unwanted body hair growth in women, typically on the back, chest, and face.

A notebook that says: Polycystic Ovarian Syndrome (PCOS).

Medical research suggests that about 75% of cases of women with hirsutism have diagnosed or undiagnosed underlying PCOS, which makes sense because this unwanted hair growth is typically in “male” body hair distributions.

One of the high female testosterone symptoms is excess body hair, facial hair, and back hair because testosterone is an androgen hormone, so it promotes the growth of hair in these body regions that we generally associate with only having hair for men rather than women.

In addition to causing abnormally high testosterone in females, PCOS has other classic symptoms such as ovarian cysts, painful or abnormal menstrual periods, and other symptoms of high levels of androgen hormones such as cystic acne, weight gain, and sometimes voice changes.

Uncontrolled PCOS in women can lead to insulin resistance. This, in turn, can cause weight gain, which further contributes to higher testosterone levels, exacerbating the condition and the signs and symptoms of high testosterone in women.

It is thought that ovarian cysts affect the production of androgen hormones and increase testosterone production in women with PCOS.

A patient with her doctor.

#2: Nonclassical Congenital Adrenal Hyperplasia (NCCAH)

Although a fair number of people are familiar with PCOS being a cause of higher testosterone levels in women, a condition called nonclassical congenital adrenal hyperplasia can also increase testosterone in women and mimic many of the symptoms of PCOS and high androgen hormones in women.

NCCAH is a genetic condition that can crop up at different points in the life span.

Late onset of NCCAH is especially likely to cause elevated testosterone in women because this condition is characterized by a lack of a certain enzyme in the adrenal glands that are supposed to be present in order to produce healthy adrenal steroid hormones.

Due to the absence of this enzyme, the body compensates by producing excessive androgen steroid hormones such as testosterone, which causes an abnormally high testosterone level for women with NCCAH.

A person pointing to ovaries in a model.

#3: Tumors On the Adrenal Glands or Ovaries

As with the ovarian cysts in PCOS, tumors on the adrenal glands or ovaries and cells can impact the production of androgen hormones in women, leading to higher testosterone production.

#4: Anabolic Steroid Abuse

Anabolic steroids can increase testosterone in women.

Sometimes, anabolic steroids are prescribed for females who have wasting diseases such as HIV or AIDS in order to increase muscle mass, but anabolic steroid abuse or misuse can cause abnormally high female testosterone levels and unwanted symptoms of high testosterone in women.

How Is High Testosterone In Women Treated?

Treating high testosterone in women is a matter of identifying and treating the underlying cause of elevated testosterone production.

In certain cases, lifestyle adjustments such as changing your diet and exercise can help control PCOS in its early stages.

Medications may also be needed to treat conditions that cause high testosterone in females and/or to manage the symptoms of high female testosterone.

A stethoscope and variety of medications.

Some of the medications used to treat high testosterone levels in women include the following:

Glucocorticosteroids

Particularly in females with high testosterone levels due to nonclassic congenital adrenal hyperplasia, steroid hormone medicines such as glucocorticosteroids are often given to help suppress the production of testosterone and other androgen hormones.

Oral Birth Control Drugs

Oral birth control medications, sometimes progestin-only birth control or progesterone and estrogen combination oral birth control medications, are given to women with high testosterone.

This helps regulate hormonal levels (suppressing androgen hormones like testosterone and increasing female sex hormones like estrogen and progesterone) and treat symptoms of high testosterone in women, such as cystic acne, facial hair, and back hair or body hair.

A doctor writing a perscription.

Aldactone (spironolactone)

This is actually a diuretic medication, which means that it is intended to increase fluid excretion, but it has been shown to slow down the production of androgens like testosterone. 

For this reason, this medication is sometimes given to women who have PCOS or abnormally elevated testosterone production.

Vaniqa (eflornithine)

To treat signs of excess testosterone in women, such as unwanted facial hair or body hair, this cream is sometimes prescribed and applied because it can slow the growth of body hair.

Women with low testosterone may be given the following medications:

Testosterone Replacement Therapy (TRT)

TRT is when biologically identical testosterone is medically prescribed in the form of a patch, gel, or injection to supplement low testosterone in women.

On the other hand, hormone replacement therapy, HRT, with estradiol for postmenopausal women who have higher testosterone and lower estrogen/estradiol levels, is sometimes indicated.

Birth control pills.

DHEA Supplements 

DHEA is considered a precursor to testosterone and helps the body produce more endogenous testosterone.

Herbs and Lifestyle Management

There are also herbal supplements that may boost testosterone production, such as Ashwagandha, Tongkat Ali, and omega-3 fatty acids.

Additionally, the following can boost testosterone in women or balance abnormal testosterone levels in females and males alike:

  • Following a nutritious diet that eliminates processed foods, is rich in antioxidants, and contains healthy fats from fatty fish and nuts
  • Getting enough regular exercise, particularly including resistance training
  • Reducing stress
  • Getting enough sleep

Learn more about healthy eating to support overall health and hormone balance here.

A variety of healthy foods.
Photo of author
Amber Sayer is a Fitness, Nutrition, and Wellness Writer and Editor, as well as a NASM-Certified Nutrition Coach and UESCA-certified running, endurance nutrition, and triathlon coach. She holds two Masters Degrees—one in Exercise Science and one in Prosthetics and Orthotics. As a Certified Personal Trainer and running coach for 12 years, Amber enjoys staying active and helping others do so as well. In her free time, she likes running, cycling, cooking, and tackling any type of puzzle.

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