Abnormally high testosterone levels can cause problems for both males and females. Testosterone is a male sex hormone, but females also produce small amounts of it.
In males, testosterone’s functions include the regulation of libido, bone mass, and muscle mass, as well as the production of sperm. In females, testosterone assists in the growth and maintenance of female reproductive tissue and bone mass.
Normal amounts of testosterone are essential for health. However, too much can cause several issues, including problems with fertility and an increased risk of certain types of cancer.
In this article, we discuss the signs of high testosterone in males and females. We also list potential causes and treatment options.
A 2017 study involving more than 9,000 men living in Europe and the United States found that the normal total testosterone range for males aged 19–39 years is 264–916 nanograms per deciliter (ng/dl). Levels higher than this are abnormally high.
Men with very high testosterone levels may experience:
- aggressive or risk-taking behaviors
- excessive body hair
- heart or liver problems
- high blood pressure (hypertension)
- high sex drive (libido)
- increased appetite
- low sperm count
- mood swings
- prostate enlargement, which may cause difficulty passing urine
- swelling of the legs and feet
- unexplained weight gain
It is uncommon for high baseline testosterone levels in males to occur naturally. Often, abnormally high testosterone levels in males result from anabolic steroid use. Athletes and bodybuilders sometimes use these drugs to improve athletic performance and build muscle mass.
Supplementation with testosterone, whether a person has a prescription or obtains it illegally, can also increase testosterone levels.
Other causes of high testosterone levels in males include tumors in the adrenal glands or testicles. Sex hormone-producing adrenal tumors are rare, affecting 2 out of every 1 million people. They may be noncancerous (benign) or cancerous.
According to the Centers for Disease Control and Prevention (CDC), the normal total testosterone range for adult females is 8.37–48.8 ng/dl. Results above this indicate abnormally high testosterone levels.
High testosterone in females can cause:
Similarly to males, females may experience high testosterone levels as a result of anabolic steroid use or tumors of the adrenal glands or ovaries.
However, abnormally high testosterone in females typically results from a medical condition, such as:
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is one of the most common causes of high testosterone in females. PCOS affects up to 20% of all females of reproductive age.
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia (CAH) is a group of rare genetic disorders that affect the adrenal glands. Those with CAH lack one of the enzymes necessary to regulate the production of certain hormones, which can lead to the overproduction of testosterone.
CAH may be mild (nonclassic) or severe (classic). There is no cure for this condition, but treatment can reduce symptoms and improve quality of life.
Doctors typically use the following procedures to diagnose high testosterone in males and females:
A physical examination
A doctor may check for signs and symptoms of high testosterone, including excessive body hair, acne, and increased muscle mass. They will also ask about a person’s libido and mood.
If relevant, the doctor may enquire about the person’s menstrual cycle.
A doctor may order blood tests to check the person’s testosterone hormone levels. They may also check the levels of glucose and cholesterol, as these are commonly raised in people with high testosterone.
As testosterone secretion is typically highest in the early morning hours, the doctor will often draw blood for the tests in the morning.
A doctor may check for PCOS by taking an ultrasound of the ovaries and uterus.
The type of treatment for high testosterone will depend on the underlying cause of the imbalance. Most people will require a combination of lifestyle changes and medication.
Stopping steroid or supplementation use
Where excessive testosterone levels result from anabolic steroid use or testosterone supplementation, ceasing the use of these substances will usually resolve the issue.
In one study, 88.4% of the male participants taking testosterone supplements did not produce sperm. However, 6 months after stopping the use of the supplements, 65% of these individuals began to produce sperm again.
Treatment for tumors or cancer
If cancer or tumor growth contributes to high testosterone levels, treating the problem should help reduce testosterone levels.
Medication options for high testosterone include:
- eflornithine (Vaniqa), a topically applied cream that slows down facial hair growth
- glucocorticosteroids, which reduce inflammation
- metformin, a type 2 diabetes drug that may aid fertility in those with PCOS
- oral contraceptives, for females who are not actively trying to conceive
- progestin, which may regulate periods and aid fertility
- spironolactone (Aldactone), a diuretic that regulates the body’s levels of salt and water and reduces female hair growth
Lifestyle changes and home remedies can help manage the symptoms of high testosterone. In some cases, they can reduce testosterone levels.
It is important to achieve and maintain a moderate body weight to aid hormonal balance. In people with PCOS, for example, a modest weight loss of even 5–10% of body weight can improve symptoms and reduce testosterone levels.
A 2015 study showed that a low starch, low dairy diet helped reduce testosterone levels in females with PCOS after 8 weeks. It also improved insulin sensitivity. Insulin resistance is a complication of PCOS.
Hair removal treatments
Several home remedies or professional treatments can remove excessive facial and body hair. Options include:
- chemical depilatories
Bleaching the hair is another option. It will not remove the hair, but it can make it less visible.
For more long-lasting results, a person may wish to consider electrolysis or laser hair removal.
Individuals who have signs of high testosterone should talk to their doctor. It is important to seek help for high testosterone because, without treatment, it can increase the risk of heart and liver problems and other serious conditions.
A 2020 study suggests that high testosterone can increase the risk of type 2 diabetes, PCOS, breast cancer, and endometrial cancer in females. It can also increase the risk of prostate cancer in males, but it may lower their risk of type 2 diabetes.
High testosterone in males and females can cause a variety of symptoms, including excessive facial and body hair, aggression, and infertility.
In males, high testosterone is most frequently due to anabolic steroid use or testosterone supplementation. In females, it typically results from an underlying medical condition.
People who show symptoms of high testosterone should see their doctor for diagnosis and treatment. Untreated high testosterone levels can raise the risk of infertility, cancer, and other problems.