High Testosterone in Women

High testosterone in women affects up to 13% of women, causing symptoms like irregular periods, excess hair growth, and acne. This guide explores what causes elevated testosterone levels in females, the warning signs to watch for, and effective solutions that address root causes rather than just symptoms.

What Causes High Testosterone in Women?

Testosterone is typically considered a “male hormone,” but women naturally produce small amounts in their ovaries and adrenal glands. Optimal testosterone levels in women support muscle mass, bone density, energy, and cognitive function. However, when levels rise too high, it can disrupt your hormonal balance and overall health. (For information on the opposite condition, see our guide on Low Testosterone in Women.)

Understanding Normal vs. Elevated Testosterone Levels

Measurement	Normal Range for Women
Total testosterone	15-70 ng/dL
Free testosterone	0.3-1.9 pg/mL

Levels above these ranges are considered elevated and may cause symptoms.

12 Common Signs of High Testosterone in Women

When you have high testosterone levels, your body sends clear signals. Watch for these common symptoms that can significantly impact your daily life:

• Irregular or missing periods — Your menstrual cycle becomes unpredictable or stops completely
• Unwanted facial and body hair — Thick, dark hair appears on your face, chest, or back
• Stubborn acne — Especially along your jawline and chin that doesn’t respond to typical treatments
• Thinning hair on your head — Similar to male-pattern baldness
• Voice becoming deeper — A noticeable change in your vocal tone
• Increased muscle development — Particularly across your shoulders and upper body
• Mood swings — Including irritability, anxiety, and emotional changes
• Weight gain around your middle — Despite diet and exercise efforts
• Difficulty getting pregnant — Due to irregular ovulation
• Intense cravings — Particularly for salty and sweet foods
• Swelling in extremities — Especially noticeable in ankles and hands
• Skin tags — Small flesh-colored growths, often in areas where skin rubs together

Why Women Develop High Testosterone Levels

PCOS: The Leading Cause of High Testosterone in Women

The most common cause of elevated testosterone in women is PCOS, affecting up to 13% of women of reproductive age. PCOS is fundamentally a metabolic disorder characterized by:

• Insulin resistance
• Hormonal imbalance
• Ovarian dysfunction
• Chronic inflammation

When insulin levels remain chronically elevated, they stimulate the ovaries to produce excess testosterone, creating a cascade of hormonal imbalances.

Other Medical Causes of Elevated Testosterone

• Adrenal dysfunction due to chronic stress
• Insulin resistance and metabolic syndrome
• Excessive exercise creating physical stress
• Perimenopause hormonal fluctuations
• Congenital adrenal hyperplasia (CAH)
• Environmental toxin exposure disrupting hormone function
• Certain medications that affect hormone metabolism

Health Risks Associated with High Testosterone

Untreated high testosterone levels can lead to several health complications:

• Increased risk of developing type 2 diabetes due to insulin resistance
• Cardiovascular issues, including high cholesterol and hypertension
• Higher risk of endometrial cancer from irregular menstrual cycles
• Infertility challenges due to irregular ovulation
• Mental health concerns, including anxiety and depression
• Metabolic syndrome, a cluster of conditions increasing heart disease risk
• Sleep apnea, particularly in women with higher BMI
• Fatty liver disease

Testing for High Testosterone

If you suspect elevated testosterone, comprehensive testing is essential for accurate diagnosis:

Recommended Tests

• Total and free testosterone levels
• DHEA-S (another androgenic hormone)
• Sex hormone binding globulin (SHBG)
• Fasting insulin and glucose to assess insulin resistance
• Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) ratio
• Complete thyroid panel
• Inflammatory markers
• Cortisol testing to assess adrenal function

Functional Medicine Approach to High Testosterone

Unlike conventional approaches that often rely solely on birth control pills or medications to manage symptoms, functional medicine addresses the root causes of hormonal imbalance.

1. Fix Insulin Resistance to Lower Testosterone Naturally

When your cells stop responding to insulin properly, your body produces more testosterone. Think of insulin resistance like a doorbell that stops working – you keep pressing harder (more insulin), but nothing happens. Here’s how to fix this underlying problem:

• Balance your blood sugar by eating protein, healthy fats, and fiber with every meal
• Try eating within an 8-10 hour window each day to reset insulin sensitivity
• Move your body regularly with both strength training and moderate cardio
• Replenish key nutrients that improve insulin function, including magnesium, chromium, and zinc
• Consider natural alternatives like berberine, which research shows works similarly to prescription medications for improving PCOS symptoms

2. Reduce Inflammation

Chronic inflammation contributes to hormone disruption and exacerbates symptoms:

• Anti-inflammatory diet rich in omega-3 fatty acids, antioxidants, and phytonutrients
• Identifying and removing food sensitivities, particularly gluten and dairy if reactive
• Optimizing gut health to reduce systemic inflammation
• Stress management techniques to lower inflammatory cortisol levels
• Adequate sleep to support hormone regulation and reduce inflammation

3. Support Natural Detoxification

Environmental toxins can disrupt hormone function and contribute to elevated testosterone:

• Enhancing liver detoxification pathways with supportive nutrients
• Reducing exposure to endocrine-disrupting chemicals in personal care products, plastics, and household items
• Supporting phase 1 and phase 2 liver detoxification to properly metabolize hormones
• Ensuring regular bowel movements to eliminate processed hormones

4. Herbal Support for Hormone Balance

Several botanicals have been shown to help modulate testosterone levels in women:

• Green tea extract (EGCG) increases sex hormone binding globulin, which binds to excess testosterone
• Licorice root may help decrease testosterone synthesis
• White peony tea helps improve progesterone, reduce testosterone, and modulate estrogen
• Saw palmetto can block the conversion of testosterone to its more potent form, DHT
• Spearmint tea has shown benefits in reducing hirsutism in women with PCOS
• Nettles provide natural support for hormone balance

Lifestyle Modifications for Hormone Balance

Nutrition Plan

• Focus on whole, unprocessed foods
• Emphasize protein, healthy fats, and fiber-rich vegetables
• Include anti-inflammatory spices like turmeric and ginger
• Prioritize foods rich in zinc, magnesium, and B vitamins
• Consider a Mediterranean-style eating pattern

Physical Activity

• Aim for balanced exercise—not too little, not too much
• Include strength training 2–3 times weekly
• Incorporate restorative movement like yoga
• Avoid excessive high-intensity exercise which can increase stress hormones

Stress Management

• Practice regular stress reduction techniques
• Prioritize quality sleep (7–9 hours nightly)
• Consider mind-body practices like meditation or breathwork
• Support adrenal health with adaptogenic herbs when needed

When to Seek Professional Help

While lifestyle modifications are powerful tools for rebalancing hormones, working with a knowledgeable healthcare provider is important, especially if you experience:

• Severe or worsening symptoms
• Fertility challenges
• Rapid onset of symptoms
• Changes in menstrual cycle
• Multiple symptoms affecting quality of life

Your Questions About High Testosterone in Women Answered

Next Steps: Balancing High Testosterone in Women Naturally

Living with high testosterone doesn’t mean you have to accept uncomfortable symptoms forever. By addressing the real underlying causes—insulin resistance, chronic inflammation, and environmental hormone disruptors—you can rebalance your hormones and reclaim your health.

At Richmond Functional Medicine, we look beyond isolated testosterone levels to understand your complete hormone picture. Your testosterone works alongside progesterone, estrogen, cortisol, thyroid hormones, and insulin in a delicate balance. Our science-backed approach creates an individualized plan to restore this balance and help you feel like yourself again.

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Related Resources

• If you’re experiencing the opposite issue: Low Testosterone in Women
• For younger women with hormone concerns: PCOS in Young Women: A Functional Medicine Approach
• Learn about The Insulin-Testosterone Connection and why it matters