“Testosterone isn’t always on the top of our list when it comes to hormone balance, especially for women, but it’s an incredibly important hormone and one that helps us to feel energetic, motivated and strong.”

“While addressing your unique causes to elevated testosterone is the goal, there are some common action steps that will support women with elevated testosterone.”

How To Balance Testosterone In Women – Part 1: Elevated Testosterone 

Testosterone isn’t always on the top of our list when it comes to hormone balance, especially for women, but it’s an incredibly important hormone and one that helps us to feel energetic, motivated, sexy and strong. 

In my recent hormone series on the blog, I’ve discussed cortisol, progesterone, estrogen dominance and plant-based approaches for estrogen detox. With all of these hormones, either low levels or high levels lead to symptoms and imbalances. The same is true with testosterone in women; we want to take a goldilocks approach, not too much or too little testosterone, but just right. 

That’s exactly what we are going to dive into in this two part series: understanding both high testosterone in women and low testosterone along with action steps to address both cases. 

Today in Part 1, we are going to cover high testosterone. Keep reading to learn more about: 

• Elevated testosterone and the PCOS connection
• Signs and symptoms of high testosterone in women
• Action steps to lower testosterone

Let’s get started!

Elevated Testosterone In Women With PCOS 

Polycystic Ovarian Syndrome, or PCOS, is the most common cause of elevated testosterone that I see in my practice.  (Click here to learn more about what is PCOS and PCOS diagnosis. And click here for PCOS treatment approaches.)

Hormones don’t operate alone and very directly influence one another. Insulin-resistance is common in PCOS; 50 to 60 percent of PCOS patients also have metabolic syndrome. Insulin is the hormone that moves sugar from the blood into your cells and when blood sugar and insulin are high, over time, the cells have a hard time hearing insulin’s signal. 

When insulin is high, ovulation is inhibited which leads to the irregular cycles common with PCOS. High insulin often causes high estrogen in relationship to progesterone (remember you need ovulation to make progesterone). High insulin also signals to the ovaries and adrenal glands to make more testosterone. With insulin, estrogen and testosterone high, both weight and fertility are impacted. And since fat cells can also make testosterone, it can be hard to break the cycle. 

It’s important to note that not all women with PCOS have high testosterone and it’s also possible to have high testosterone without PCOS, which happens frequently when coming off of hormonal birth control. Causes of elevated testosterone levels in women vary from person to person. This is why it’s so important to work with your practitioner and have hormone testing done so you can address your own, personal root causes. 

Signs And Symptoms Of High Testosterone In Women

The following signs and symptoms might be clues to elevated testosterone levels when compared to normal testosterone levels in women. 

• Male pattern hair growth on chin, upper lip and/or chest
• Hair loss on head
• Mood swings
• Acne and oily skin
• Irregular or absent menstrual cycles
• Changes in body weight or shape
• Increased muscle mass
• Infertility
• Mood swings

If this pattern sounds like you, some testing will help confirm your suspicion and distinguish high testosterone from other hormone imbalances. 

How To Lower Testosterone In Women 

While addressing your unique causes to elevated testosterone is the goal, there are some common action steps that will support women with elevated testosterone. 

• Balance blood sugar. By using food and other lifestyle tools to balance blood sugar, you will also heal the metabolic pattern of elevated insulin and insulin resistance that contributes to elevated testosterone, inflammation and hormone imbalance. This might require dramatically reducing or fully eliminating processed sugar and refined carbs from the diet. Instead, focus on real, whole foods you cook at home such as vegetables, low-glycemic fruits, high quality protein and healthy fats. Eating regularly and certain supplements such as chromium, fiber and myo-inositol are helpful. 

• Drink green tea. Green tea has been shown to increase sex hormone binding globulin (SHBG), which can bind up excess testosterone in the body.  EGCG found in green tea is also an incredible antioxidant and shows anti-cancer properties. 

• Consider taking herbs. White peony, licorice, nettles, spearmint tea, reishi mushroom and others all have research to support testosterone - lowering effects and are commonly used in both PCOS and other cases of elevated testosterone in women. Be sure to check with your provider (or make an appointment with me) to discuss the specific herbs, forms and dosages that are right for your unique situation.  

• Increase your zinc. Zinc-deficiency is common and zinc is a mineral important for suppressing androgens including testosterone, while also supporting ovarian function. Zinc-rich foods include pumpkin seeds, hemp seeds, chickpeas, lentils, cacao, mushrooms and avocado. If you include animal foods in your diet, grass-fed beef and oysters are very high in zinc. Consider zinc your PCOS testosterone blocker!

My hope is that this gives you some information and action steps for exploring your own hormones and what to look out for as far as testosterone. In part 2 of my testosterone series, I will cover low testosterone. Stay tuned!

References

1. Karakas S. E. (2017). New biomarkers for diagnosis and management of polycystic ovary syndrome. Clinica chimica acta; international journal of clinical chemistry, 471, 248–253. Abstract: https://pubmed.ncbi.nlm.nih.gov/28624501/ 
2. Nagata, C., Kabuto, M., & Shimizu, H. (1998). Association of coffee, green tea, and caffeine intakes with serum concentrations of estradiol and sex hormone-binding globulin in premenopausal Japanese women. Nutrition and cancer, 30(1), 21–24. Abstract: https://pubmed.ncbi.nlm.nih.gov/9507508/ 
3. Dhariwala, M. Y., & Ravikumar, P. (2019). An overview of herbal alternatives in androgenetic alopecia. Journal of cosmetic dermatology, 18(4), 966–975. https://pubmed.ncbi.nlm.nih.gov/30980598/ 
4. Briden, L. (2017). Period Repair Manual. 2nd Edition. 

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