How to lower testosterone in women

Hormones help the body function normally, but sometimes a person’s body doesn’t produce the right amount of a particular hormone. For example, some women produce too much of the male sex hormone testosterone, which can cause unwanted changes to their body. It can also affect their fertility. 

Fortunately, there are a few ways to lower those testosterone levels. Here’s what you need to know if you suspect that your testosterone levels are higher than they should be. 

How to lower testosterone in women

Obtaining the information to make a correct diagnosis is key when it comes to choosing the best way to lower testosterone levels in women.

“The underlying reason for elevated testosterone levels will determine the optimal course of treatment once a diagnosis has been made,” says Christopher Asandra, MD, founder of Asandra MD. 

Talk to your doctor about taking medication to lower testosterone

Depending on the cause of the high testosterone levels, different medications are often used to bring hormone levels back into a normal range. Examples include:

• Corticosteroids – These are potent steroid hormones such as prednisone and dexamethasone that treat congenital adrenal hyperplasia. They’re available in a number of different forms, including oral, topical, intravenous, and injectable versions.
• Oral contraceptives – Birth control pills are an effective way of preventing pregnancy when used correctly. But they can also help address elevated levels of testosterone. Combined oral contraceptive pills are often used to balance hormone levels in the treatment of PCOS. These are pills or tablets that must be taken daily. There are many brands available, including Apri, Aranelle, Loestrin, Ortho Tri-Cyclen, Yasmin, and Yaz. While most women tolerate them pretty well, some experience side effects such as breakthrough bleeding, nausea, cramping, breast tenderness, or bloating. 
• Spironolactone – The anti-androgenic medication spironolactone can help lower or block the effects of high testosterone levels. Spironolactone usually comes in tablet form, and most people take it once a day, usually with food. However, it can cause potassium levels to become elevated, so it may be necessary for your doctor to monitor your potassium levels while you take this medication. 
• Metformin – Metformin is a medication that’s very commonly prescribed to people with type 2 diabetes. Research suggests that it may also reduce testosterone levels by 20% to 25% in women with PCOS. Metformin, which comes in liquid and tablet form, also affects blood sugar levels and may cause side effects such as diarrhea, gas, bloating, stomach pain, indigestion, and constipation. 

Follow a healthy diet

One strategy to try is to reduce your consumption of trans fats, sugar, and processed foods. Eating more fruits, vegetables, whole grains, and lean meat and fish can decrease inflammation, which may contribute to elevated androgen levels in females with conditions like PCOS. Plus, it will be a boon for your cardiovascular health. Foods to cut back on include commercially baked goods like cakes and cookies, fried foods, and margarine. Eating healthier may also help with weight loss, which provides benefits in balancing hormone levels. 

Try licorice root

Research suggests that licorice root may reduce elevated testosterone levels in some women. Glycyrrhizin, which is the main bioactive component, is the driver behind its effectiveness. You can buy licorice root in preparation for tea, in powdered form, as well as in tablets and capsules. It can, however, contribute to a drop in potassium levels, which can be problematic because many systems of the body, including the heart, need proper potassium levels to function normally. Talk to your healthcare provider before adding herbs and supplements to your routine.

Try spearmint

Some research suggests that incorporating spearmint, such as spearmint tea, into your diet might help lower testosterone levels. For example, a study published in 2017 found that spearmint oil reduced testosterone levels, weight, and ovarian cysts in rats that were induced with PCOS. 

Try white peony

The dried root of the white peony plant has an established role in traditional Chinese medicine. This flowering plant, which also grows in gardens in the United States, may provide some promise in lowering testosterone levels because it contains phytoestrogens and may have some anti-androgenic effects, according to research published in 2012. However, more research is needed to confirm it.

It’s important to keep these strategies in perspective. “It is crucial to conduct research and speak with a healthcare professional before utilizing natural goods, as certain herbs or supplements may have negative effects or interfere with pharmaceuticals,” Dr. Asandra says. It’s also beneficial to “lead a healthy lifestyle that includes frequent exercise and a healthy diet. Reach out to your healthcare provider for a safe and effective plan.”

What causes high testosterone levels in women?

The main reproductive hormones at work in the body of someone assigned female at birth are estrogen, testosterone, and progesterone, which are instrumental in sexuality and fertility. Testosterone is one of several male sex hormones, or androgens, that are also produced in female bodies. In fact, both the ovaries and adrenal glands produce some testosterone and other androgens. And women need a healthy balance of all their hormones for their bodies to function properly. 

However, women can develop a condition called hyperandrogenism. That’s a condition where there are high levels of testosterone and other androgens. Some of the most common causes of high testosterone and other androgens in people assigned female at birth are polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), and tumors.

PCOS

According to research, PCOS is the most common cause of high androgen levels in the female body. Symptoms of PCOS vary but often include irregular periods, infertility, weight gain, and excess hair growth. The World Health Organization (WHO) estimates that PCOS affects 8% to 13% of reproductive-age women in the world, but it often goes undiagnosed. In fact, as many as 70% of people who are affected have not been diagnosed, according to WHO.

CAH

This syndrome causes changes to the adrenal glands, which are glands on top of the kidneys that produce the hormones cortisol, aldosterone, and androgens such as testosterone. The imbalance of hormones results in physical changes in females that vary, depending on which gene is affected and how much of an enzyme deficiency there is.

Tumors

An ovarian or adrenal tumor may also upset the normal balance of sex hormones in a female body. For example, if the ovaries produce too much testosterone as a result of a tumor, male characteristics may develop. 

Signs of high testosterone in women

Common signs of high testosterone levels in women may include the following:

• Acne – Women with higher-than-normal levels of male sex hormones tend to be more likely to experience acne, according to research. High testosterone levels can stimulate the body to produce excess sebum, which can clog or inflame the sebaceous glands, causing pimples or acne outbreaks. 
• Unwanted facial and body hair – When new hair begins to appear on the face, this can be a sign of higher-than-normal male sex hormone activity in the body. Thicker, darker hair, known as terminal hair, may grow up on the upper lip or chin. Thicker, darker, or coarser hair may also appear on the back, chest, and limbs. This is referred to as hirsutism. 
• Thinning of hair on the head – Male-pattern baldness, or androgenetic alopecia, can also result from high levels of testosterone or male sex hormones. 
• Irregular menstrual cycles or periods – Heavy, long, irregular, or infrequent periods are commonly associated with PCOS.
• Enlarged clitoris – Hyperandrogenism, which is the term used for having excess amounts of male sex hormones like testosterone, can cause the clitoris to become enlarged in some females, a condition called clitoromegaly.
• Increased muscle mass – Some women with high testosterone levels may experience an increase in their muscle mass.
• Other bodily changes – Women with high levels of testosterone or other androgens may find their bodies changing in other ways. Their breasts may shrink somewhat, or they may put on some additional weight, especially around the abdomen. 
• Deepening voice – Sometimes, a female with elevated testosterone levels may find that her voice has become a little deeper than usual, according to Mount Sinai. 

However, a woman with a condition such as PCOS may not always exhibit noticeable symptoms other than irregular menstrual cycles. “About 50% of PCOS patients don’t have obvious signs,” says Terri DeNui, DNP, a nurse practitioner with expertise in hormone replacement therapy and the founder and chief medical officer of EVEXIAS Health Solutions. 

The WHO notes that blood tests are useful because, in addition to elevated levels of testosterone, PCOS often causes elevated levels of other hormones, including estrogen, luteinizing hormone (LH), insulin, and anti-müllerian hormone. 

A normal total testosterone range for a woman age 19 or older is 8–60 nanograms/deciliter. 

Bottom line

Conditions that contribute to high levels of testosterone may be more common than many people realize. Women who experience symptoms such as acne outbreaks, changes in body or facial hair, or an irregular menstrual cycle should consult their healthcare provider before taking any supplements or medication on their own. By taking a blood sample to check for elevated levels of testosterone and other androgens, your healthcare provider can find the root cause of your symptoms before recommending ways to safely and effectively balance your hormones.