Testosterone is an important androgen hormone in people of all sexes. In this article, we’ll cover exactly what it does in the body, what the symptoms and causes of high or low testosterone are and how you can ensure your levels are balanced and healthy. 

Quick facts:

• Everybody produces testosterone and it plays an important role in many of the body’s functions.
• Imbalances in testosterone levels can be due to various underlying health conditions.
• Excessive testosterone levels are most commonly seen in cases of PCOS.
• Treatment for imbalances depends on the cause, but generally, it is a combination of lifestyle changes and medications.
• Testing your hormones can help you get to the bottom of any symptoms.

What is testosterone?

Testosterone is an important hormone for regulating sex drive (libido), bone and muscle mass and fat distribution. It’s part of a group of hormones called androgens. 

There are a lot of misconceptions about testosterone being just a “male” hormone. Whilst testosterone plays an important role in the development of the male sex organs and male secondary sex characteristics, people of all sexes have testosterone. 

Everyone produces and requires a certain amount of androgen hormones for reproductive development. The difference is just how much testosterone we have based on our sex-at-birth.

How is testosterone made?

In women and people assigned female-at-birth, testosterone is produced by the ovaries and adrenal glands. It’s then converted to hormone–oestrogen. Testosterone production is age-dependent and it gradually declines with age.

Most of the testosterone in the body is inactive. It remains bound to a protein called, sex hormone-binding globulin (SHBG). The small amount of testosterone that’s unbound and therefore active, is called freely circulating testosterone (free T). 

Free T can enter cells to bring about its effects. Our free T levels are affected by the levels of SHBG. Low levels of SHBG result in higher free testosterone, whereas high levels of SHBG result in lower free testosterone.

What does testosterone do in the body?

Some of the functions of testosterone are:

• maintaining sex drive (libido)
• maintaining muscle mass and bone density
• helping to regulate the menstrual cycle and fertility
• helping to stabilising mood
• growth, repair and maintenance of reproductive tissues
• may help support cardiovascular health

What are the symptoms of high testosterone?

Excess levels of testosterone in the body is called hyperandrogenism. This can bring about symptoms like: 

• acne and oily skin, specifically around the jawline, back and chest
• excess facial and body hair (hirsutism)
• thinning or loss of scalp hair (alopecia)
• irregular or absent periods
• Irregular or no menstrual cycles
• changes in mood
• changes in libido
• deepening of the voice
• issues with weight

Some studies suggest that high testosterone levels may increase the risk of developing high cholesterol, heart disease and type 2 diabetes.

What causes high testosterone levels?

The most common causes of high testosterone levels are underlying health conditions. It can also be caused by certain medications and lifestyle factors. Let’s look at the main ones…

PCOS

Polycystic ovary syndrome (PCOS) is a hormonal and metabolic condition affecting 1 in 10. The exact cause is still being researched, however, the proposed causes include an excess of androgens and insulin, genetic and environmental factors. If you suspect you might have PCOS, our at-home tests can give you a better insight into your hormones. 

Congenital andreal hyperplasia

Congenital adrenal hyperplasia (CAH) is an inherited condition that affects the adrenal glands. These are small glands located on top of the kidney. They produce hormones like cortisol (stress hormone), dehydroepiandrosterone (DHEA) and testosterone.

People with CAH are unable to produce an enzyme necessary to regulate the production of these hormones, which can result in an overproduction of testosterone. It’s been found to be more common in some ethnic groups such as people of Hispanic, Mediterranean, Yugoslavian and Ashkenazi Jewish descent.

Cushing’s syndrome is another hormonal condition impacting the adrenal glands. It results in excessive cortisol and androgen production.

Medications

Testosterone levels can rise due to certain medications, such as:

• Anabolic steroids: these are made up of testosterone and other related substances that promote muscle growth. They’re often used to improve athletic performance and appearance. 
• DHEA: This is a precursor to testosterone. taking DHEA supplements could increase the levels of testosterone.

Alcohol

Excessive alcohol consumption may increase levels of testosterone in premenopausal women, however, research is conflicting. 

How to lower my testosterone levels?

Treatment for high testosterone depends on the cause, but generally, it is a combination of lifestyle changes and medications. Achieving a healthy weight by including a healthy balanced diet and exercise routine may help with the symptoms of a hormonal balance. 

Medications used to treat high testosterone, and associated symptoms include:

• Oral contraceptives: Particularly the combined oral contraceptive pill is an effective treatment for blocking testosterone by inhibiting ovarian and adrenal androgen synthesis and increasing levels of sex hormone-binding globulin (SHBG). 
• Spironolactone (Aldactone) is an anti-androgen drug that decreases the production of testosterone. It is often used to treat hormonal acne and excessive body hair.
• Metformin is prescribed to manage blood glucose and insulin levels. For people with  PCOS, it is also often used to help with ovulation (ovulation induction). 

What are the symptoms of low testosterone?

If you’re experiencing low testosterone, you may experience some of the following symptoms: 

• Reduced sex drive
• Negative impact on mood 
• Anxiety or depression
• Irregular periods 
• Tiredness
• Increased body fat
• Muscle weakness, loss of muscle mass or tone
• Osteoporosis
• Vaginal dryness
• Changes in breast tissue

Low testosterone over a long period may also contribute to long-term health conditions such as heart disease, memory issues and loss of bone density.

Often, the symptoms of low testosterone in women are undiagnosed or misdiagnosed. Some of the conditions that low testosterone may be mistaken for include stress, depression and the side effects of menopausal changes in women.

What could cause low testosterone levels?

The most common causes of low testosterone levels are often age, underlying conditions and problems with certain glands.

Age

Testosterone levels naturally decrease as we age. As it’s produced in the ovaries, the natural decrease in ovarian function with age means that some may experience low testosterone levels as they transition from the perimenopausal phase into menopause. 

Underlying health conditions

Premature ovarian insufficiency (POI) can increase your risk of low testosterone. Additionally, surgery, such as the removal of the ovaries, can cause lowered testosterone levels. 

Problems with the hypothalamus or pituitary gland

Underlying health conditions impacting the pituitary, hypothalamus, or adrenal glands can also cause lowered testosterone levels. This is because these parts of the brain are responsible for the secretion of hormones which control the proper functioning of the ovaries. 

A disruption in the pituitary gland can also impact the adrenal gland. Addison’s disease or adrenal insufficiency is a hormonal condition that occurs due to underactive adrenal glands and can cause a low level of its hormones.

What can I do to increase my testosterone levels?

Low testosterone levels effects and treatments in women are still being researched and treatment is usually recommended only if symptoms are significantly impacting health and quality of life. 

Testosterone replacement therapy is a form of hormone replacement therapy (HRT) based on the replacement of testosterone. It may be prescribed orally, as injections, gels or skin patches.

DHEA is a precursor to testosterone, and it is believed that taking DHEA supplements could increase the amount of testosterone. It is always recommended to speak with a doctor before starting any medication or supplements.

How to test testosterone levels?

If you’re experiencing any of the symptoms mentioned above, our at-home hormone tests can determine your testosterone levels. Hormone testing is the only way to know what your testosterone levels are for definite. 

Our Doctors can recommend a care plan for you, based on your symptoms, hormone levels and specific health goals.

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