Written by Ada’s Medical Knowledge Team
Testosterone is a sex hormone that’s often associated with secondary sexual characteristics in men like facial hair and deep voices. However, both men and women need testosterone and it plays an important role in everyone’s body. It’s possible for both men and women to have testosterone imbalances, but it’s far less common for testosterone to get too high naturally.
Let’s look at the main functions of testosterone and get an overview of what testosterone imbalances can look like.
What is testosterone?
While testosterone is an androgen, or male sex hormone, both men and women have, and need, testosterone. Testosterone is produced by the testicles, the ovaries, and the adrenal cortex, and gets converted into dihydrotestosterone or estrogen. In a healthy body, sex hormones, including testosterone, balance themselves naturally. Men have a higher level of androgens and a lower level of estrogens. In women, it’s the other way around.
Testosterone is responsible for: 1
- Sexual and reproductive functions like sperm maturation and sex drive
- Development of male secondary sexual characteristics
- Muscle growth
- Hair growth, especially facial and body hair
- Production of red blood cells
What are normal testosterone levels?
Testosterone levels vary depending on a range of factors like age, sex at birth, time of day, medication, lifestyle, supplements, nutrition, general health, and the menstrual cycle. According to the American Urological Association, healthy adult men have a testosterone level of at least 300 ng/dL. Levels lower than this can be classified as a testosterone deficiency. 2
Testosterone levels are considerably lower in women. A healthy testosterone range for an adult woman is between 20 and 60 ng/dL. 3 To properly diagnose a testosterone imbalance, a doctor will need to test blood testosterone levels, observe any symptoms that are present, and perform a clinical exam.
What are the symptoms of a testosterone imbalance in men?
Testosterone decreases naturally as men get older. 4 However, obesity, chemotherapy, liver conditions and pituitary gland dysfunction or tumors can also lower testosterone levels. Low testosterone in men may present as the following symptoms: 5
- Sexual and reproductive problems like low sex drive 6, erectile dysfunction, or infertility issues 7
- Emotional symptoms, like depression or lethargy
- Decrease or loss of body and facial hair
- Abnormal breast development
- Weight gain
- Muscle weakness or shrinkage.
If a man’s testosterone levels are too high, it’s unlikely that it has a natural cause. Most often, it happens as a result of anabolic steroid misuse. This may present as: 8
- Reduced sperm count, testicle shrinkage, impotence, or infertility
- Kidney and liver damage
- Hair loss
- Emotional problems, like aggressive behavior, paranoia, and mood swings
- High blood pressure
- Heart attack or stroke
When should testosterone levels be checked?
People should seek medical advice if they experience any unusual symptoms or suspect a hormonal imbalance. The first port of call is a family doctor, who can, if necessary, refer to a specialist like an OBGYN, an endocrinologist, an internal medicine specialist, or a urologist.
How to raise testosterone levels?
If a doctor diagnoses a testosterone deficiency, they may suggest a course of testosterone replacement therapy. This should only be done with the guidance of a physician as it can lead to dangerous health issues if done incorrectly. Testosterone replacement therapy is not an option for everyone and must be evaluated on a case by case basis by an appropriate healthcare professional.
Low testosterone resulting from an underlying cause usually resolves once the cause has been treated. However, there are many other causes of low testosterone in both men and women.
The misuse of testosterone supplements, such as testosterone cypionate, testosterone pills, or testosterone booster injections, is common in athletics and bodybuilding. These can easily be misused if the person hasn’t had proper guidance from a medical professional. Teenagers are especially at risk of permanent growth damage due to anabolic steroid misuse. 9
What symptoms do women experience with testosterone imbalance?
Low levels of testosterone in women is fairly uncommon and mainly affects postmenopausal women. 10 It may lead to the following:
- Menstrual irregularities
- Lethargy, fatigue, and feelings of depression
- Reduced sex drive and vaginal dryness, which can make sex painful and difficult
Oral contraceptives like birth control pills can be a cause of testosterone deficiency in younger women. It’s a good idea to talk to a family doctor or OBGYN to discuss another contraceptive method.
High testosterone levels in women can be caused by polycystic ovary syndrome (PCOS) and adrenogenital syndrome, as well as anabolic steroid misuse. Symptoms of high testosterone levels in women may be: 11
- Excessive hair growth on face and body hair with hair loss on scalp
- Weight gain
- Menstrual cycle irregularities, lack of ovulation, or difficulties to get pregnant
- Changes in sex drive
- Emotional symptoms, such as mood swings or depression
How can women lower their testosterone levels?
As with any other hormonal imbalance, women with symptoms of overly high testosterone should always seek professional advice before starting treatment.
In some conditions, an anti-androgenic birth control pill improves symptoms of high testosterone. However, this does usually not treat the underlying cause. Symptoms might reappear when the person decides to stop using hormonal contraception.
If women who do not use hormonal contraception observe that their cycles are very irregular and/or permanently longer than around 35 days, 12 they should consult their family doctor or gynecologist. Reporting the basal body temperature curve (body temperature right after waking up) over the course of a few cycles can be a tool to indicate whether ovulation happens regularly.
A healthy lifestyle that maintains a healthy weight, balanced nutrition, regular exercise, sufficient water intake and avoids excess stress is the foundation for a healthy hormone balance in both men and women.
What is testosterone for?
Testosterone is a male sex hormone (androgen). It’s essential for sexual and reproductive health in both men and women. It also affects the development of the male body in puberty, muscle growth, bone stability, and more.
Where can I buy testosterone supplements?
Testosterone supplements, such as anabolic steroids, should never be taken without a doctor’s supervision since they can cause severe health problems and permanent damage. If a doctor prescribes testosterone supplements to treat testosterone deficiency symptoms, people can usually buy these in their local pharmacy.
How can I improve my testosterone level naturally?
Usually, there is an underlying cause for any hormonal imbalance, including testosterone. Testosterone excess or deficiency can be improved naturally with a healthy lifestyle that includes a balanced diet, regular exercise, maintaining a healthy range, and limiting stress.
When should I seek advice from a doctor?
If you notice any symptoms, you should always consult a doctor. Women should pay particular attention to potential symptoms like loss of sex drive if they are using hormonal contraception and consult their gynecologist if they experience symptoms.