Women normally have a low level of circulating testosterone, which is produced by the ovaries. An abnormally elevated testosterone level is termed hyperandrogenism. Androgens are male sex hormones and include testosterone, dihydrotestosterone, dehydroepiandrosterone and androstenedione. Polycystic ovary syndrome causes the overwhelming majority of hyperandrogenism. Other disorders of the ovaries and adrenal glands can also cause this condition. Symptoms of a high testosterone level in women correlate to the masculinizing effects of this male sex hormone.
Persistent Acne
The American Association of Clinical Endocrinologists (AACE) notes in its “Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Hyperandrogenic Disorders” that acne in women beyond their teens may be a symptom of abnormally high levels of testosterone or other androgens. Acne that is resistant to standard treatment is highly suggestive of hyperandrogenism, especially in women with other symptoms of the disorder.
Hirsutism
Hirsutism is an abnormal overabundance of coarse body hair in a woman. Androgens are the primary determinants of the distribution and growth of body hair in both men and women. Hence, excess testosterone in women often causes increased or new hair growth in a masculine pattern. Women with hyperandrogenism may grow hair on the face, chest or back. The hair of the arms, legs and genital region may grow thicker and more widely distributed. In a 2008 article, “Signs of Hyperandrogenism in Women” published in the journal Hospital Physician, Dr. Bernard Karnath reports hirsutism occurs in 60 to 80 percent of women with hyperandrogenism.
Balding
AACE states excess testosterone in women may cause male-pattern hair loss on the head. The hair loss is typically on the top of the head toward the face, just as it is in balding males. This symptom is often quite distressing and is commonly the reason women with hyperandrogenism seek medical assistance.
Menstrual Abnormalities and Infertility
Excess testosterone interferes with the normal menstrual cycle. Menstrual periods may be irregular or cease in women with hyperandrogenism. In a 2009 academic chapter on polycystic ovary syndrome published electronically by Endotext, Dr. Richard Legro of Pennsylvania State University College of Medicine reports that approximately 50 percent of women seeking care for polycystic ovary syndrome-induced hyperandrogenism do not menstruate. The lack of menses is a reflection of the fact that women with polycystic ovary disease and other forms of hyperandrogenism frequently do not ovulate. Ovulation is the release of an egg from the ovary into the womb. Without ovulation, menstruation does not occur. Infertility is a common problem in women with excessive testosterone.
Masculinization
Testosterone has many of the same effects on a woman’s body as it does on a pubescent boy’s body. These effects are collectively termed masculinization. As noted in the AACE practice guidelines on hyperandrogenism, symptoms of masculinization may include deepening of the voice, loss of breast tissue, unusual muscle development, enlargement of the clitoris, and increased sex drive.
About this Author
Tina Andrews has been a medical writer and editor since 2000. She has published in “Cancer,” “Ethnicity & Disease,” and “Liver Health Today,” and was formerly a medical officer with the Centers for Disease Control and Prevention. Andrews holds a Doctor of Medicine degree and a Bachelor of Arts in chemistry.
