Testosterone in women: the rate of total testosterone in women, increase, decrease, diagnosis
The content of the article:
- Testosterone in women
- The rate of total testosterone in women
- Decreased testosterone
- Increased testosterone
- Diagnostics of violations
- How to normalize testosterone levels in women
The rate of testosterone in women varies depending on many factors: age, time of day, phase of the menstrual cycle, etc. Deviation up or down may indicate pathology, but also be associated with a sedentary lifestyle, psychoemotional overload, inappropriate nutrition, chronic stress … To identify the cause of the violation and its correction, you should consult a doctor.
Testosterone (from Latin testis - male testicle, male strength and stereos - solid) is a male sex hormone that ensures the normal sexual development of men and women, regulates puberty and sexual function, and affects the development of secondary sexual characteristics. Its biosynthesis occurs with the participation of pituitary gonadotropic hormones - follicle-stimulating and luteinizing.
Testosterone in women is produced by the adrenal glands and ovaries.
The precursor of testosterone is cholesterol, which, in the composition of lipoproteins, enters the hormone-synthesizing cells of the glands. Testosterone biosynthesis begins with the cleavage of the side chain of cholesterol and occurs through a series of sequential enzymatic reactions in which tissue enzymes take part. During biosynthesis, testosterone completely loses its side chain and is transported into the bloodstream.
Circulating in the bloodstream, the main part (40-60% of total testosterone) combines with globulin that binds sex hormones, passing into a metabolically inactive form. The rest of the testosterone circulating in the blood weakly binds to albumin, and only about 1–2% of the total testosterone remains in free form. Free testosterone and testosterone bound to albumin are available to tissues and easily penetrate target cells. In the process of metabolic activation, testosterone is converted into a more active form - dihydrotestosterone, a small part is transformed into estradiol. Testosterone is inactivated in the liver.
Testosterone in women
Testosterone has a major impact on women's sexual and reproductive health. The main sources of the male hormone in women are the adrenal cortex and ovarian cells. A small amount is secreted in the placenta, muscle, skin and adipose tissue.
What is the testosterone hormone responsible for in women:
- affects protein, carbohydrate, fat metabolism, takes part in the synthesis of lipoproteins in the liver, improves the absorption of minerals and water by the body, controls blood sugar levels;
- regulates the development of the skeleton and bone growth during puberty, is responsible for bone density;
- increases protein synthesis and breakdown, is responsible for the growth of muscle mass;
- regulates the functions of the reproductive system;
- affects the maturation of the egg and the formation of the corpus luteum;
- participates in the maintenance of normal physiology in pregnant women;
- influences the formation of mammary glands;
- responsible for the development of adipose tissue;
- regulates the process of natural sweating;
- activates the sebaceous glands;
- is responsible for sexual hair growth, affects hair follicles;
- reduces the risk of cardiovascular disease;
- causes changes in brain activity, has a stimulating effect on the development and functioning of the nervous system, increases stress resistance and endurance;
- stimulates libido.
The deviation of testosterone levels from the norm in women has a noticeable effect on health and appearance.
The rate of total testosterone in women
Testosterone norm values in women can vary greatly depending on the method of determination, laboratory, units of measurement, so it is important to consider all these factors when interpreting test results.
The rate of testosterone in women fluctuates depending on the time of day, age, phase of the menstrual cycle, pregnancy.
Daily fluctuations in the concentration of the hormone in the blood are associated with the rhythm of its secretion. In the morning hours, the androgen level is higher, in the evening it reaches its minimum value. Women produce an average of 0.4 mg of testosterone per day.
The norm of the testosterone hormone in women is in direct proportion to the phase of the menstrual cycle:
- follicular phase - from 0.45 to 3.17 ng / ml;
- ovulatory phase (peak) - from 0.46 to 2.48 ng / ml;
- luteal phase - from 0.29 to 1.73 ng / ml.
During pregnancy, the content of testosterone in the blood of women increases, by the third trimester it becomes 3-4 times higher.
The rate of testosterone in women also varies with age. The content of the hormone in girls increases during puberty. After 35 years, it begins to gradually decline. With the onset of menopause, the testosterone rate in women decreases by 1.5-2 times. Table of the norm of testosterone in women by age:
| Age | Hormone content, nmol / l |
| less than 1 month | 11.8-51 |
| up to 1 year | 50-181 |
| 1-4 years old | 51-158 |
| 4-7 years old | 48-142 |
| 7-10 years old | 31-103 |
| 10-13 years old | 20-100 |
| 13-16 years old | 16.6-77 |
| 16–20 years old | 9.3-75 |
| 20-50 years | 32.4-128 |
| 50 years and older | 22.1-108 |
These norms take into account all forms of the hormone in the blood serum, i.e., total testosterone. To determine the ratio of free and total testosterone, the free testosterone index (IST) is used.
Decreased testosterone
A decrease in testosterone production in women can cause pathologies of the pituitary gland, hypothalamus, adrenal glands, ovarian neoplasms, endocrine and autoimmune diseases, and surgical menopause. A decrease in the level of androgen can be influenced by conditions accompanied by a deficiency of adipose tissue, natural age-related changes, the period of pre- and postmenopause, rare exposure to the sun, low sexual activity, abuse of bad habits, a sedentary lifestyle, psycho-emotional overload, chronic stress, inappropriate nutrition (low-calorie and low-protein diets, fasting). Testosterone deficiency can also be caused by taking certain medications, including hormonal contraceptives, immunosuppressants, antimycotics, anticonvulsants, and antiulcer drugs.
Testosterone deficiency in women is manifested by the following symptoms:
- decreased libido;
- decreased muscle mass, loss of muscle tone;
- dry skin, a decrease in its tone and thickness;
- increased sweating;
- reducing the amount of vaginal lubrication;
- hair loss, dryness and fragility;
- lability of mood, irritability, tearfulness, depression;
- chronic fatigue syndrome, poor exercise tolerance;
- sleep disorders;
- memory impairment, ability to concentrate.
Increased testosterone
Physiological increase in testosterone levels occurs during puberty, pregnancy, breastfeeding.
In other cases, an excess of testosterone in women is a consequence of disorders in the hypothalamus-pituitary-ovary-adrenal system.
Increased testosterone levels in women may indicate the presence of androgen-producing adrenal and ovarian tumors, diabetes mellitus, hypothalamic pathologies, polycystic ovary syndrome, and Itsenko-Cushing's disease. Also, excess testosterone is caused by unhealthy diet, obesity, and the use of certain hormonal drugs.
Symptoms of high testosterone in women:
- Excessive male-pattern hair growth (hirsutism)
- menstrual irregularities (irregular periods, anovulation, bleeding)
- miscarriage, infertility;
- obesity;
- diffuse thinning of hair on the head;
- striae;
- arterial hypertension;
- excessive sweating;
- decrease in the timbre of the voice;
- acne, oily seborrhea;
- development of a male figure, an increase in muscle mass, atrophy of the mammary glands;
- hypertrophy of the clitoris and labia;
- disorders of electrolyte and carbohydrate metabolism;
- increased libido;
- irascibility, aggressiveness.
Excess testosterone in women causes changes in appearance towards masculinization
Diagnostics of violations
The initial examination includes a detailed study of the hereditary history, clarification of the characteristics of metabolic disorders, genetic analysis, study of hormonal status, gynecological examination in order to identify concomitant pathology of the pelvic organs. To exclude tumor processes, MRI of the hypothalamic-pituitary region and CT or MRI of the adrenal glands are performed.
A blood sample for testosterone testing is taken from a vein. Women are recommended to undergo an examination on the 6th or 7th day of the menstrual cycle, if necessary, the analysis is taken at the beginning of the cycle, on the 2nd or 3rd day. For a reliable assessment of the androgenic status, it is recommended to pass the analysis several times at regular intervals.
The analysis is taken on an empty stomach, after the last meal, at least 8 hours should pass, it is allowed to drink only water. On the eve of the study, it is necessary to reduce psycho-emotional and physical activity, exclude fatty foods, alcohol, smoking, postpone taking medications (in agreement with the doctor) and ultrasound and X-ray examinations.
How to normalize testosterone levels in women
The main treatment for disorders of testosterone secretion is hormonal therapy. Medicines and the duration of the course of treatment are selected by the doctor.
If testosterone is elevated, its decrease is carried out using drugs that contain metformin and spironolactone. These substances inhibit testosterone synthesis or prevent it from binding to receptors in target cells.
Since increased testosterone levels in women are almost always accompanied by overweight, a diet balanced in macro- and micronutrient composition is recommended, but with a reduced calorie intake.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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