High testosterone refers to when testosterone levels are above the normal reference level in the blood. Testosterone levels and other sex hormone can be suspected to be high when patients present with symptoms like acne, increased hair growth, a thicker voice, irregular periods and infertility.

Although it is considered to be the main male hormone, testosterone is also naturally found in women. It is produced in the ovaries, in the adrenal glands or through the conversion of other hormones found in tissue like the muscles, the liver and the brain. Some health conditions can cause high testosterone such as polycystic ovarian syndrome or tumors.

If you suspect you have high testosterone, you are advised to consult your family doctor or an endocrinologist, gynecologist or a urologist for assessment and treatment as needed. Treatment will depend on the underlying cause of the high testosterone, and may involve the use of corticosteroids, hormonal birth control, and in some cases, surgery and/or chemotherapy.

Common symptoms

Symptoms of high testosterone can vary, and are often more noticeable in women. This is because women typically produce less testosterone than men do.

High testosterone in men

The most common symptoms of high testosterone in men include:

Increased sex drive;
Acne;
Infertility;
Higher blood pressure;
Headache;
Trouble sleeping;
Increase in muscle mass;
Irritability.

In males, symptoms of high testosterone are more obvious in children and adolescents. High testosterone in boys can lead to early puberty and an increase in testicular volume and the size of the penis.

Men who use anabolic steroids can develop infertility, gynecomastia (the appearance of breasts), acne, hair loss, higher blood pressure, an increased risk of cardiovascular disease, and liver problems.

High testosterone in women

In women, high testosterone can cause symptoms such as:

Increased hair growth;
Deepening of the voice;
Clitoral enlargement;
Infertility;
Irregular periods;
Acne;
Oily hair and skin;
Increase in muscle mass.

High testosterone in pregnant women can affect fetal genital formation, especially in female fetuses.

Confirming a diagnosis

If you have symptoms of high testosterone you should consult your family doctor or an endocrinologist, who can order a blood test to check your testosterone levels. Read more about what a normal testosterone test result is for men and women, and when this test is ordered.

Your doctor may also recommend other tests, like an abdominal MRI or abdominal ultrasound, to determine the cause of your high testosterone.

Possible causes

The main causes of high testosterone are:

Testosterone replacement therapy;
Anabolic steroid use;
Polycystic ovarian syndrome;
Cushing's disease;
Ovarian, testicular, or adrenal tumors;

High testosterone in babies can also be caused by a disease called congenital adrenal hyperplasia, which can be tested for on a newborn screening test (heel stick).

Treatment options

Treatment of high testosterone depends on the cause. If you are already taking testosterone replacement hormones, your doctor may recommend stopping or adjusting the dose. Patients who are currently taking anabolic steroids may be advised to discontinue them. If you have a confirmed diagnosis of congenital adrenal hyperplasia, treatment may involve the use of corticosteroids.

High testosterone related to polycystic ovarian syndrome can be treated with hormonal birth control and medications like spironolactone or finasteride, in consultation with your doctor.

Other treatments may be indicated if high testosterone is the result of an adrenal, ovarian, or testicular tumor, and may include surgery to remove the tumor, chemotherapy, and/or radiation.