Lower Testosterone Levels

While testosterone is typically seen as a "male" hormone, it's also present (albeit in much smaller amounts) in women. However, between 4-7% of American women produce too much testosterone in their ovaries, which usually leads to a condition called polycystic ovary syndrome. Too much testosterone in women can lead to infertility due to lack of ovulation, as well as some embarrassing symptoms like acne, a deepening voice and facial hair growth. Reducing testosterone levels in women is often accomplished with medication, although dietary change can make a positive impact also.

Steps

Reducing Testosterone Levels via Medication

1. Consult with your family physician. Make an appointment with your doctor if you feel that something is "out of whack" with your hormones. Blood tests can identify hormone imbalance. The classic signs of too much estrogen are hot flashes and emotional outbursts, but symptoms related to too much testosterone may be less noticeable and take more time to develop. Genetics and unknown environmental factors trigger certain glands (ovaries, pituitary and adrenal glands) to malfunction, leading to excessive testosterone production.
   • Polycystic Ovary Syndrome (PCOS) is often the result of too much testosterone production in women — it can develop at any age post puberty.
   • PCOS develops because the testosterone prevents the release of eggs from their follicles within the ovaries. Since the follicles can't open, eggs and fluid collects within the ovaries, forming what appears to be numerous cysts.
   • In addition to lack of menstruation and PCOS, other symptoms of excessive testosterone production include hirsutism (increased hair growth), enhanced aggression and libido, increased muscle mass, clitoral growth, acne development, deepening voice, and darkening or thickening of the skin.
2. Get your diabetes under control. Type 2 diabetes is characterized by reduced cellular sensitivity to the effects of insulin. Type 2 diabetes is often triggered by obesity and results in an over-production of insulin, which can cause the ovaries to produce more testosterone. Thus, obesity, type 2 diabetes (insulin resistance), high testosterone production and PCOS often occur together within women if given enough time to develop. Your doctor can test your insulin and blood glucose levels to see if you have or are at risk of developing diabetes.
   • Type 2 diabetes can be prevented and even reversed with weight loss, regular exercise and dietary changes (such as less processed carbohydrates and harmful hydrogenated fats).
   • Your physician may prescribe medication that reduces insulin resistance, such as metformin (Glucophage) or pioglitazone (Actos). These medications can normalize insulin and testosterone levels, which helps to restore normal menstrual cycles.
   • When high insulin levels are coupled with high testosterone levels, there's an increased risk of developing hypertension (high blood pressure), blood cholesterol imbalance (too much "bad" LDL cholesterol) and cardiovascular disease.
   • In one study it was found that 43% of PCOS patients suffer from metabolic syndrome. Metabolic syndrome is the co-occurrence of risk factors with diabetes. These risk factors include obesity, hyperglycemia, hyperlipidemia, and hypertension.
3. Talk to your doctor about birth control pills. Once PCOS develops from chronically high testosterone levels, there's an increased risk of uterine cancer if the menstrual cycle has stopped (in pre-menopausal women). As such, it's important to "kick start" normal menstrual cycles to reduce cancer risks. This can be readily accomplished by supplementing with progesterone pills or by taking birth control pills that contain estrogen and progesterone on a regular basis. Remember that menstruating while on the pill will not restore your fertility (ability to get pregnant).
   • If you have PCOS, the benefits of taking birth control pills are clear, although ask your doctor to explain the potential negative side effects, such as reduced libido, mood changes, weight gain, headaches, breast tenderness and nausea.
   • It usually takes about six months of birth control pill usage for women to notice changes in their symptoms related to high testosterone, such as less facial hair (particularly on the upper lip) and acne.
4. Consider taking anti-androgen medication. Another option for women who have chronically high testosterone levels, particularly if they don't have diabetes and would prefer not to go on birth control pills, is anti-androgen medication. Androgens are a group of interrelated hormones, including testosterone, which are responsible for the development male characteristics. Commonly used anti-androgen drugs include spironolactone (Aldactone), leuprolide (Lupron, Viadur, Eligard), goserelin (Zoladex) and abarelix (Plenaxis). Your doctor might recommend experimenting with anti-androgen meds at low doses for six months to gauge effectiveness versus potential negative side effects.
   • Anti-androgen drugs are also used by male-to-female transsexuals as part of their efforts to reduce testosterone levels, particularly if they opt for gender reassignment surgery.
   • Other diseases and conditions that can lead to high testosterone levels in women include ovarian cancer / tumors, Cushing's disease (pituitary gland problem) and cancer of the adrenal glands.
   • In healthy women, ovaries and adrenal glands (which sit atop the kidneys) produce up to 50% of their testosterone.

Reducing Testosterone Levels via Diet

1. Eat more soy products. Soybeans are rich in phytoestrogenic compounds known as isoflavones (especially genistein and glycitein). These compounds mimic the effect of estrogen in the body, which can reduce the production of testosterone secondarily. Soy also contains a compound called daidzein, which can be transformed in the large intestine by some people (the process needs certain "friendly" bacteria) into the highly anti-androgenic compound equol. Equol can directly reduce the production or effects of testosterone.
   • Soy products are diverse and can be found in cereals, breads, tofu, various beverages, energy bars and meat substitutes (vegetarian hot dogs and burgers, for example).
   • Soy is a phytoestrogen, or plant compounds that also bind to estrogen receptors. They "are not" equivalent to human produced estrogen. Unlike human produced estrogen which acts upon both of estrogen's alpha and beta receptors, plant estrogens preferentially only act upon beta receptors. Despite rumors on the contrary, soy consumption is not associated with breast or thyroid issues (estrogen alpha receptor issues) and have shown in clinical studies to be generally healthful.
   • Nevertheless, soy has a number of real issues, one may be related to GMO soybeans, the other is food processing. High temperature acid hydrolysis of soy protein commonly used to process soy makes cancer causing substances such as 3-MCPD and 1,3-DCP. Make sure your sauces and soy powders based on soy are processed without high heat. (for soy/oyster/hoisin/teriyaki sauce in particular, this means "naturally fermented", a process which weeks not hours.)
   • Overconsumption of soy may reduce collagen production as collagen is disrupted through the estrogen beta receptor.
2. Add more flaxseed to your diet. Flaxseeds are high in omega-3 fatty acids (which have an anti-inflammatory effect) and compounds called lignans, which are highly estrogenic (stimulates estrogen production). Lignans are also able to reduce total and free testosterone levels in your body, while suppressing the conversion of testosterone into the more potent dihydrotestosterone. Remember that flaxseed needs to be ground up in order to be digested by people. Sprinkle ground flaxseed on your breakfast cereal and/or yogurt. You can also find whole grain breads with flaxseed added at most quality grocery stores.
   • Lignans work by increasing levels of sex hormone binder, which renders testosterone molecules inactive by binding to androgen receptors within the body.
   • Among commonly eaten foods, flaxseed is the richest source of lignans by far, with sesame seeds a distant second.
3. Limit your fat consumption. Testosterone is a steroidal hormone that requires cholesterol to be produced. Cholesterol is only found in saturated fat from animal products (meat, cheese, butter, etc.). Some cholesterol is essential for making steroidal hormones and virtually all the body's cell membranes, but diets rich in saturated fat tend to trigger increased testosterone production. Furthermore, diets high in monounsaturated fat (avocados, most nuts, olive oil, canola oil, safflower oil) boost testosterone levels also. Polyunsaturated fatty acids (PUFA) are the only fats associated with reduced testosterone levels.
   • Most vegetable oils (corn, soy, rapeseed/canola) are rich in omega-6 PUFAs, although consuming them in large amounts to reduce testosterone could very well lead to other health problems, so be cautious.
   • Healthier forms of PUFAs (rich in omega-3) include fish oils, fatty fish (salmon, tuna, mackerel, herring), flaxseed, walnuts and sunflower seeds.
   • Diets high in saturated fat may also increase your risk of cardiovascular disease, although omega-6 PUFAs may not be much better for your heart. Balancing natural fats is the key, while eliminating hydrogenated fats.
4. Avoid refined carbohydrates. Refined carbohydrates are high in easily digested sugar (glucose), which spikes insulin levels and triggers the ovaries to produce more testosterone — similar process to type 2 diabetes, although short-term effects instead of long term. Thus, avoid refined carbohydrates (anything with high fructose corn syrup) and choose healthier carbs such as whole grain products, fresh berries and citrus fruits, fibrous veggies, leafy greens and legumes.
   • Products high in refined sugars that you should avoid or minimize include candy, cookies, cakes, most store-bought baked goods, ice cream, chocolate, soda pop and other sugary drinks.
   • A diet high in refined sugars also increases your risk of heart disease, obesity and type 2 diabetes.
5. Consider using herbal remedies. There are a number of herbs that can have anti-androgenic effects (based on various animal studies), although their direct effect on testosterone levels in women has not been well studied. Herbs most commonly used for their anti-androgenic properties include saw palmetto, chaste berries, black cohosh, licorice, spearmint and peppermint teas, and lavender oil. Always consult with your doctor before taking any herb that has a reputation of being able to impact hormones.
   • DO NOT take these herbal supplements if you are pregnant or breastfeeding, or wanting to become pregnant in the near future.
   • Women who have a history of cancer (breast, uterine, ovarian) or other hormone-related problems, should supplement with these herbs only while under their doctor's supervision.

Tips

• Women normally have about 1/10 the amount of testosterone compared to men, but as women age their testosterone levels can increase proportionally.
• Not all side effects of high testosterone levels in women are unwanted — increased muscle mass and a higher libido (sex drive), for examples.
• To better deal with hirsutism, consider plucking facial hair or getting cosmetic laser treatments (electrolysis).
• Vegetarian diets tend to reduce testosterone levels in the body, whereas diets high in saturated and/or monounsaturated fats tend to increase testosterone.
• Cardiovascular exercise for losing weight is a great idea, but think twice before lifting heavy weights at the gym — it clearly increases testosterone production in men and likely also for women.

Warning

• If you believe you're experiencing a hormonal imbalance, see your doctor for a consultation before trying to alter your hormone levels. Dietary modifications are generally safe, but without knowing the cause of your symptoms you may make your condition worse.
• Speak with your doctor in-depth about the side effects of any drugs she may wish to prescribe to lower your testosterone levels. Tell her about any other conditions or medications or supplements you are taking.

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Sources and Citations

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