Female Androgen Dominance
If you scored high in the ‘Female Androgen Dominance’ section of the Health Score Quiz, please read this article as it contains some useful information and resources to help you.
This page is designed to help you understand why you might be experiencing symptoms relating to excessive levels of androgens. In this section we look at what androgens are, where they are made, how they can impact the female body, particularly when elevated or elevated comparative to other sex hormones like estrogen and progesterone, what tests you might consider and any initial tips to help rebalance sex hormones and reduce the possibility of androgen dominance.
What are androgens and where are they made?
Androgens are often called “male hormones”, however this is a little misleading. Both sexes have androgens, it’s just that we have different levels and ratios. These different levels and ratios contribute to different functions as well as physical and mental characteristics.
The primary androgen that most would have heard of is testosterone, however you also have androstenedione, DHEA, DHEA-S and DHT.
In females, a large majority of these androgens are used to produce estrogens. However, androgens have also been shown to help support bone health, support kidney function, liver function, muscle function, sexual desire and more.
Androgens are produced in the ovaries, adrenal glands and also in fat cells. Thus, adrenal function may influence sex hormone balance, fat levels may influence sex hormone balance and of course ovarian function will contribute to sex hormone balance.
What are the symptoms of high androgens in females?
There are a variety of symptoms that may result from excess androgens in females, the most common include:
- Excessive body and facial hair
- Balding/thinning hair
- Irregular menstrual cycles
- Mood changes
- Challenging body composition management
- Reduction in breast size
Equally, conditions such as PCOS are significantly associated to elevated or dominant androgens. in fact, this is the most common condition associated to high androgens in pre-menopausal females.
Infertility is also another major factor with androgen dominance, and there is an increased risk of miscarriage when androgens are out of balance to other sex hormones.
Testing considerations for androgens in females
Testing should include the following blood tests:
- Luteinising hormone (LH)
- Follicle stimulating hormone FSH)
- Estradiol (E2)
- Total Testosterone
- Free Testosterone
- Sex Hormone Binding Globulin (SHBG)
If you are menstruating then these tests may want to be timed on specific days of the cycle, however, without menstruation then they can be performed any day.
In addition to the above, I would also strongly recommend looking at the following markers as well, to help determine possible underlying causes of the noted imbalances:
- Haematology and biochemistry – broad assessment looking at kidney function, liver function, red blood cell, white blood cells, lipids etc.
- Fasting insulin or fasting C-Peptide (very important)
- Fasting glucose
With some clients we may also explore more advanced hormone assessment, using urine hormone analysis to explore hormone metabolites. This allows for a more thorough assessment of estrogens, androgens, progesterone and adrenal hormones.
If you are looking to work with a professional to help you understand more about the levels and interactions between your hormones, then please feel free to get in touch to enquire about working with us on a 1-2-1 basis, using the enquiry form at the bottom of this page. Following or sometimes before an initial consultation we can guide you with appropriate laboratory tests.
It’s not just levels, it’s balance too
Androgen dominance can come about from increased levels of androgens. Perhaps there is excess production, perhaps there is poor conversion taking place from androgens to estrogen.
Not only can you have high androgens, another cause of imbalance resulting in androgen excess symptoms and conditions can also be caused by low levels of estrogen and progesterone, thus resulting in a comparative excess.
So, you can have high androgens and normal estrogen and progesterone or normal androgens and low estrogen and progesterone, ultimately both these circumstances can result in an androgen excess picture.
What causes androgen dominance in females?
There are a variety of potential causes, below I list some of the most common causes of androgen excess in females.
Congenital Adrenal Hyperplasia (CAH)
Although a rare one, congenital adrenal hyperplasia, a disorder of the adrenal glands, can influence the production of hormones, and in many cases result in the overproduction of androgens. If test results demonstrate high androgens, then this may want to be ruled out by assessing 17-hydroxy progesterone (17-OHP).
Excessive Insulin Production
Much more common would be the influence of excessive insulin. Insulin is a hormone produced by the pancreas, and it helps to manage blood glucose levels by stimulating mechanisms that allow for glucose to be cleared from the blood stream. Poor glucose control, excessive refined carbohydrates or total carbohydrates are significant factors; thus, diet can be used to significantly influence androgen excess and also treat conditions like Polycystic Ovarian Syndrome (PCOS). This is also why one of the most common medications used to help treat PCOS is a type 2 diabetic medication, with its main mechanism of action being that to suppress the release of glucose from the liver.
Insulin not only serves to stimulate androgen production, it can also lower sex hormone binding globulin, resulting in increased levels of free testosterone and thus more androgenic symptoms.
Higher than optimal levels of circulating insulin can make weight loss more challenging. High insulin can suppress the breakdown of fat cells, making one less responsive to normal weight loss efforts.
High androgens and conditions like PCOS often result in a lot of frustrations in females that just don’t seem to respond to exercise and calorie management in the way that they might expect. Especially when they are told to just go away and lose weight as part of their treatment. Of course in some that might be a useful end result, however if there are metabolic adaptations making your weight loss effort more challenging, this can have a significant impact on one’s emotional health. This in turn often makes it harder to be consistent with the changes required.
Having said all that, you can still have very slim females with elevated androgens. In fact, a reasonable proportion of PCOS patients are of a healthy body fat level.
The truth is insulin function, insulin receptor function and glucose uptake by the cell are impacted by a whole host of things. Resolving imbalances that lead on to excessive insulin, would be a primary step in resolving increases in androgens that are not caused by a specific condition like a tumour, use of androgenic drugs or CAH.
Nutrition & Lifestyle considerations for androgen dominance in females
As mentioned above, one of the main focuses is the management of glucose and insulin.
Dietary changes like adopting a lower carbohydrate-based diet may be beneficial for some individuals with high androgens, high androgen symptoms or high androgen associated conditions like PCOS, hirsutism (excess hair growth).
Equally interesting is that imbalances in the gut microbiome have been shown to contribute to increased gut permeability, leading to increase inflammatory load and result in impaired insulin receptor function, thus increasing insulin indirectly. Remember, high insulin in females often results in high androgen production, not the opposite way around as some authorities will have you believe.
Because of the above a largely wholefood-based diet with management of total calories and carbohydrates is likely advantageous.
If digestive health symptoms are present, then this warrants investigation as well.
Stress is another major factor that is often overlooked as well. Stress acts as a stimulator of glucose, but also induces insulin resistance as well. Stress is often overlooked as a cause/major contributing factor of type 2 diabetes. I have seen incredible results with some type 2 diabetic clients using stress management as a primary intervention.
Appropriate exercise is also another area of consideration. Excessive exercise without adequate recovery can lead to a chronically inflamed state, and for those with low body fat levels, this can result in androgen dominance because of a lowering of estrogen levels. Equally, a lack of exercise means that you may not be as insulin sensitive, resulting in increased insulin production. Exercise has an ability to stimulate the sensitivity of our cells to insulin and therefore helps us to manage insulin more effectively.
Excessive androgens are often a sign that one needs to implement a level of self-care. Whether that self-care comes from changes in diet, appropriate movement, stress management, developing a healthy relationship to yourself and others or a combination of all these areas. If you have completed my health quiz and you found yourself on this page, review your results. Look at the foundational areas, are there areas to work on there. Did you score high in the section relating to high glucose, which can also be a sign of high insulin? Do you have any digestive imbalances going on?
I hope you have found this content useful. If you feel that you could benefit from additional support in this area, don’t hesitate to get in touch using the enquiry form below.
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