Testosterone imbalance: Signs of low and high testosterone in men and women

Testosterone is a good thing, but too much or not enough can cause trouble.

Amanda Capritto
3 min read

Often thought of as a male-only problem, testosterone imbalance can affect females, too. 

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Testosterone is an important hormone in both men and women. It's the key male sex hormone, but in addition to regulating fertility, testosterone also affects muscle mass, body fat distribution and red blood cell production.

Many women think of testosterone as a man's problem, but low or high testosterone levels can affect women, too. Sometimes, lifestyle changes can correct a testosterone imbalance, but in some cases, medical treatment may be necessary. 

In this article, learn more about the signs of low testosterone in men and women, plus expert tips for maintaining healthy testosterone levels. 

Signs of testosterone imbalance

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Testosterone imbalance can cause issues in both men and women.

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Both men and women can experience testosterone deficiency. Both sexes can also experience abnormally high levels of testosterone, but that's more common in people with ovaries. 

Signs of low testosterone in people with testes include: 

  • Reduced sex drive
  • Erectile dysfunction
  • Loss of body hair
  • Loss of muscle mass or trouble gaining new muscle mass
  • Muscle weakness
  • Increased body fat 
  • Increased breast tissue 

Signs of low testosterone in people with ovaries include: 

  • Low libido
  • Muscle weakness
  • Loss of muscle mass
  • Fatigue
  • Weight gain
  • Poor sleep 

Signs of high testosterone in people with ovaries include: 

  • Acne
  • Facial hair
  • Excessive body hair (more than what's normal for the individual)
  • Muscle mass gain without much effort
  • Deepening of the voice
  • Balding 
  • Decreased breast size
  • Irregular menstrual cycles

What causes testosterone imbalances? 

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Testosterone imbalances can be genetic, a product of lifestyle factors or a combination of both. These are some common reasons for low or high testosterone levels. 

Genetics: "There is a huge genetic component to low testosterone," says Dr. Jessica Wright, owner of Rejuvenate Austin, "and scientists have even pinpointed certain genes that cause low T." Genetic disorders, such as Klinefelter Syndrome, can also cause low testosterone. 

Aging: Testosterone levels in both sexes naturally decrease with age. In some people, this decline is more abrupt or significant than in others. 

Body fat: High body fat percentages can affect hormone production and signaling. 

Medical conditions: Any health conditions that affect the testes or ovaries can alter testosterone production. In addition, any medical conditions of the pituitary gland (a gland in your brain) or hypothalamus (part of your brain responsible for testosterone production) can affect testosterone levels.

Medical treatments: Chemotherapy, radiation or any medical treatment that affects the testes or ovaries can lead to testosterone imbalances. 

Stress: Prolonged and excessive stress can cause hormonal imbalances of all sorts, including testosterone imbalance. 

Exercise: Lack of exercise, especially lack of resistance training, can cause testosterone levels to decline. On the flip side, consistent weight training can boost testosterone. 

Diet: Eating too little overall may reduce testosterone. Overconsumption of alcohol can also contribute to low testosterone. Certain foods, including soy products and vegetable oil, are associated with low testosterone, while other foods are associated with higher testosterone. 

Complications of testosterone imbalances

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Loss of muscle mass is one of many complications of low testosterone.

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One of the primary long-term complications of a testosterone imbalance is mismatched libido in relationships, Dr. Wright says. This is especially true when it comes to low testosterone in females, she says.

"Mismatched libidos in marriage are a setup for marital issues and can result in your partner feeling rejected," Dr. Wright says, and this is something that often happens as women approach menopause. "I personally think the fatigue women feel at the beginning of perimenopause is oftentimes low testosterone," Dr. Wright says. 

In severe cases, untreated low testosterone in people with testes can lead to infertility, depression and brittle bones and increased risk of bone fracture. Not much is known about the long-term effects of low testosterone in people with ovaries.  

High testosterone can also cause problems. People with abnormally high levels of testosterone can experience a number of complications, including low sperm counts, heart muscle damage, liver disease, insomnia, increased risk of blood clots, aggressive behavior, high blood pressure and high cholesterol. In people with ovaries, high testosterone levels are associated with conditions such as polycystic ovary syndrome (PCOS) and infertility. 

How to fix testosterone imbalances 

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Strength training is one thing you can do to combat age-related low testosterone.

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Treatment for a testosterone imbalance will depend on whether you have a deficiency or excess of the hormone. Treatment for either will likely involve lifestyle changes. You may have to make changes to your diet, exercise routine, sleep routine, or even your job to manage stress. 

Hormone replacement therapy is also an option for more severe cases, but it's imporant to research thoroughly and talk to multiple experts who can help you decide if hormone replacement therapy is right for you. 

To get a sure diagnosis and rule out any other medical conditions, you should see a doctor if you're struggling with signs of high or low testosterone.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.