Testosterone (T) is a crucial sex hormone that’s most well known for stimulating puberty and the development of secondary sexual characteristics, such as body hair growth and sperm production, in people with penises.

T is also involved in numerous processes around the body, including the maintenance of bone and muscle mass, as well as the storage and metabolism of body fat.

T is found in much higher levels in people with penises, but it’s also present in the bodies of people with vulvas, in much lower concentrations. And having balanced T levels is necessary for optimal health and growth, no matter your sex.

Let’s get into how you can recognize the signs of high T levels in people with penises and people with vulvas, how it’s diagnosed, and what to do about it.

Let’s start with an overview of the common symptoms of high T levels in people with penises:

1. Acne

Acne may be a sign of high T when there isn’t any other obvious cause, like excessive sweating from working out.

2. Blood pressure changes

Changes in your blood pressure, including high blood pressure (hypertension) and low blood pressure (hypotension), can lead to:

  • dizziness
  • headaches
  • fatigue
  • nausea
  • fainting

3. Sexual health

Changes in your sexual health could be a sign of abnormal T levels. This can include trouble getting or keeping an erection, also called erectile dysfunction (ED), a reduced desire to have sex, and a lower than normal sperm count.

4. Body hair

You might also see changes in your head and body hair, including excessive body hair growth and early male pattern balding on your head.

5. Mood

You could also experience changes in your mood like irritability, anxiety, or depression.

Other signs can include:

Now, let’s get into the symptoms of high T levels in people with vulvas:

1. Body hair

You may notice abnormalities in body hair, like the growth of more hair than is typical for you on your face, chest, and back (hirsutism). You could also experience balding from having too many hormones called androgens in your body.

2. More muscle

You may notice that you have an increase in muscle mass throughout your body.

3. Irregular periods

You could get your period at irregular intervals. For example, going months without one or having two in a month, or having a period last longer than usual.

4. Sexual health

You may notice changes in your sexual health like a reduced sex drive, vaginal dryness, or difficulty getting pregnant.

5. Mood

People with vulvas may also notice changes to their mood like irritability, anxiety, or depression.

Other signs can include:

  • abnormal episodes of acne
  • larger clitoris than is typical for you
  • reduction in your breast size
  • voice getting deeper than usual
  • having trouble conceiving (infertility)
  • gaining weight without any changes in diet or activity

Common causes of high T levels in people with penises include:

  • Tumor growth near hormonal glands, such as your adrenal gland or your testicles.
  • Using anabolic steroids to build muscle mass or enhance athletic performance.
  • Taking T supplements or T replacement therapy (TRT) for abnormally low T levels. In this case, your doctor will closely monitor your T levels to make sure they don’t get too high.
  • Accidentally touching testosterone gel. This can cause it to absorb into your skin and make your T levels spike.

Common causes of high T levels in people with vulvas include:

There are two primary methods your doctor may use to diagnose high T levels:

  • Physical examination. Your doctor will ask you questions about your overall health and look closely at any physical symptoms of high T, such as body hair growth and abnormal sex organ size (breasts, testicles, etc.)
  • T blood test. Your doctor will take a sample of your blood using a hypodermic needle and send it to a laboratory for analysis. This gives you a definitive measurement of T in your blood to confirm high T levels. This test is usually done in the morning when T levels are at their highest.

Treatment for high T levels depends on the cause.

Treatments for people with penises

Eliminating any external source of high T levels is often the first line of treatment for high T caused by medication or steroid use.

Stop taking anabolic steroids immediately and see your doctor to monitor any changes in your T levels. If you’re on T supplements or TRT, talk to your doctor about how your T levels might respond if you’re taken off those medications.

You may just want to treat the symptoms of high T levels. Keeping excess hair shaved or using facial cleaners for acne may help control your symptoms.

Making lifestyle changes can also help if you’ve been receiving T supplementation because you have low T.

Getting regular exercise and eating a diet of whole, nutrient-dense foods can help you naturally boost T levels. This can also help you lose excess weight caused by T imbalances and get more of the nutrients you need to support T production in your body.

If a tumor is causing your T levels to spike, your doctor may recommend surgery to remove the tumor. If the tumor is cancerous, your doctor will discuss the next steps with you to treat and eliminate the cancer from your body.

Treatments for people with vulvas

Treating your symptoms may be an easy initial way to reduce the effects of high T on your body.

You may want to shave or bleach any excess hair, or use an over-the-counter facial cleaner for acne to help reduce breakouts.

Making lifestyle changes can also help lower your T levels and reduce your symptoms.

Try exercising regularly with about 30 minutes of light to moderate exercise every day. Also try eating whole, nutrient-dense foods to lose weight or ensure you’re getting the nutrition you need.

Your doctor may recommend medications to lower your T levels, including:

  • low doses of oral contraceptives (birth control pills)
  • metformin
  • glucocorticosteroids
  • spironolactone

Birth control pills are known to block T levels from getting too high. Some common birth control pills used to treat high T levels include desogestrel, gestodene, and norgestimate.

Low-dose contraceptives aren’t recommended if you’re planning to get pregnant.

You should also see your gynecologist before you start taking any birth control to see if there are any risks of side effects or complications from the changes that contraceptives cause in your hormones.

See your doctor as soon as possible if you experience any of the following symptoms that may mean you have high T levels:

  • chest pain
  • difficulty breathing
  • having trouble speaking
  • dizziness
  • fainting episodes
  • abnormal changes in your HDL (“good”) cholesterol
  • having a stroke
  • having a heart attack
  • swelling in your hands or legs
  • having trouble sleeping or breathing while you sleep

High T levels can be an issue for both people with penises and people with vulvas.

Talk to your doctor if you notice any symptoms of high T. The cause is usually treated easily, and catching it early minimizes the risk of any complications from T imbalances.