Causes of abnormal testosterone levels in women. What determines testosterone levels? High testosterone - good or bad?

Such a typically male hormone as testosterone is also present in a woman’s body. It is produced by the ovaries and adrenal glands. Testosterone in women is responsible for such important functions body, such as creating and maintaining muscle mass, regulating function sebaceous glands, functioning of the nervous system. This hormone regulates the process of follicle ripening, is responsible for the growth of the mammary glands, and affects a woman’s sexuality.

What is the normal level of testosterone hormone in women?

Unlike the male body, the hormonal background in women is subject to constant changes, expressed in fluctuations. If these deviations from the norm are within the acceptable range, nothing threatens women’s health. The level of testosterone in the blood is affected by age and pregnancy: during pregnancy, testosterone levels increase two to three times. In medicine, two indicators of hormone levels are used:

• Free testosterone. This term refers to the amount of free substance not bound to proteins. The normal content of free testosterone is 0.25 – 1.25 ng/ml.
• Total testosterone. This term refers to the total amount of the hormone in the body. To determine the level of hormone content, it is necessary to undergo tests and tests in laboratories medical institutions. If you have doubts about the results, we recommend checking your hormone levels in another laboratory.

Detailed hormone content data is shown in the table:

During pregnancy

During pregnancy, testosterone levels increase several times, and this increase is considered normal. The amount of the hormone increases due to the fact that in the pregnant woman’s body the placenta is connected to the production of testosterone. An excess of the hormone is also due to the fact that the fetus begins to produce it: its content is especially high if a woman is pregnant with a boy.

By the third semester, testosterone in women is at its highest level. It is considered normal if its content in the body increases three to four times or more. Experts find it difficult to voice exact figures. In some women, an increase in hormone levels can be caused not only by pregnancy, but also by ovulation.

Causes of testosterone imbalance

The cause of hormonal disorders will be reliably determined by a doctor who will rely on information obtained during medical research. There are several causes of violations of different nature. If you suspect a deficiency or excess of the hormone, we recommend that you do not hesitate and seek medical help. The following reasons for increased testosterone levels are known:

• Diseases, disorders of the ovaries and uterus: polycystic disease, endometriosis, fibroids, tumor diseases.
• Hereditary factor - hormonal disorders are inherited.
• Disorders associated with improper functioning of the adrenal glands.
• Pathology of the pituitary gland.

The main factor influencing the increase in testosterone levels is incorrect operation adrenal cortex. Also considered a common cause of hormonal imbalance are various diseases genitals. Among the reasons causing low level hormones in women, experts call the following factors:

• Alcoholism.
• Poor nutrition – lack of sufficient carbohydrates in the diet.
• Fasting, a diet based on limited consumption fat

Symptoms of high testosterone levels

A woman will guess that pathological hormonal changes are occurring in the body by external signs. These signs are evidence serious illnesses, therefore, if the symptoms mentioned below occur, it is better to consult a specialist. The sooner you find out and eliminate the cause of hormonal imbalance, the faster the recovery will come. There are such symptoms high content testosterone in the body:

• Accelerated hair appearance – and not only over upper lip, but also on other parts of the face, on the chest. The existing hairs on the legs and arms become thicker, and many new hairs appear. The hair on your head quickly becomes oily.
• Dry, flaky and cracked skin, acne appears.
• The voice becomes rougher and sounds like a man's.
• The body becomes similar to the body of a man, muscle mass is gained, and weight increases.
• There is a desire to increase physical and sexual activity.
• Signs of aggression appear, and for no apparent reason.

How to downgrade?

top scores demonstrates a combination of several measures to lower the hormone. Experts advise carefully studying your diet and, if necessary, revising it. You will have to temporarily abandon the diet; you should include in your diet all the substances necessary for life: proteins, fats, carbohydrates. In addition to vegetables, you should consume foods such as meat, fish, seafood, which contain vitamins, microelements, phosphorus, iron, calcium, and potassium.

To normalize hormone levels, doctors advise doing sports - fitness, yoga. This is especially useful if you have to give up your diet: movement will allow you to burn extra calories without harming the body. Regular yoga and fitness classes will help restore hormonal balance without the use of medications.

If it is impossible to reduce the production of the hormone using the methods described above, doctors will prescribe treatment with folk remedies. In some cases, it is necessary to resort to hormonal therapy. It has been proven that medicinal herbs such as vitex, black cohosh, licorice root, evening primrose and others can normalize the hormonal balance in a woman’s body.

Signs of Low Testosterone Levels

If testosterone in women is contained in small quantities, they experience muscle and psychological fatigue, and these phenomena begin to wear chronic nature. The intimate sphere suffers especially: due to hormonal imbalance, a woman stops producing vaginal secretions: sex begins to bring unpleasant sensations. In addition, the following signs of low testosterone levels are observed:

• Decrease in the amount of hair throughout the body.
• Decrease in muscle mass, constant feeling weaknesses.
• Increase in fat layer under the skin.
• Dry skin.
• Absence sexual desire.
• Bad mood turning into depression.

How to increase when there is a shortage?

If you suspect a lack of testosterone, you should not start taking it on your own. hormonal drugs, it is dangerous to health. If necessary, the doctor will prescribe medical supplies, such as propionate or any other containing sufficient bioavailable testosterone. But before this, the doctor will definitely prescribe the necessary tests, based on the results of which therapy will be prescribed. For normalization hormonal balance We also recommend taking the following measures:

• Eat foods that contain a large number of zinc – seafood, nuts, dietary chicken.
• Eat foods that contain necessary for the body fats and amino acids - seafood, vegetable oil, nuts, seeds, olives.
• Try to get rid of excess fat.
• Reduce the content of estrogen and xenoestrogens in the body. To do this, try to eat foods of natural origin, without pesticides and hormones.

Is treatment possible without hormones?

Treatment for testosterone deficiency or excess depends on the cause of the disease. Thus, there are often cases when hormonal imbalance is caused by poor nutrition, strict diets, and alcoholism. If you start eating right, include in your diet useful material and exclude harmful ones, there are some chances to increase or decrease testosterone levels in the body. In many cases, taking pills and other natural medications will help correct hormonal imbalances. But in some cases it is impossible to do without taking hormones.

Testosterone is a male sex hormone classified as an androgen. Present in the blood of men and women. Begins to be produced during the period of embryonic development in the male fetus by the testes and adrenal cortex, causing correct formation genital organs male type.

A small amount of the hormone is produced during childhood, and during puberty there is a sharp increase in testosterone secretion. In girls, normal production of the hormone by the cells of the ovaries and adrenal cortex begins only during puberty.

Testosterone in men

The biological effects of testosterone in men consist in the body acquiring masculinity - a complex of physiological, psychological and behavioral characteristics that distinguish a man from a woman. These include signs that appear in puberty and persisting throughout subsequent life:

• proper development of male genital organs
• formation of sperm in the testes - spermatogenesis
• hair growth on the face, chest, abdomen, pubis, hair growth on the arms and legs
• growth of bones in length and width, increase in bone density
• muscle mass gain
• changes in the larynx and deepening of voice
• activation of sebaceous and sweat glands

In addition, testosterone in the male body takes part in the regulation of the metabolism of potassium, calcium, phosphorus, salt and water, and in enhancing anabolism ( advanced education) protein in the body, in the formation of sexual desire and potency, and also determines psychological characteristics sexual behavior.

Among women

Women produce testosterone in much smaller quantities than men. The effect of the hormone in women:

• regulation in combination with female sex hormones of egg maturation and corpus luteum, maintaining pregnancy
• sex appeal
• sexual desire
• formation of mammary glands
• regulation of fat and protein metabolism - in women, unlike men, testosterone, on the contrary, leads to increased breakdown of protein in the body
• participation in the growth of skeletal muscles and bones during puberty

Normal testosterone levels in the blood

Fine physiological level the hormone drops. These drops become critical between the ages of 30 and 50 and after 90. The population average does not exceed 25 nmol per liter. If we assess the risk of death, then high testosterone as bad as low. For the elderly, the approximate norm would be 15 nmol per liter.

Deviations from the norm - low testosterone in men

According to statistics, approximately 13% of men under 50 years of age have a hidden or obvious deficiency of testosterone in the body. The reasons for decreased testosterone can be divided into:

Risk factors that contribute to a decrease in the hormone in the blood

• aging – natural cause decrease in testosterone levels in the body; after 40 years, the hormone content decreases by 1.5% per year
• somatic diseases – ischemic disease heart, atherosclerosis, prostatitis. It has been proven that with obesity in men, testosterone production decreases by 2.4 times, with diabetes mellitus - by 2.1 times, with arterial hypertension— 1.8 times
• chronic alcoholism, drug use and smoking
• constant stressful situations, insufficient physical activity, unhealthy diet, including starvation, etc.

Diseases manifested by symptoms of hypogonadism

• congenital defect of the enzyme 5-alpha reductase - inability to convert testosterone into biological active form dihydrotestosterone, as a result of which testosterone in the body is normal, but it cannot act on cells, since it is unable to contact receptors on cells. A boy with such a defect is born with hermaphroditism or severe underdevelopment of the penis (micropenis)
• genetic diseases with primary hypogonadism (underdevelopment of the testicles) - Shereshevsky-Turner syndrome, Klinefelter, etc.
• testicular injuries and tumors
• early castration
• Panhypopituitarism (pituitary hormone deficiency) resulting from a brain tumor, pituitary adenoma
• pituitary adenoma with increased secretion
• constant use of glucocorticoid hormones (prednisolone, dexamethasone) and cytostatics (cyclophosphamide) for rheumatological and hematological diseases

Symptoms of Low Testosterone in Men

If a violation of testosterone synthesis is due to genetic reasons, the male fetus experiences underdevelopment of the external genitalia or their formation according to the female type. False or true hermaphroditism develops - signs of male and female genitalia at the same time.

In the case of a decrease in testosterone during puberty, young men experience a lack of development of the scrotum and penis, slower growth, formation of a female-type figure (wide hips, narrow shoulders, engorgement of the mammary glands), lack of increase in muscle mass, “breaking” of the voice and secondary sexual characteristics – hair growth of the chest, pubis and armpits. In the development of an adolescent, instead of the natural acquisition of signs of masculinity, infantile traits predominate.

In adulthood, the following symptoms help suggest a decrease in testosterone levels:

• depression, mood instability, general depression and lack of desire for life, sleep disturbances
• acquisition of female character traits - tearfulness, touchiness, irritability
• decreased physical endurance, general detraining of the body
• erectile dysfunction, decreased libido
• impaired sperm formation and infertility, decreased seminal fluid volume during ejaculation, eunuchoidity
• muscle tissue atrophy
• decreased saturation of bone tissue with calcium, leading to osteoporosis and frequent fractures
• hair loss on arms, legs and chest
• decreased growth of oxen on the face
• obesity of the “pear” type, or female type – deposition of adipose tissue on the hips and buttocks, in the waist area
• gynecomastia – enlargement of the mammary glands
• sweating, hot flashes, similar female symptoms during menopause

Metabolic consequences of testosterone deficiency:

• Abdominal obesity is two and a half times more common.
• The incidence of diabetes mellitus is increasing; its incidence when testosterone levels drop in men over the age of 40 is 50% higher than the population average.
• Arterial hypertension.
• Increased cholesterol levels and lipid metabolism disorders.

It has not yet been precisely established whether male abdominal obesity or testosterone deficiency is primary. In fact, there is not always a direct relationship between the laboratory-registered level free hormone in the blood and clinic. Meanwhile, it is noted that the lower the testosterone profile, the more visceral fat.

Abdominal fat almost always takes on the role of hormonal activity, producing leptin, which is a biological opponent of testosterone, blocking its production. In addition to leptin, estradiol, which belongs to female hormones, counteracting the effects of testosterone.

The most dangerous manifestation of the activity of fat cells is their production of inflammatory markers and cytokines that are involved in damage to the inner layer of blood vessels, provoking thrombus formation in them.

Increased testosterone in men

Not always increased level hormone indicates pathology. Some men experience excess testosterone in the blood without any diseases during early puberty.

Causes of pathological increase in testosterone in men:

• adrenogenital syndrome (congenital dysfunction of the adrenal cortex - CDA)
• Itsenko-Cushing disease and syndrome caused by pituitary adenoma (gonadotropinoma, corticotropinoma) and tumor of the adrenal cortex (corticosteroma)
• prostate cancer
• testicular tumors
• excessive use of anabolic steroids for the purpose of building muscle mass

Symptoms

In boys and young men, disorders that cause high levels of the hormone are manifested by early “brittle” voices, premature puberty, penis enlargement with lack of scrotal growth, accelerated bone growth, jumps rapid growth. Bone growth plates quickly close early, leaving teenagers with short stature. At adrenogenital syndrome boys from two to three years of age have external signs adult men – hair growth on the face, chest and pubic area, involuntary erection, increased muscle development.

High levels of testosterone in adult men are accompanied by changes in the psycho-emotional sphere - increased aggressiveness, frequent changes mood, impulsiveness. Characterized by high physical endurance and strength, increased sexual desire, long-lasting erection, relaxed relationships with the opposite sex, frequent sexual contacts with different partners. Men with high testosterone have a corresponding appearance - developed muscles without a hint of excess fat, excessive hair growth on the limbs, chest and abdomen, at the same time with hair loss on the head and the formation of a bald spot.

Low testosterone in women

Despite the fact that testosterone is a typically “male” hormone, its role is also important in the female body for the proper functioning of the musculoskeletal, endocrine and nervous systems. Lack of the hormone causes discomfort and affects appearance women.

Causes

In most cases, insufficient formation of the hormone in the body is due to for harmless reasons, the elimination of which leads to normalization of the analysis and regression clinical manifestations. These include:

• menopause
• diet with limited animal fats and carbohydrates, lack of vitamins in food
• alcoholism and smoking
• obesity, sedentary lifestyle, lack of exercise
• long absence of sexual activity
• long-term use

But sometimes androgen deficiency is caused by diseases that require medication:

• diseases of the uterus (endometriosis)
• surgery to remove the ovaries (surgical menopause)
• pituitary adenoma, adrenal insufficiency

Symptoms

These diseases and the condition of the woman’s body, in which there is a decrease in testosterone levels, are characterized by:

• lethargy, apathy, decreased or complete absence of sexual desire, unpleasant sensations during sexual intercourse, lack of orgasms, insomnia, absent-mindedness, low mood.
• the skin becomes dry, thin and flabby, and the amount of hair throughout the body decreases.
• characterized by muscle weakness, fatigue and decreased endurance.
• in women with osteoporosis, diabetes, obesity with fat deposits on the shoulders, hips and buttocks - the level of this hormone is most often reduced

Increased testosterone in women

Women are much more likely to have high rather than low testosterone levels in their blood.

Causes

• pregnancy. In pregnant women, testosterone production increases due to the functioning of the placenta, and its role in the pregnant woman’s body is reduced to regulating metabolic processes. It is considered acceptable to increase the concentration of the hormone in the blood of a pregnant woman up to three to four times, especially if the woman is carrying a boy. But too strong an increase can lead to the threat of miscarriage in the so-called critical periods - 4 - 8 and 14 - 20 weeks of pregnancy.
• ovulation
• hereditary predisposition

In addition to the above natural conditions of the body, an increase in the concentration of androgens is observed with:

• hyperfunction of the adrenal cortex is the most common cause
• virilizing ovarian tumor, polycystic ovary syndrome (PCOS)
• breast cancer
• congenital dysfunction of the adrenal cortex (adrenogenital syndrome)
• pituitary adenoma

Symptoms of high testosterone in women

With congenital hyperproduction of testosterone by the adrenal cortex in a female fetus, signs of virilization are observed - the formation of external genitalia according to the male type with the correct structure of the uterus and appendages. A girl is born with an enlarged clitoris, a high perineum and enlarged labia, which can be mistaken for the birth of a male child with a penis and underdeveloped testicles. If treatment congenital syndrome started on time, and then the girl develops normally.

In girls and young women, hyperproduction of testosterone manifests itself clinically at the age of 6–8 years and is characterized by a low voice, a rapid growth spurt, and excessive hair growth. midline chest and abdomen, on the limbs and pubis, forming a male-type figure - narrow hips and broad shoulders. By the age of ten, the child’s growth stops due to the rapid closure of growth plates in the bones, and short stature develops.

Constantly exceeding the normal concentration of the hormone in the adult female body leads to the acquisition of signs of male appearance.

• Hirsutism is characteristic - hair growth on the arms and legs increases, coarse black hair appears on the mammary glands, the growth of a mustache and beard is possible on the face, while the hair on the head is rapidly falling out, and even patches of baldness may appear.
• The psycho-emotional sphere suffers - the woman becomes more “tough”, rude, aggressive, and quick-tempered.
• Libido increases sharply.
• Purulent acne is noted on the skin of the face and décolleté, and muscle mass increases.
• Violations menstrual cycle– rare scanty menstruation, anovulatory cycles, uterine bleeding, absence of menstruation and inability to become pregnant.
• In women with high testosterone levels, it is observed.
• It is possible to develop obesity or, conversely, excessive weight loss and anorexia nervosa.

What examination is needed?

If deviations from the norm are suspected, the patient is prescribed a study venous blood on the hormone content in it. If there is indeed an increase or decrease in testosterone, the doctor will order further testing. This is necessary in order to accurately identify the cause this state, and determine whether the disturbance in testosterone levels in the body is natural (menopause, “male” menopause, fasting) or caused by some disease that requires active treatment tactics. If the latter is suspected, the following are indicated:

• determination of blood concentrations of adrenocorticotropic hormone (ACTH), somatotropic hormone (GH), prolactin and female sex hormones (estrogens), hormones thyroid gland in order to assess the total in the body.
• Ultrasound of the testicles and prostate gland
• Ultrasound of the mammary glands, uterus and ovaries
• Ultrasound of internal organs and adrenal glands
• MRI of the brain, pituitary gland, adrenal glands

For early diagnosis of adrenogenital syndrome in the maternity hospital, all newborns are screened - an examination for five congenital pathologies, one of which is this syndrome. To do this, blood is taken from the child's heel. In case of a questionable analysis, the child’s parents will be invited to a medical genetic consultation to further clarify the diagnosis. There are often false positive results with this screening.

Preparing for the study

Testosterone is determined in venous blood. The result will be ready within a day. The cost of analysis ranges from 200 to 1000 rubles in different laboratories.

Hormone levels are analyzed on an empty stomach. Two to three days before the study, it is necessary to discontinue any hormonal medications that affect the results, in consultation with the attending physician. For 12 hours you should avoid drinking alcohol and smoking, limit physical exercise and playing sports. For women, the study is recommended to be carried out on days 6–7 of the menstrual cycle.

Do deviations from the norm require treatment?

If a patient has an abnormal testosterone test, the doctor must figure out what is the cause, the disease leading to hormonal imbalance.

Low testosterone. There is a misconception among patients that if an examination reveals a deviation in androgen levels, then they should immediately take testosterone medications. The time for such experiments has passed. In most cases, you first need to reconsider your lifestyle, eliminate provoking factors, and if there is no effect, be examined further.

At the beginning of treatment, it is necessary to reduce the influence of factors that reduce the production of the sex hormone, and only then focus on increasing it. The problem of increasing testosterone should only be approached comprehensively, then the effectiveness of therapy and prevention of androgen deficiency will become much higher.

In men, in the absence of gross pathology of the endocrine system, testosterone imbalance can be corrected by following the following recommendations:

• eating foods rich in zinc - liver, oysters, seafood, nuts, poultry
• consumption of fats contained in oily fish(salmon, mackerel), avocado, olives
• eating mineral-rich foods - legumes, cabbage, turnips, radishes, zucchini, eggplant, celery
• taking vitamins C, A, B and E in courses
• exclusion of alcohol, especially beer, fizzy and carbonated drinks
• limit stressful situations
• regular sex life
• physical activity and training
• fight against excess weight
• strength training with weights two to three times a week

To increase testosterone and build muscle, you should not take anabolic steroid, since their constant use inhibits the body’s own production of hormones, which is fraught with the opposite effect and testicular atrophy.

If there is no effect, according to strict indications and medical supervision, the following testosterone drugs can be taken:

• preparations for oral daily use – andriol. The disadvantage of this form is that the drug must be taken every day, since the hormone is quickly eliminated from the body.
• injection drugs for intramuscular and subcutaneous administration once every two to three weeks - testred cypionate, nebido (once every three months)
• transdermal (percutaneous) forms - androderm patch (pasted on the skin of the scrotum or skin of the thigh, back, chest daily and worn for at least 20 hours), androgel (applied to the skin of the abdomen or shoulders once a day). The downside of the drugs is skin irritation at the site of application.

Cancer, high degree of hyperplasia and unspecified nodules in the prostate gland and breast cancer are contraindications for the use of these drugs.

Safety criteria for testosterone therapy

Between 2007 and 2013, urology and endocrinology practices experienced a boom in the prescribing of testosterone drugs. But since publications appeared about an increased risk of developing myocardial infarction in patients undergoing such therapy, sales of drugs containing the hormone have fallen by a quarter. In the UK, from that time on, urologists began to adhere to the tactics of primary prescribing drugs only for hospital patients, which they only continued, but did not intensify at the outpatient stage.

In 2015, a group of international experts from 11 countries developed nine resolutions regarding the hormone, which were published in the medical press in 2016. Here are some of them:

• There is no age limit for testosterone use.
• The insufficient evidence base of data on high cardiovascular risks published in 2013 has been argued with reason.
• Using the hormone does not increase the risk of prostate cancer.

Recommendations on maintaining work and rest schedules and maintaining good sleep at least 8 hours a day, proper nutrition with balanced consumption of meat and giving up bad habits. Regular sex life, to the best of the body’s ability to engage in physical activity. If these measures have no effect, the doctor prescribes testosterone replacement therapy (Estratest - combination drug, containing estrogens and testosterone, prescribed in postmenopause).

Increased testosterone in young men during puberty it is normal and does not require treatment. At excessive consumption anabolic steroids should be completely discontinued.

If available congenital diseases or tumor process appropriate therapy is carried out - removal of an adrenal tumor, pituitary adenoma or testicular tumor, hormonal therapy (glucocorticoids - dexamethasone for adrenogenital syndrome). Analogues of gonadotropic releasing hormone are prescribed - zoladex, lucrine Depot, diferelin, buserelin, which are also prescribed for prostate cancer. There are dosage forms for subcutaneous and intramuscular administration every day or once a month, as well as a nasal spray (buserelin). The course of treatment is at least three months.

In women with high concentration hormone, non-drug therapy methods are required - maintaining a balanced diet (without fasting or dieting) with limiting fatty meats and carbohydrates, eating large amounts of vegetables and fruits. You should avoid weight training, limit significant physical activity and do yoga. In case of a pronounced excess of the hormone, the doctor prescribes hormonal therapy. Analogs of gonadotropic releasing hormone are indicated for breast cancer, in preparation for in vitro fertilization.

Consequences of hormone deficiency or excess

Testosterone deficiency

• in men, indicates the presence of disorders in the body caused by natural or pathological reasons, which leads to the development of impotence, impaired sperm viability and infertility. In men with similar hormonal disorders Diabetes mellitus, heart and vascular diseases (heart attacks and strokes) are also usually observed.
• In women, this condition causes a decrease in the quality of life due to constantly low mood, depression, suicidal attempts and problems of a sexual nature. Also causal factors can cause osteoporosis and frequent fractures with prolonged healing.

Excess hormone

• in men may indicate prostate cancer, and cancer can be both a cause and a consequence of increased testosterone levels in the body. Due to the high concentration of the hormone in the blood, the pituitary gland begins to produce less regulatory hormones, which causes testicular atrophy with erectile dysfunction and infertility. Increased risk of heart disease vascular diseases, hypertension, bleeding disorders and increased thrombosis, liver diseases.
• Women who have very high levels of testosterone should be examined more thoroughly, as it may indicate diseases of the ovaries, adrenal glands, breast cancer, and also increases the risk of developing obesity and diabetes.

Every woman with infertility must be examined for testosterone levels in the blood, because its excess in the body indicates disruption of the endocrine system, which prevents normal conception and gestation.

Often, such patients, due to the impossibility of spontaneous pregnancy, require IVF. During pregnancy, in case of hormonal imbalance there is a high risk of spontaneous interruption.

Principles of treatment for low testosterone in men

During replacement therapy, hormone levels must correspond to physiological limits, the upper threshold of which will be 25 and the lower threshold 12 nmol per liter. If we make an age sample, then in

• 30-49 years old the maximum will be 23 nmol per liter,
• 50-79 - 17 nmol per liter,
• and over 80 - 15 nmol per liter.

The average therapeutic corridor is between 15 and 23 nmol per liter.

1. Injectable drugs work in such a way that the patient a third of the time has very high levels of the hormone, a third - low, and only a third - normal physiological levels. During high level Testosterone increases cardiovascular risks and reproductive health suffers.
2. Transdermal (cutaneous) forms, regardless of the dose, produce fluctuations in the physiological corridor during the day, so they have a higher level of safety and are preferable. Short-acting forms allow timely discontinuation of treatment if undesirable effects occur.

Testosterone preparations in the Russian Federation

• Andriol is a tablet that must be taken with fatty foods to increase bioavailability. 80-160 mg of the drug after 4 hours gives a testosterone concentration of 40 nmol per liter.
• Omnadren (Sustanon) - injections that increase the hormone up to 70 nmol per liter, which puts it in the category of rather insensitive and potentially harmful drugs.
• Nebido is a milder injectable form with better tolerance, giving a testosterone level of 17 after a week, and 45 nmol per liter after 2 weeks.
• Androgel is a cutaneous option without supraphysiological peaks. 5 mg increases testosterone to a physiological level. After discontinuation of the drug, testosterone begins to decrease a day after last use, returning to the original level on day 3-4.

Prospects for drugs as male contraceptives

Fighting for gender equality, society persistently demands new contraceptive options for men from pharmaceuticals. It is known that high doses testosterone can suppress male fertility. However, extremely high dosages give reverse effect. To date, clinically significant progress has not been achieved in this area, however, research is underway on combinations of testosterone with progestins. Today it has been proven that transdermal forms of testosterone do not work, but promising direction is testosterone undecanoate injectable.

Testosterone resistance theory

At the same level of testosterone, the response of target organs to it varies different men may be different. It's connected with genetic characteristics androgen receptor gene. It is thanks to it that two men with the same hormone production can have different metabolism, sexuality and cardiovascular risks. This gene is located on the X chromosome and comes to the boy from his mother. Roughly speaking, it consists of several repeating triplets of amino acids (cytosine, adenine, guasine).

How more times this triplet is repeated, the worse the receptor binds to testosterone. This receptor not only participates in the differentiation of the baby’s sex, but also determines its future: the development of prostate cancer or hyperplasia, fertility and susceptibility to diabetes and osteoporosis. An important point is the function of the endothelium of the vascular bed determined by the gene (the higher the sensitivity to testosterone, the better the endothelial function) and the tendency to pathologies of the heart and blood vessels determined by it: the risks of heart attack, thrombosis. They are trying to link anxiety, a tendency to depression, and even genius with the characteristics of the androgen receptor.

Testosterone is a truly male hormone, an androgen, which is responsible for masculinity, strength, and the formation of primary sexual characteristics (meaning the genitals). Thanks to the influence of testosterone on the male body, its reproductive function is performed. Of course, small amounts of testosterone can be found in the female body. If it is above a certain norm, then this is a pathology. Also in the male body, a reduced level of the hormone testosterone is considered a symptom of a disease and hormonal disorder.

Androgens - what are they?

There are several types of male hormones, more precisely, they all belong to testosterone, being its components:

• Dihydrotestosterone;
• Androstenedione;
• Dehydroepiandrosterone.

In the body of a man and a woman, testosterone is found in two states - free and bound. And therefore, if you take an analysis in the laboratory to determine the level in the body, then it is necessary to clarify what type of testosterone you have in mind or what type your doctor will look for.

Free testosterone in the human body is the result of metabolic processes. Its level is always within 2%. If a woman has hormonal imbalances, this is manifested by an increase in the level of free testosterone, male-type hair begins to grow on the body, there are no periods, and reproductive function is disrupted.

Important male hormone

Testosterone is a very important male hormone. He is responsible for how a man’s genital organs are formed, for his muscles, body, behavioral response, strength, endurance. Testosterone regulates sexual function and is decisive in a man’s ability to conceive.

If during puberty a young man has any physical abnormalities, then it is necessary to take a blood test to determine the level of the hormone testosterone and check whether everything is normal. At any stage of male development, hormonal levels can be regulated.

If a man has low testosterone levels, this is determined by:

• Sleep disturbance;
• Depressive state;
• Dry skin;
• Excess weight concentrated in the abdomen and hips;
• Sexual dysfunction, a man's reproductive function is impaired.

Testosterone levels in men are: from 12 to 33 nmol/l.

Free testosterone – norm 4.5 – 42 pg/ml.

Biologically active testosterone – the norm is from 3.5 to 12 nmol/l.

Why is testosterone low?

Male hormone levels may decrease due to:

• Depression, stress, neuro-emotional state and unbalanced psychological state(injuries);
• Abuse of alcohol, caffeine;
• Poor nutrition (the diet contains a large amount of fatty, fried, spicy, smoked foods, fast food, carbonated water);
• Long-term treatment with medications that have by-effect– decreased testosterone (carefully read the instructions for all medications you are taking or intend to take!);
• Physical inactivity (office work most often involves a sedentary lifestyle, and after work, few men go in for sports or devote minimal time to active exercise);
• Age (with age in men, testosterone levels decrease and this is a variant of the norm).

When testosterone is elevated, then...

Elevated testosterone levels do not mean masculinity or health benefits. male body. On the contrary, everything that exceeds the norm harms the body. Thus, increased levels of testosterone can cause testicular atrophy in a man and.

If the level of the hormone is elevated, then the man very often gets angry, loses his temper, has a large amount of hair on his body, has acne.

Woman and testosterone

As mentioned above, women have testosterone in their bodies. This hormone is produced by the ovaries and adrenal glands. If testosterone is normal in the female body, then:

• In the ovaries, follicles fully mature, from which an egg is then released, ready for fertilization (that is, the reproductive function is performed);
• A woman’s mood is always normal - she is not aggressive (increased testosterone levels are responsible for aggression);
• The sebaceous glands work correctly and there are no acne, pimples or boils on the body, face;
• The skeleton is developed according to the female type - wide hips, narrow waist, lush breasts.

The average level of testosterone in women is from 0.26 to 1.30 ng/ml.

Testosterone levels in girls under 20 years of age: from 0.13 to 3.09 ng/ml.

• in women from 20 to 40 years old - o t 0.13 to 4.1 ng/ml;
• in women from 40 to 59 years old – from 0.13 to 2.6 ng/ml;
• in women aged 60 years and older – from 0.1 to 1.8 ng/ml.

If testosterone is low in a woman’s body, then...

• concerned about the lack of orgasm and sexual arousal;
• decreased sexual function;
• weakness, lethargy of the body;
• exposure to stress, depression, passive mood.

If testosterone is elevated in a woman’s body, then...

• hair on the body is arranged according to the male type - mustache, beard, abdominal area, back, crotch;
• rough voice;
• acne, comedones on the face;
• reproductive dysfunction – a woman cannot become pregnant;
• scalp hair falls out;
• the genitals are pathologically enlarged (meaning the clitoris);
• the menstrual cycle is disrupted or absent;
• If pregnancy occurs, it most often fails (miscarriage occurs).

Recommendation: if you are planning a pregnancy, both women and men need to take a blood test to determine the level of the hormone testosterone. Otherwise, this may lead to prolonged attempts to conceive or severe consequences in the form of termination of pregnancy due to high levels of the hormone.

Where to go?

You can take testosterone yourself, without a doctor’s referral, in any laboratory. To do this, blood is taken from a vein. Preparation for the analysis consists of: no sexual contact 3 days before the analysis; giving up alcohol, smoking, and eating 12 hours before the test. Blood is donated in the morning, on an empty stomach.

Testosterone is a “male” hormone. It is from this statement that sometimes the conclusion is drawn that women do not have it. This is wrong. Testosterone, the norm in women is lower than in men, is still present in the female body, and it is very necessary. Moreover, in the absence of testosterone in the female body, we are not talking about absolute “femininity”. We are talking about a serious illness. After all, the normal functioning of, for example, the ovaries also largely depends on the presence of testosterone.

Testosterone hormone

It's time to figure out what this “male” hormone does in the female body and where it comes from.

Testosterone is produced in men by the testes and adrenal glands, and in women by the ovaries and the same adrenal glands. Of course, women have much less of it, which is why it is called the “male” hormone.

To compare concentrations, we present the following numbers:

• in women testosterone - 0.31-3.75 nmol/l;
• in men - 5.76-28.14 nmol/l.

For those who no longer remember the school chemistry course: nmol is “nano mole”. The prefix “nano” is 10 -9, and 1 mole is 6.02 * 10 23 molecules. Thus, 1 liter of blood in women contains from 1.8 * 10 14 to 2.25 * 10 15 molecules. Quite a number, as you can see. In grams, the number is less impressive: 0.26-1.30 ng/ml (nanograms per milliliter).

These figures are very conditional and approximate, since they show general level testosterone, without taking into account its varieties and the person’s age. Somewhat - " average temperature around the hospital." Even more. In women, testosterone levels also depend on the time of day! It is highest in the morning. Physical activity can also cause an increase. Interestingly, during pregnancy, testosterone levels in women increase, and several times in the second half of gestation.

Norms for different ages

Testosterone can be free or bound. This means whether it has a connection with the protein structures of the blood or not (with albumin, hemoglobin, etc.). The normal amount of free testosterone is 2-3%.

Norms of total (free + bound) free testosterone for women:

It should be noted that during pregnancy (regardless of a boy or a girl), the level is increased 3-4 times compared to the testosterone level in a woman before pregnancy.

There is also a change in testosterone levels when taking oral contraceptives to a level of 0.24-2.88 nmol/l. In most cases this medicine contains two hormones: estrogen and progestin. Progestin - steroid hormone, it actively “works” during pregnancy, one of the functions of which is to prevent the next egg from being released. In a contraceptive, an “illusion” is created that fertilization has already passed and the ovaries are suppressed, in order to prevent the release of a new egg, which prevents the production of testosterone in full.

As you can see, the concept of normal in women, in relation to testosterone content, is very ambiguous. But, if it is produced even during pregnancy, and even in large quantities than usual, so its function is not only to support the functioning of the ovaries? What else does it affect?

Functions of testosterone in women

As already mentioned, testosterone is produced in women and affects the functioning of the ovaries.

In addition, testosterone regulates the work bone marrow, who is responsible for chemical composition blood.

As already noted, testosterone can be bound or free. If testosterone is free, this does not mean that it does not participate in the work of the body, but simply lies “in reserve”. It is the result of its work, when in excess, that a woman’s voice “coarsens” or “extra” hair appears on the body.

Another “job” of testosterone is to serve as a basis for other hormones. In the cells of a maturing follicle (an egg in the ovary, which is surrounded by a layer epithelial tissue and two layers connective tissue) testosterone is processed into estrogens (in particular, into female estrogens), which in a woman’s body is responsible for the creation of special aromatic substances “pheromones” that attract men.

Another purpose of testosterone in a woman’s body is the development of mammary glands. That is why, during pregnancy (from about the 13th week), the level of testosterone in a woman’s blood increases significantly. In this case, excess testosterone inhibits (slows down) the release of the egg (since this is not necessary during pregnancy). But, in the absence of pregnancy, this can lead to disruption of the rhythm of menstruation or their complete cessation.

Testosterone itself is not very chemically active, therefore, in essence, it is not a hormone, but a prohormone, a substance from which hormones (estradiol and dihydrotestosterone) are subsequently produced.

And of course, testosterone is responsible for the formation of “secondary male sexual characteristics”: muscle mass, skeletal mass, etc. That is why many drugs for athletes contain testosterone. Of course, with an excess of testosterone, women experience an enlargement of the skeleton and an increase in muscle mass, hair may appear in places uncharacteristic for women, etc. But women need it in minimal quantities (women, after all, also have a skeleton and muscle mass, which can be There is no need to build up, but it is worth maintaining).

Also, an overdose of testosterone can lead to skin diseases, in particular: acne (acne skin disease due to blockage of the sebaceous gland around the hair), seborrhea (disruption of the sebaceous glands of the skin), etc. This is due to the fact that the sebaceous glands are sensitive to testosterone and excess testosterone causes them to function in “ emergency mode, which can lead to malfunctions.

What factors change testosterone levels in girls?

In addition to pregnancy, factors that change the amount of testosterone in the blood are:

1. Age-related changes in the body (adolescence, menopause, etc.).
2. Diseases of the endocrine system or complications after other diseases that cause disturbances in the functioning of the endocrine system.
3. Wrong diet. In this case, we are talking about an excessive desire to lose weight. As a result, the body “throws” more testosterone into the blood, increasing energy and aggressiveness (secondary male sexual characteristics)
4. High physical loads to which the body tries to respond by “strengthening” the skeleton and muscle mass, increase the amount of testosterone in the blood. Moreover, this does not necessarily happen with weight gain. If you pay attention to the figures of many ballerinas or gymnasts, you will see that there is no excess weight, but their shoulders are developed. It is characteristic that for gymnasts this is somehow justified from the point of view of the fact that they have exercises on the bars, but for ballerinas their shoulders grow even without such loads on their arms, simply due to the increased amount of testosterone produced due to loads in general, and not specifically on the hands.
5. Perhaps the worst and most dangerous of the options is disruption of the ovaries due to some kind of inflammatory processes (or another problem related specifically to the ovaries). This problem You can’t solve it anymore by “normalizing” your diet, regimen, etc. Even medications don’t always exist to solve such problems. It's all about the “isolation” of the female reproductive system. To dosage form worked, you should take, for example, tablets with food. The medicine must pass through the digestive tract, without disintegrating in the acidic environment of the stomach, be absorbed into the blood and reach the ovaries, without harming other organs. There is, of course, the option of a “direct” injection, but you still have to get it right. Therefore, it is often necessary to resort to surgical methods. This is, of course, an extreme case, but it needs to be treated.

Normalization of hormonal levels

First of all, it is recommended to balance your diet. The body must receive the necessary diet every day. Juices (preferably freshly squeezed), dairy products with medium fat content, a small amount of sugar and salt, vegetable oils, possibly caffeine and honey.

In some cases it may be prescribed drug treatment. Moreover, various hormonal drugs in this case are an extreme measure. There are, for example, medicinal “female” herbs that reduce testosterone levels: evening primrose (or “evening primrose”), angelica, black cohosh (cohosh). In many cases, it will be rational to combine folk remedies with traditional medicine, but you cannot do this on your own without consulting a doctor, so that there is no conflict between the active ingredients.

From pharmaceuticals, which reduce the level of testosterone in a woman’s body, can be identified: Cyproterone, Dexamethasone, Digitalis, Digostin, Diethylbestrol, Diane-35. Here, however, it should be noted that in the instructions themselves of many of these drugs, the antiandrogenic effect is written not as a purpose of the drug, but as one of the effects produced. And the purpose of the medicine could be, for example, “contraception”. Therefore, before using this medicine, you should definitely consult your doctor.

Hormones are very serious. Together with nervous system they implement the function of a regulator in the body. To one degree or another, changes in the level of hormones in the blood affect all organs of the body.

If the cause of the increase in hormone levels is not the adrenal glands, but the ovaries, then the use of contraceptives may well be unacceptable. And in general, it doesn’t make much sense to fight the effect; the cause should be corrected. But, in any case, “amateur activity,” especially in relation to sex hormones, can lead to very bad irreversible consequences. Surely everyone will agree that fighting acne at the cost (or even risking) of reproductive function is somehow wrong and illogical.

Every phenomenon has its own reasons. Taking some tincture from medicinal herbs, there is a risk of “finishing off” the adrenal glands if the failure in testosterone production is their fault.

It doesn't work without a doctor. Don't listen to your friends or pharmacists. Because their knowledge is based on simple statistics: “everyone is prescribed this medicine.” But where is the guarantee that this particular case is the same as “everyone’s”? A lot of people fall during winter ice and it’s okay, but one in a hundred will break something, and one in a thousand will hurt their head.

The hormone testosterone is present not only in men, but also in women.

Concentration important substance among the fair sex it is much lower.

Excess and deficiency of the male sex hormone negatively affects the functioning of the female body.

What is free testosterone? The norm for women during pregnancy, during menopause, causes of lack/excess of male sex hormone. What drugs are prescribed to correct testosterone levels? What signs indicate hormonal imbalances? The answers are in the article.

Many women ask the endocrinologist questions: “Why does the fair sex need the male hormone? Perhaps this substance harms the body, provokes the development dangerous pathologies, leads to hormonal imbalances?

Doctors explain: “Lack of testosterone negatively affects the development of the female body. The male hormone has a positive effect on many processes, participates in the synthesis of estradiol, and regulates the rhythm of menstruation.”

Testosterone also performs other important functions in the female body:

• participates in protein synthesis;
• regulates the growth and development of the mammary glands;
• strengthens muscles, participates in the formation of the skeleton;
• responsible for sexual desire in women;
• influences the timely maturation of the follicle in the egg;
• supports correct work sebaceous glands.

Testosterone is a prohormone, a substance with fairly low chemical activity. On its basis, the production of hormones occurs - estradiol and dihydrotestosterone.

Free testosterone index: normal

The content of the male sex hormone in women is 7–12 times lower than in men.

Testosterone is produced by the adrenal cortex and ovaries.

The concentration of an important substance involved in many life processes is measured in nanomoles per liter.

The optimal indicators are the concentration of free testosterone (in nanomoles per liter).

Men
From 5.76 to 8.14	From 0.31 to 3.78

During pregnancy, indicators increase sharply (on average, from the 13th week). The process does not happen by chance: an excess amount of male hormone inhibits the release of the egg.

If testosterone levels are various reasons increases noticeably in non-pregnant woman, then the frequency of menstruation is disrupted or they completely stop until hormonal levels are restored.

At different periods of the menstrual cycle, the rate of free testosterone in women differs: follicular phase– from 0.45 to 3.75, ovulation period – from 0.46 to 2.48, luteal phase – fluctuations from 0.20 to 1.73 pg/ml.

Age

The level of testosterone in the female body changes at different periods of life. Deviation from the norm worsens hormonal levels, provokes obesity or excessive thinness, reduces muscle mass, leads to brittle bones, and causes problems with reproductive function.

No.	Age	Testosterone level (measured in nmol/l)
1	Up to 12 months	From 0 to 2.31
2	From 1 year to 6 years	From 0 to 1.22
3	From 6 to 11 years	From 0.49 to 1.82
4	From 11 to 15 years	From 0.84 to 4.46
5	From 15 to 18 years old	From 1.36 to 4.73
6	Women of reproductive age	From 0.31 nmol/l to 3.78
7	During pregnancy	Increasing performance by 3–4 times compared to point 6
8	Menopause	From 0.42 to 4.51
9	Against the background of the use of oral contraceptives	From 0.45 to 2.88

Index

During the research, doctors found: maximum concentration of an important substance was noted in the morning; by the evening the levels decrease.

Significant fluctuations in hormone levels in women negatively affect the functioning of the entire body.

To clarify testosterone levels, a blood test is prescribed. The optimal period is from 8 to 10 days of the cycle.

Preparation rules:

• women who smoke should give up cigarettes several hours before the test;
• the day before donating blood, it is not advisable to be nervous or play sports;
• for 24 hours before the test, you should not take hormonal medications or eat fatty or spicy foods;
• It is important to donate blood on an empty stomach; you should not drink liquid.

Causes of Low Testosterone

Provoking factors:

• passion for diets;
• vitamin deficiency;
• excessive alcohol consumption, smoking;
• overweight;
• malfunction of the gonads;
• Down syndrome;
• severe form of renal failure;
• menopause period;
• sudden weight loss.

A decrease in male sex hormone levels provokes diseases and negative conditions:

• depression;
• damage to the heart and blood vessels;
• excessive sweating;
• increased dryness of the skin;
• chronic fatigue;
• irritability;
• decreased density, disruption of bone tissue structure - osteoporosis develops;
• accumulation of fat on the arms, thighs, abdomen;
• decreased libido;
• development of hormone-dependent tumors;
• decreased concentration, poor memory of information;
• malignant neoplasms in the mammary glands;
• discomfort, vaginal dryness during sexual intercourse;
• diabetes;
• weakness, low physical activity;
• uterine fibroids;
• endometriosis.

Causes of high testosterone

Excess male hormone appears due to the following factors:

• genetic predisposition;
• ovulation period;
• improper, irregular nutrition;
• excessive activity of the adrenal cortex;
• long-term use of hormonal drugs;
• third trimester of pregnancy;
• tumors in the ovaries.

Main features:

• increased physical activity;
• irregular menstrual cycle;
• a sharp increase in sexual desire;
• the face and body are covered with acne;
• the size of the clitoris increases;
• deepening of the voice;
• alternation of periods causeless aggression and apathy;
• reduction of body fat;
• Excessive hair growth on the face (above the upper lip) and body (in armpits, on the arms, legs);
• discomfort in the ovaries and lumbar region;
• problems sleeping, irritability;
• infertility due to lack of ovulation;
• active muscle building;
• enlargement of individual parts of the skeleton according to the male type (widened shoulders).

How to normalize testosterone levels

1. Visits to an endocrinologist, gynecologist, examination, tests, identifying factors that provoke hormonal imbalances. Medication or surgical treatment in the presence of endometriosis, ovarian cysts, tumors, uterine fibroids. It is important to eliminate abnormalities of the reproductive system organs.
2. Treatment of chronic diseases, against the background of which immunity decreases, develops pathological processes V various organs. Special attention - endocrine pathologies, which negatively affects the functioning of the genitourinary system in women.
3. Diet correction. Balanced diet- the basis of therapy. Only with a sufficient amount of vitamins, minerals, regular intake biologically active substances You can restore health from food. More fresh vegetables, fruit and berry juices, low-fat fermented milk products. The bird is useful lean fish, seafood, vegetable oils, nuts, honey, leafy greens.
4. To reduce testosterone levels, a decoction of “female” herbs is prescribed: primrose, black cohosh, angelica. Medicinal plants used only on the recommendation of an endocrinologist and gynecologist.
5. You can bring the indicators back to normal when the concentration of the male sex hormone increases with the help of drugs: Dexamethasone, Digostin, Diane-35, Cyproterone. If the cause of the failure is the improper functioning of the ovaries, and not the adrenal glands, then contraceptives should not be used. Diseases need to be treated and stopped inflammatory process, remove tumors. In each case, the doctor develops a treatment regimen individually.

If signs indicating problems with hormonal levels, you should not self-medicate, uncontrollably take herbal infusions or oral contraceptives.

Only based on the test results, after clarification of the level of free testosterone, examination by an endocrinologist and gynecologist, therapy under the guidance of experienced doctors. It is important to give up bad habits, be sure to reconsider your attitude towards life, and adjust your diet.

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