In Part 1 of this series, I covered the enzyme aromatase that converts testosterone into estrogen in a process called aromatization. I also covered what can go wrong when this enzyme is either underactive or overactive. Aromatase inhibitors, such as insulin, are an underlying factor in high androgens in women, and is our topic for today.
Keep reading to learn more about:
● Hormone tests for women
● The case of high androgens in women
● How to reduce androgens in female naturally
Let’s get started!
Hormone Tests for Women
In my practice, I use standard and functional testing along with an understanding of my patient’s symptoms, history and story. Testing often includes:
● Comprehensive metabolic panel – Metabolic health informs us of hormonal health. This is a panel of 14 blood tests that look at kidney and liver function, electrolytes, protein and blood glucose.
● The DUTCH hormone test – This is a dried urine hormonal panel test that takes an important look at testosterone and other androgens, estrogen and estrogen
metabolites, progesterone and progesterone metabolites, cortisol levels and the daily cortisol pattern and other hormone, neurotransmitter and nutrition markers. It also gives us a view into aromatase activity.
In the DUTCH test example below, you can clearly see the aromatase pathway (with the dotted lines) from testosterone to estradiol (and from androstenedione to estrone too). In this patient, aromatase is overactive, resulting in high estrogen, but low testosterone.
● Hormone blood tests – I look at thyroid hormones, pituitary hormones, insulin and testosterone levels in the blood.
Androgens in Women – How Much Is Too Much?
Let’s circle back to androgens in women. Androgens are often referred to as “male” hormones but play an important role in women’s health too. Androgens help us build muscle, have drive and are necessary for healthy organ function. The problem arises when we have either too much or too little.
“Androgens are often referred to as “male” hormones but play an important role in women’s health too.”
High testosterone is a common hormonal imbalance that I see in my practice, with PCOS and in other cases as well. When levels are on the high end of the lab range or over the lab range, women may begin experiencing unwanted symptoms like hair loss on the head, hair growth on the chest or face, acne, aggression and changes in the menstrual cycle.
Optimal testosterone, and other androgen levels, depend upon age. Be sure to work with your provider for personalized review of your lab tests.
How To Reduce Androgens in Female Naturally
If testing and symptoms align with a high testosterone pattern, consider that insulin resistance could be a driver. It is often the number one piece to address and can be done so with diet.
“If testing and symptoms align with a high testosterone pattern, consider that insulin resistance could be a driver. It is often the number one piece to address and can be done so with diet.”
It might mean a large overhaul of the diet as women tend to have dietary preferences and patterns that they’ve followed for decades, but with education and consistency, profound changes in hormone balance and metabolic health can be made with food.
Here are some important diet and lifestyle tools to address insulin resistance if it is a root cause:
● Balance blood sugar. Ear regular, balanced meals composed of whole foods that include colorful produce, healthy fats and enough protein. Consider using a continuous glucose monitor to learn more about how your body responds to different foods and meals.
● Exercise. Exercise is a great way to lower blood sugar without the need for insulin. Time exercise to after your highest carb meal of the day. Even walking after meals is helpful. But some research points to HIIT training twice a week, especially in the follicular phase (first half of cycle) to be helpful for women struggling with high T due to underlying insulin resistance.
● Prioritize sleep. Our sleep schedule sets our circadian rhythm, which supports hormonal rhythm and balance too. Poor sleep increases our drive to eat higher glycemic foods, perpetuating the vicious cycle of increased insulin and testosterone. It’s also a major stress on our system. Speaking of stress…
● Manage stress. Don’t skip this step! When stress is high (like we discussed with sleep), cortisol goes up, which makes our blood sugar go up too. This is how stress contributes to insulin resistance. But it’s not just poor sleep – stress comes in so many forms from worrying about your children to making that deadline at work. All stress matters so don’t shrug it off.
While working on lifestyle change, we can often use supplements to influence hormones in the direction we are going. For high testosterone, specifically, here are some supplements to consider:
● EGCG in Green tea
● White peony
● Nettles (stinging nettle)
● Saw Palmetto
Here are the main takeaways from this series on hormone balance, aromatase and metabolic issues:
1. Always test. Different hormone patterns may present with similar symptoms, and it is worth understanding exactly what is going on to effectively bring hormones back into balance.
2. Consider aromatase. For high testosterone in women especially, but other hormonal patterns as well, consider the role of aromatase. The biggest driver to changes in aromatase is insulin resistance.
3. Address the root causes. Use testing to see if insulin resistance is a driver for your metabolic and hormonal symptoms and work on reversing this first.
4. Use targeted supplements. Supplements are a great tool to support hormonal health and the specific imbalances you may face.
5. Work with a functional medicine provider. Don’t try to do this on your own; collaborate with someone knowledgeable who is able to personalize your treatment plan and use a variety of medical, herbal and nutritional tools.
I’m currently taking new clients in my practice and hormone balance, in women of all ages, is one of my passions and specialties. Please reach out if you’d like to connect and collaborate on your health journey.
1. Regidor, P. A., Schindler, A. E., Lesoine, B., & Druckman, R. (2018). Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature. Hormone molecular biology and clinical investigation, 34(2),
2. Nagata, C., Kabuto, M., & Shimizu, H. (1998). Association of coffee, green tea, and caffeine intakes with serum concentrations of estradiol and sex hormone-binding globulin in premenopausal Japanese women. Nutrition and cancer, 30(1), 21–24. 3. Grant, P., & Ramasamy, S. (2012). An update on plant derived
anti-androgens. International journal of endocrinology and metabolism, 10(2), 497–502.
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