Part Ten of the Harmonising Hormones Series!
Excess testosterone is not just a few annoying hairs, it can affect your family fertility goals and your metabolic health. There is a huge genetic component but also, helpfully, a lot you can do to turn the tide in your favour.
We definitely need adequate amounts of testosterone.
It is essential for building muscle, strong bones and overall health and energy levels. It can also regulate our metabolism, sexual function and desire. Testosterone can also contribute to your overall vivacious spirit, it promotes feelings of agency and self-confidence! Other androgens produced and needed by our body include: Dehydroepiandrosterone (DHEA), androstenedione and dihydrotestosterone (DHT)
When androgens get too high, however, they can begin to cause problems such as PCOS, infertility and some of the other below described symptoms. In some severe cases, the evaluation and assistance of a medical doctor/endocrinologist is needed. More often, it is a few uncomfortable symptoms that indicate an imbalance that can be addressed through some feel-good dietary and lifestyle changes. Take note of the symptoms below and take action to restore your hormones to optimal.
What are the symptoms of excess androgens?
- excess hair (on face, back or stomach) or and thinning hair on head, greasy skin or hair
- discolouration of armpits (they appear darker)
- acne, skin tags
- unstable blood sugar
- reactivity or irritability, depression or anxiety
- delayed menstrual cycles
- ovarian cysts, PCOS
- mild cycle pain, infertility
More on Poly Cystic Ovarian Syndrome (PCOS)
Close to 82% of women with increased androgens will develop PCOS. PCOS is major factor reducing fertility and something that often goes undetected but for some of the symptoms to the left. Insulin resistance is another unfortunate characteristic of PCOS but something that can absolutely be managed with a fabulous nutrition plan.
See the resources on insulin and insulin resistance.
Co-morbidities: poorer cardio-metabolic health, potentially precancerous changes, mood problems, liver dysfunction. This information is not to scare, it is to educate, encourage action and further validate your quest for health and high quality treatments. Addressing the root cause of the problem and taking preventative actions can mitigate the symptoms of PCOS and improve life and health quality.
How do you go about diagnosing PCOS?
Symptoms include: Difficulty losing weight, acne, rogue hairs, inflammation, insulin resistance.
Tests: on day 21 of your cycle, getting progesterone, fasting insulin & glucose and CRP (to check for inflammation). Scans to look for cysts in a ‘string-of-pearls’ pattern around the ovaries.
Contributing factors to excess androgens
Genetic vulnerability can play a role but this is not cause for giving up or feeling your biology is set in stone. Symptoms can be managed and the right lifestyle and nutrition choices can shift you in a more positive direction. Testing for (very rare) androgen-secreting tumors, congenital adrenal hyperplasia (CAH) and other rare inherited disorders is the first step to assessing options such as bio-identical hormones or other medical interventions. Treatments for CAH and PCOS differ and testing is therefore an important step.
Body composition: excess body fat stores and metabolic dysfunction is associated with abnormal levels of gonadatropin. This has down stream affects on the delicate balance between luteinising hormone, follicle-stimulating hormone, oestrogen and testosterone.
Stress can increase the production of cortisol and androgens an anxiety has been implicated in excess production of DHEA. See the resources on building resilience to stress and managing caffeine intake.
Taking action against excess androgens, hair loss and PCOS
Using nutrition: Losing weight and improving your metabolic health through nutrition is an excellent intervention! Things to increase: your fibre by getting creative with beans and loading up on fresh vegetables. Dietary zinc with red meat and pumpkin seeds. Protein, great sources include organic chicken, turkey and lean red meats . Oily fish such as salmon and mackerel are also amazing options which can lower inflammation with their high omega-3 content. Things to avoid: conventional dairy can lead to increased inflammation and excess androgens. Sugar does dastardly work on insulin, body fat stores and promotes excess androgens. Opt for whole foods that are lower on the glycemic index. Fried foods and inflammatory oils like vegetable, canola and sunflower oil. Avoiding foods that are packaged and made in a factory is a difference you can feel in your jeans size, energy levels, sleep and the blissful hormonal balance that begins to envelop you. The recipe below is an example of a high fibre, whole food, dairy free meal that tastes excellent and can be made in bulk for family meals or meal prepping.
Using exercise: Establishing exercise as part of your routine can work to reduce chronic stress, balance hormones, improve cardiovascular health and help you to lose weight. Weightlifting is an important component for improving the metabolic function of your muscles and reducing the co-morbidities associated with PCOS.
Using other behaviours: Minimise your exposure to BPA (found in some plastics and receipt papers). Reduce stress where you can by taking walks, practicing yoga, pilates and other low intensity exercise. Connect and laugh with friends and family members. Consider volunteering and finding other ways of enjoying the stress buffering effects of having purpose and meaning. Evaluate your work load and strategise how you can set helpful boundaries and refine your work practice to find a balance between being productive whilst avoiding burnout. Practicing re-appraisal techniques and building resilience to stress are discussed in the following resources.
Supplementation:
- Chromium (200-1,000mcg/ day) for insulin resistance
- Inositol/ vitamin B8 (2g once or twice/day)
- vitamin D (2,000IUD/day)
- Berberine (500 mg, 3/day)
Helpful herbal remedies:
- Cinnamon (1/2tsp/day) can improve cholesterol levels, insulin sensitivity and fight free radical damage associated with excess androgens.
- Saw Palmetto (160mg/day) has been shown to reduce the conversion of testosterone to the more powerful DHT and can block androgen receptors.
- Tian Gui from traditional Chinese medicine is a composition of various herbs that demonstrates lowering effects on androgens.
Specific to hair loss:
Did you know low iron, thyroid imbalance and insulin resistance and autoimmune conditions can also cause hair loss?
Tests to ask for include: Blood count & ferritin to assess iron levels and immune function. TSH &T3 to assess thyroid, cortisol, fasting insulin & glucose, testosterone to check for PCOS, insulin resistance or PCOS. Testing antinuclear antibodies will assess autoimmune conditions. and then refining your approach to the root cause using the resources specific to that options following sound medical advice.
Need someone who will work with you across the full spectrum of your health? Hormones, nutrition and exercise are all key parts and I’m here to simplify and help you take action.
Further resources and reading
Burns, A. C., Saxena, R., Vetter, C., Phillips, A. J. K., Lane, J. M., & Cain, S. W. (2021). Time spent in outdoor light is associated with mood, sleep, and circadian rhythm-related outcomes: A cross-sectional and longitudinal study in over 400,000 UK Biobank participants. Journal of Affective Disorders, 295, 347–352. https://doi.org/10.1016/j.jad.2021.08.056
Dobbyn, S. (2008). The Fertility Diet : How to Maximize Your Chances of Having a Baby at Any Age. Simon & Schuster, Limited.
Fauser, B. C. J. M., Tarlatzis, B. C., Rebar, R. W., Legro, R. S., Balen, A. H., Lobo, R., Carmina, E., Chang, J., Yildiz, B. O., Laven, J. S. E., Boivin, J., Petraglia, F., Wijeyeratne, C. N., Norman, R. J., Dunaif, A., Franks, S., Wild, R. A., Dumesic, D., & Barnhart, K. (2012). Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertility and Sterility, 97(1), 28-38.e25. https://doi.org/10.1016/j.fertnstert.2011.09.024
Ferrazzi, Enrico., & Sears, Barry. (Eds.). (2015). Metabolic Syndrome and Complications of Pregnancy : The Potential Preventive Role of Nutrition (1st ed. 2015.). Springer International Publishing. https://doi.org/10.1007/978-3-319-16853-1
Rosenfield, R. L. (2024). The Search for the Causes of Common Hyperandrogenism, 1965 to Circa 2015. Endocrine Reviews, 45(4), 553–592. https://doi.org/10.1210/endrev/bnae007
Vishnubhotla, D. S., Tenali, S. N., Fernandez, M., & Madireddi, S. (2022). Evaluation of Prevalence of PCOS and Associated Depression, Nutrition, and Family History: A Questionnaire-based Assessment. Indian Journal of Endocrinology and Metabolism, 26(4), 341–347. https://doi.org/10.4103/ijem.ijem_467_21
Vollmer, J., Christian, W. J., & Lacy, M. E. (2024). Diabetes screening among women with polycystic ovary syndrome: a descriptive study of commercial claims, 2011-2019. BMC Endocrine Disorders, 24(1), 194–196. https://doi.org/10.1186/s12902-024-01717-y
Witchel, S. F., Teede, H. J., & Peña, A. S. (2020). Curtailing PCOS. Pediatric Research, 87(2), 353–361. https://doi.org/10.1038/s41390-019-0615-1
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