What should I do if my testosterone levels are high?

Testosterone, also known as androgen or “testicular hormone,” is a male sex hormone. While testosterone is predominantly present in males, it is also naturally produced in females. In males, testosterone is primarily secreted by the testes; in females, it is mainly produced by the ovaries, with minor contributions from the adrenal glands. Although circulating testosterone levels fluctuate, they generally remain within a physiological range. Certain medical conditions may cause abnormally elevated testosterone secretion—a relatively common clinical issue. So, what should one do if testosterone levels are too high? Let’s explore the options below.

What to Do When Testosterone Levels Are Elevated

1. Pharmacological Treatment

Patients with elevated testosterone may benefit from drug therapy aimed at suppressing androgen production or blocking androgen action, controlling body weight, and reducing hirsutism. The primary pharmacological agent used for hyperandrogenism is cyproterone acetate–ethinylestradiol tablets. This medication counteracts the effects of androgens and promotes follicular maturation and ovulation. Typically, treatment lasts for approximately three to six months. Therapy should begin on the first day of menstruation and continue for 21 consecutive days, followed by a 7-day drug-free interval. During treatment, patients must undergo periodic assessment of the six key reproductive hormones (i.e., serum FSH, LH, estradiol, progesterone, testosterone, and prolactin). Once hormonal parameters normalize, medication may be discontinued.

Women diagnosed with polycystic ovary syndrome (PCOS) may additionally be prescribed metformin tablets, usually taken with the first bite of each meal. Metformin helps reduce intestinal glucose absorption, thereby preventing weight gain. When combined with postprandial administration of cyproterone acetate–ethinylestradiol tablets, metformin can effectively lower serum testosterone levels.

2. Surgical Intervention

If pharmacotherapy proves insufficient—particularly when androgen levels fail to decline significantly—laparoscopic surgery may be considered. Under laparoscopic guidance, ovarian follicles may be punctured to reduce androgen production and achieve therapeutic goals.

(1) For patients who have completed childbearing and have no further fertility intentions, oophorectomy may be performed.

(2) For patients wishing to preserve fertility, laparoscopic electrocautery or laser ablation of ovarian cysts can help lower androgen levels.

The above outlines management strategies for elevated testosterone levels. We hope this information is helpful to you.