4 Causes of High Testosterone in Women

There are many causes of high testosterone in women, and the symptoms of high testosterone levels can be just as debilitating as low testosterone levels.

However, men and women usually come to us because they have low testosterone — in fact, many women are misdiagnosed with high testosterone (when in reality, you might have low testosterone).

Learn more about how you may have been misdiagnosed with high testosterone (and how low testosterone might actually be the problem).

causes of high testosterone in women

For women, low testosterone can be a nightmare. Fatigue, low sex drive, weight gain—all these and more can be debilitating for women suffering from low testosterone.

Women can have low testosterone for many different reasons, and getting those levels back to a normal level can turn their lives around — sometimes, this doesn’t happen for years because they’re misdiagnosed with high testosterone.

But what about high testosterone?

Women certainly don’t have normally high levels of testosterone. In fact, the average woman has about a tenth of the amount of testosterone that a man has.


But just like men, women can suffer a variety of different diseases and disorders that can cause their testosterone to become too low or too high. There are many different causes of high testosterone levels in women, and some of them are more common than others. Here are 4 different reasons why women might have high testosterone levels.

(Also, if you want to learn more about our testosterone therapy services for women, click here.)

1. Polycystic Ovarian Syndrome (PCOS)

This is one of the more common causes of high testosterone in women. Not only does this disease affect 5-10% of American women, it can also cause testosterone levels to skyrocket, resulting in a variety of symptoms. If you’re experiencing excess acne, excessive hair growth (especially on the face), or infertility, this may be the culprit.

2. Adrenal Disease

Another one of the causes of high testosterone in women is late-onset congenital adrenal hyperplasia. The adrenal glands cause your body to disrupt the delicate balance of hormones in your body, resulting in too much testosterone. A hormonal test by a medical professional may be enough to diagnose this issue.

3. Diabetes

Diabetes may also be one of the culprits behind your high testosterone levels. Diabetes is a complicated disease, and the connection between diabetes and obesity may be partially responsible for these fluctuations in testosterone levels. However, the symptoms of high testosterone are the same as the above diseases—Keeping your diabetes under control is one way to fight any symptoms you might be experiencing

4. Other Causes of High Testosterone in Women

Unfortunately, because testosterone plays a role in so many bodily functions in both men and women, many diseases and disorders can affect it. If you are suffering from any of these illnesses, it may be the cause of your high testosterone:

  • Dwarfism
  • Gigantism
  • Acromegaly
  • Adrenal neoplasm disorders
  • Cushing’s syndrome
  • Adrenal or ovarian tumor
  • Conn’s syndrome
  • Congenital adrenal hyperplasia
  • Thyroid disorders

Any of these causes of high testosterone in women needs to be diagnosed by a medical professional, but some of the symptoms can be treated, depending on the illness or disorder.

If you think you have a hormone imbalance and want to get your hormone levels checked, click below to sign up for your free consultation.

Two sets of lab tests, done on different days, are required to confirm the diagnosis of Low T. The cost of the two sets is $200, and the associated consultation is free.

Sign up here

And if you’ve been diagnosed with high testosterone, learn why you may have been misdiagnosed (and why you might want to get retested).


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Glenn Steponaitis, PA-C

Glenn Steponaitis, PA-C began his healthcare career nearly 20 years ago as a medical technician at Seton Medical Center while concurrently earning a Bachelor of Arts degree in Biology at the University of Texas in Austin.   His interest in medicine lead him down the path of becoming a certified Physician Assistant and achieving a Bachelor of Science degree in this field from the University of Texas Southwestern Medical Center at Dallas.   Following completion of his schooling, Glenn started a 10 year career in the field of Gastroenterology and Hepatology, and in 2010 he began focusing on the medical management of those suffering from symptoms caused by low testosterone after witnessing hormone replacement doctors help Low T sufferers.


  1. Lina Pagliuso on 07/24/2015 at 7:25 am

    I had POSC and high testosterone for years, now it has been higher since
    menopause at the age of 55 and a gradual degrease of hair and increase of
    body hair. As of 2012 my adrenal gland cat scan was normal. Since POSC
    is an ovarian problem, at my age would natural herbs help like Yam and
    saw palmento ?

    • Augie Galindo on 08/06/2015 at 5:38 pm


      Potency is the big issue with natural herbs and nutritional substances. You can often find claims that the “active ingredient” is proven effective, but the amount that OTC supplements deliver is usually sub-optimal. Balancing hormones is a delicate and involved process that will likely require frequent lab assessments and close monitoring from a knowledgeable provider.

      • Jai on 04/19/2016 at 8:31 pm

        Hello. I’ve been reading the comments and feel like you might have great advice for me.
        I’ve been experiencing a lot of head hair loss, feeling fatigued, weight gain. My ferritin was 258 December 2015. Checked last week came down to 155. My total testosterone was 55(don’t know if that’s high). Free T was normal,6. Not sure what normal progesterone and estradiol are but that was checked. Free t3 was on higher end of normal. What do you suggest and ideas on what I can ask dr about At my appt next week. Everything else seemed normal Thank u.

        • Augie Galindo on 04/19/2016 at 11:34 pm


          There are a few blank spots that I will have to fill in here, so please forgive any inaccurate assumptions. It appears that your ferritin and total testosterone levels are normal. If you free testosterone level is not a calculated free T or an equilibrium dialysis assay, then I would make any decisions based on this test. However, a calculated free T of 0.6 is in fact normal.

          Most people’s free T3 is not elevated unless they are on therapy for it. If you are, naturally desiccated thyroids products like Nature-Throid or Cytomel have been known to cause hair loss in a minority of patients. Are you on treatment for hypothyroidism? Estrogen and progesterone levels may also offer some insight.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

          • Ehren on 05/25/2016 at 11:46 pm

            Hi. Im 20. Ive had regular periods until middle of last year then theychave been irregular. I had blood testing done as well as ultrasounds and turns out i have high testosterone.. my gyn put me on a birth control. .just wondering if this will help it go away? Im wanting to try for a baby soon now that i got married..

          • Augie Galindo on 05/27/2016 at 3:01 pm


            Great question! Before I answer, I want to direct you to my blog post that goes into detail about what I am about to say.

            A “high” testosterone level may not be high at all, and if your provider never looked at your calculated free testosterone, you may have some very important puzzle pieces missing from your clinical picture. Birth control pills are a poor answer to hormonal problems. Keep in mind that their sole purpose is to keep your body from working the way it is supposed to. Now, oral contraceptives can certainly lower testosterone levels, but that may not be what your body really needs. You need to make sure that treatment is directed at fixing problems, not just treating numbers.

            Best regards,

            Augie Galindo, MPAS, PA-C
            Testosterone Centers of Texas | Founding Partner

          • Terri on 06/15/2016 at 1:00 pm

            My daughter is 22 years old in the Navy. Since going in a little over a year ago she has gained alot of weight. her period stopped almost 4 months ago. Her mood swings are crazy with alot of crying. extremely fatigued. She was told she had high testosterone. And Looking to see if she has a displaced Uterus. Also looking to see if she has pcos. She had a a ectopic pregnancy at 18. The navy medical is not what i call the best. What can she do?

          • Augie Galindo on 06/20/2016 at 3:22 pm


            It sounds like the right sort of things are being looked at. Perhaps having her seen by a local gynecologist who is familiar with PCOS workups the next time she is on leave would be helpful?

            Best regards,
            Augie Galindo MPAS, PA-C
            Testosterone Centers of Texas | Founding Partner

  2. kathy on 08/05/2015 at 11:59 pm

    My testosterone level is very high and havent had period and months and i need help don’t have much money n

    • Augie Galindo on 08/06/2015 at 5:41 pm


      Elevated testosterone levels can be very difficult to manage. It is best to do some research to find a nearby provider who can keep costs down by ordering only those tests that aid in the management of you issues and symptoms. Proper management will likely involve careful consideration of your estrogen and progesterone levels as well.

      • Kasey on 03/25/2016 at 8:18 am

        Hi my daughter who is 22 has had issues since 16. Hair on her stomach and back, No periods at all. They put her on BC pills at age 19 and her cycles were normal. She has gained a lot of weight and has mood swings all the time. She also has bad anxiety. GYN thought it could be PCOS and ran tests. She has high testosterone and low estradiol. Going to see endocrinologist next week. What does this sound like to you? Thank you.

        • Augie Galindo on 03/25/2016 at 1:52 pm


          PCOS would be at the top of my list of things to rule out as well. Make sure to find an endocrinologist that specializes in treatment involving sex hormone disturbance. With the prevalence of diabetes, many endocrinologists now manage little else.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

          • Kasey on 03/27/2016 at 6:11 pm

            Thank you for the answer. Yes he is a reproductive endocrinology specialist. Do you know what kind of tests they might do?

          • Augie Galindo on 04/04/2016 at 11:36 pm


            You are welcome. Labs are going to be important. These would consist of things like FSH, LH, estradiol, progesterone, and others. A sonogram will be needed as well.

            Best regards,
            Augie Galindo MPAS, PA-C
            Testosterone Centers of Texas | Founding Partner

          • Kasey on 03/29/2016 at 9:23 pm

            She has been diagnosed with PCOS. If she ever wants a baby, she will need fertility help.

          • Augie Galindo on 04/04/2016 at 11:45 pm


            Receiving a diagnosis is often a double-edged sword. Fertility compromise is really hard to take, even if it comes along with a concrete diagnosis. I wish both of you the best.

            Best regards,
            Augie Galindo MPAS, PA-C
            Testosterone Centers of Texas | Founding Partner

          • Jackie F. on 06/23/2016 at 11:05 pm

            Kasey, PCOS is not a death knell for pregnancy. I was diagnosed at 18.and told I would need treatment to become pregnant. I would go months between periods which is what happened end of 2008 (8 years after diagnosis, no period from August on). All of a sudden in January my books started to ache. Everything I looked up said pregnancy but I didn’t believe for obvious reasons. Turns out I was pregnant, on my own with no help. My husband and I gave birth to a very healthy happy baby girl, and now have a boy 3 years younger as well. So don’t give up hope on babies!

        • Jessi on 03/28/2016 at 5:14 pm

          Hello , what it seems like your daughter has is PCOS , Polysistic ovaian syndrome . Exactly what i have, ever since i was 16 ive never had a normal period without any medication. Im 19 now and i also have hair on my stomach and lower back. Some test she might , blood test forsure wich will be about 6-7 blood test . They will also do a physical check.

          • Kasey on 04/04/2016 at 11:44 pm

            Thank you both for the replies. She Has done all the bloodwork and ultrasound done as well n she has been diagnosed with PCOS. There are two ways they want to treat it. Birth control as well as some hormonal therapy if needed.

  3. Sarah on 08/09/2015 at 7:15 pm

    How much testosterone a women can have, without it causing problems.

    • Augie Galindo on 08/10/2015 at 7:45 am


      I am afraid that I have to give you the most generic of answers; it depends. It depends on your individual hormonal environment, your metabolism, dosing methodology, goals of therapy, and many other variables. What we have seen clinically, is that focusing on you free testosterone levels is best for determining the therapeutic window AND the potential for side effects. Also, it’s important to realize that even when testosterone is used appropriately, there will still be the need to mitigate side effects. All that being said, the dosing for women is somewhere on the order of 10% of what a male patient would need, and when ideal free testosterone levels are achieved, total testosterone levels are typically slightly above the normal reference range.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Parnter

  4. Jennifer on 08/10/2015 at 10:37 pm

    I am at a 59 score for my testosterone. Is that problem high? Can medications contribute to this? Which ones?

    • Augie Galindo on 08/11/2015 at 7:36 am


      A serum testosterone level of 59 is high-normal by most lab range, your lab report should list a reference range to help give you and idea of where it falls in comparison. Only androgens and hCG are known to reliably cause increased testosterone, but conditions like polycystic ovarian syndrome (PCOS) could cause increased levels as well. Protecting women from increased androgenic effect typically involves treating the underlying condition (like PCOS), or using medications that exhibit an anit-androgenic effect, like spironolactone.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Parnter

      • Brandy on 03/10/2016 at 10:41 am

        I’m on HRT but take no Test.. My score is 323.6. It is causing a majority of issues. Do you suggest a specialist or is there a way to lower it

        • Augie Galindo on 03/19/2016 at 12:33 pm


          If your baseline testosterone production is elevated, it is probably best to see an endocrinologist that specializes in sex-hormone treatment. While things like PCOS are a possibility, you also need to know what your free testosterone levels are.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  5. Alexandra on 08/13/2015 at 8:35 am

    if I have high testosterone levels can I take estrogen to help level myself out until i can get the proper health care?

    • Augie Galindo on 08/13/2015 at 11:08 am


      That could possibly be helpful, but really only if you are deficient in estrogen now. Other “stop-gap” methods would be the use of anti-androgen medications.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  6. carol on 08/17/2015 at 6:14 pm

    So I’m trying to get pregnant and we have been having trouble so my obgyn ordered a blood test for me to take on the third day of my cycle and these r my levels…..

    Fsh – 5.7
    Lh – 1.5
    Estrogen – 54
    – serum: 51
    – direct: 6.7

    I do have issues with ovarian cysts from time to time as well what does my results mean? Is there a way I can balance these out so I can have children?

    • Augie Galindo on 08/18/2015 at 9:27 am


      Thank you for your question. Before I answer, let me explain that fertility and gynecology are not areas that I practice in, but I will do my best to offer insight. Despite being from Wikipedia, I have found this graphic (https://upload.wikimedia.org/wikipedia/commons/0/02/Hormones_estradiol,_progesterone,_LH_and_FSH_during_menstrual_cycle.png) to be helpful in explaining the interrelation of hormones in the ovulatory cycle. Also, you can ignore the direct free testosterone level of 6.7 as this test is clinically useless per The Endocrine Society. The better test is a calculated free testosterone (cFT) which you will need your total testosterone, SHBG, and albumin levels to determine.

      What that leaves us with, is an incomplete, but fairly innocuous hormonal environment. It would be more telling to see what your hormones are doing over the course of your cycle; especially progesterone. Ovarian cysts and high testosterone levels, which you don’t appear to have based on theses results, could be worrisome for polycystic ovarian syndrome (PCOS). There is not enough evidence here to say that you are at risk for that, but if present, PCOS could negatively affect fertility. If you have been attempting to achieve pregnancy for more than one year without success, then it may be time to consult a fertility specialist. That is just a “rule of thumb” time frame, so keep in mind that there is no hard and fast guideline here. I hope that helps.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  7. Klara on 08/23/2015 at 12:44 am

    I am 56 and for over 10 years taking bioidenticsl Hormons. 1.75mg Estradiol/4mg Testosterone combination pill daily, and 25mg Progesterone. Lately I suffer from undefined unease feeling. Fast heartbeat early Morning, sometimes Midway slight nausea, some days difficulty to function, getting overwhelmed and exhausted and have to lie down every 2 hours whereby 2 hours cardio training in the morning were not a problem. Suffering from a lot of stress lately as too many things overwhelm me. Short fuse lately and being tough in every situation is never a problem. Feeling of getting very hard on everybody. If I stop the pill with estrogen/testosterone I get headaches and feeling not function well and also a feeling of unease and sickness. I have a healthy diet, taking supplements and living a healthy lifestyle for many years

    • Augie Galindo on 08/24/2015 at 5:16 pm


      Thank you for your questions! Your symptoms definitely warrant evaluation. Any time there are issues that involve an abnormal hear rate and extreme fatigue, the first thing to rule out is cardiac issues. My recommendation, in that regard, would be to see your PCP or a cardiologist if symptoms are intermittent, and to go to the ER if they are severe, frequent, or constant. Aside from that, it would definitely be important to evaluated your estrogen, progesterone, testosterone, and thyroid hormone levels. Also, hormones taken orally are historically hard on your liver so this should be being monitored very closely. Definitely don’t stop any of these medications abruptly unless ordered to do so by your provider. This could be a hormonal issue, but it could also be and underlying problem. I hope that helps!

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

    • rose smith on 09/27/2015 at 5:21 am

      I had too much thyroid given to me w similar overwhelming feelings and reactions started getting graves disease symptoms some dumb doc took me off Suddenly ALL thyroid med then I went the Other direction weight gain low energy blah confusion Augie is right hormones need check as well as liver. Meds nd gradual chsnge maybe and under dr /lab monitoring. Get a few opinions now yrs later I hsv high testosterone w its prob. Get many opinions. GOD bless you

  8. Leisha on 08/31/2015 at 4:03 pm

    I am 36 and have been on BioTe hormonal implants for a year. After the last one I noticed I didn’t feel like myself. I quick to temper and just uncertain feeling. My last injection was in July. After going to my PCP, she tested my testosterone and my level is 281. Isn’t that completely out of whack? What could be the cause? My hormone doctor hasn’t checked my blood since June 2014 when I started the injections. Could they have been giving me too much testosterone? Should I be concerned?

    • Augie Galindo on 09/01/2015 at 8:08 am


      This is a common problem with pellets. If you go looking for forums on the matter, you will see that it is rather typical for patients to have a similar response somewhere around the 4th and 5th implantation. This stems from poor oversight/management, and design flaws in the pellets themselves. Keep in mind that all pellets are made the same way. This may seem beneficial at first glance, however, what this really means is that “6 months” worth of medication dissolves in a way that sends your levels far too high in the first month, and then plummeting far too fast and low in the next 2-3.

      Your free testosterone levels need to be the target of therapy, and I have yet to come across a BioTe user that even runs the appropriate labs. If the answer to your questions has ever been “we’ll just give you a booster”, beware. I too would be concerned. We always recommend against pellets, so seeking a different form of therapy would be advisable, in my opinion.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

    • Mekayla on 05/27/2016 at 9:33 pm

      Omg, I had pellets inserted and after the 4 th insert my entire body began to go crazy. Heart race, fatique, foggy, moody, pain. Md had to suction them out. Not good.

      • Augie Galindo on 06/02/2016 at 9:41 pm


        They have great marketing, good intentions, and bad science. Sorry you had a bad experience.

        Best regards,
        Augie Galindo, MPAS, PA-C
        Testosterone Centers of Texas | Founding Partner

        • Nadine Moore on 02/08/2017 at 9:46 am

          I am a 48 years old female with NO sex drive so I have been injecting myself with .2-.3 ml testosterone cypionate , into stomach fatty tissue, every two weeks. I have had phenomenal results. I’m concerned with making sure my hormone levels are at safe levels. I get them checked twice a year. My most recent testosterone total lc/ms is 270.8
          Testosterone serum 210, free testosterone 2.8. Should I be concerned with the high serum level?
          T4 1.34, dhea 116.4, tsh, 1.440, Estradiol 107.9 , lipids were perfect. I get mixed reviews mentioning testosterone therapy too different doctors so hoping for insight from someone with your insight. Thank you

          • Augie Galindo on 02/08/2017 at 10:07 am


            Thank you for your question. Not knowing the timing of your labs (in relation to when your last injection was) makes it difficult to say, but I can tell you that your current regimen seems more aggressive than I would recommend. I am assuming that the testosterone you are using is a standard 200 mg/ml concentration. Also, I strongly prefer smaller, more frequent dosing with intramuscular delivery as the medication was designed for this modality.

            Best regards,
            Augie Galindo MPAS, PA-C
            Testosterone Centers of Texas | Founding Partner

          • Nadine Moore on 02/10/2017 at 10:14 am

            yes, 200mg/ml , last injection was 2weeks and 2 days from blood work test. my understanding of injecting in fatty tissue was for slower release of testosterone meaning more consistent levels in my system. is the Testosterone serum level 210, ok? I’ve been on this regimen for about a year. no significant side effects. based on your recommendation you would suggest 1 ml once a week? I see doctor who prescribed T next week. THANK YOU!

  9. Kim on 09/07/2015 at 8:50 pm

    Are there specific conditions that cause fluctuations in Testosterone? I’m a 46 year is women do w/fibromyalgia 9 years ago, hypothyroid 2 years ago, and am in pre-diabetes. I was on synthroid and armour for a short time, but found that I was getting acne really bad, especially on my back, so stopped the armour and it seemed to improve. It happened again some time later so I cut my thyroid pill in half and again it seem to improve. With this bad back acne flare up I realize that with these flare ups I also get strong under arm odor and the hair on my legs grows abnormally fast.

    • Augie Galindo on 09/09/2015 at 9:17 am


      Thank you for your question. There are some specific issues that can increase the likelihood of testosterone deficiency, as well as some that are not so easily defined. If you are taking any medication for pain that is opioid based for your fibromyalgia, this could be contributing to low testosterone levels. Also, there are links between blood sugar and thyroid issues and gonadal hypofunction.

      Acne is a pretty rare side effect of natural desiccated thyroid preparations. Your symptoms sound more androgenic, more specifically, DHT (dihydrotestosterone) related. Have you looked into symptoms of polycystic ovarian syndrome? http://www.pcoschallenge.org/what-is-pcos/

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  10. Sharen on 09/09/2015 at 3:22 pm

    I have been on HRT for 4 years. I am 64. Estradiol patch 0.025 twice per week. Progesterone 100 mg daily. And testosterone cream 20 MG/ML using .1 ml per night. In the past a pharmacy chain compounded it wrong at 200 MG/ML and before that was found out my libido went through the roof and body changes took affect. I now use an independent compound pharmacy that has made it correctly since 2013. Yet 3 weeks ago my libido went crazy again. I stopped using the cream and 1 week latter my doctor checked my “T’ and it was 467 and free was 9.9 pg/ml. All other blood tests were OK including thyroid. I brought the cream back to the pharmacy including a new batch not used yet. They sent it to an analytical company and both came back correct. The cream she was using had a result of 91.4% or 18.275 MG/ML. It is now 3 weeks since stopping and libido is normal. Next “T” test on the 18 of Sept. If it was a medical problem, why would my libido be OK now?

    • Augie Galindo on 09/14/2015 at 9:22 am


      It’s really difficult to say what the issue is here. Compounded medications will have slightly more variance than standard pharmaceuticals, but it sounds like that was not the issue with your most recent case. Also, understand that labs aren’t as concrete as you might think. There can be lab errors that lead to bad data. It’s always best to look at the whole picture. If your clinical response is good, and without significant side effects, the problem could lie in bad lab data.

      It is also very easy get a bit more cream than is prescribed, and over time, this can have a cumulative effect. This is why we use injections instead of topicals for testosterone therapy. It does sound as if your symptoms were tracking with your reported lab results.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  11. Susan on 09/20/2015 at 6:16 pm

    Hi, my sister is 39 years old and her doctor prescribed Progesterone for not being able to sleep after ablation surgery. The surgery went fine. After 6 weeks, she noticed her hair thinning and falling out. Now, it has been 5 months and hair is really thinning and falling out and her testosterone level is at 80. Started at 25. The doctors aren’t sure why this is happening….

  12. sara on 09/24/2015 at 5:16 pm

    I am 32. female. i was tested high in testosterone, low in DHEA, High in cortisol, low in estrogen, low in prgesterone, low thryroid function. I am deficient in a lot of vitamins and minerals. ive been eating a very healthy gluten free diet and taking the necessary vitamins for years now and my hormones are still out of whack. google has been no help… My imbalance doesnt sync up with anything i read online. im seeing a natropathic doctor about it. she put me on progesterone oil for days 14-28 of my cycle. she just upped my dosage and it made me feel terrible for the 2 days i was on it, so i went back to my regular dosage which made my period come a week early… i feel ok on my regular dosage but didnt get my period on time.. she just started me on pregnenolone but im afraid to take it. I read it raises testosterone in a lot of women and worsens symptoms… i cant handle worsening of symptoms. Does progesterone oil raise estrogen and lower testosterone? Im also taking seriphos for the cortisol. She wants me off that since it didnt help me sleep at night… but it did seem to help with stress… im so confused. dont know what to do. Can you give me any helpful information please?

    • Augie Galindo on 10/02/2015 at 10:53 pm


      The balance of many, if not all, of these hormones have some overlap. Your goal should be to find a provider that focuses both on your symptoms, and a sound methodology for measuring progress. Relying on labs doesn’t have to mean that somebody is “treating your numbers, instead of treating the patient”. When I hear vague terms like high this, or low that, it makes me fearful that your provider may be flying completely by the seat of their pants. Doubling a dose, without knowing where you stand before the dose increase is rarely a good idea. Also, it’s not advisable to try to change all things at once. I would recommend starting with thyroid balance first. Then, since you are menstruating, take a slow approach to balancing estrogen and progesterone. Depending on how you metabolize DHEA and pregnenolone you could have profoundly different outcomes than those which are desired. Additionally, before you rule out a testosterone deficiency, make sure you look at your calculated free testosterone first. Adrenal issues are the most complicated and I would save those for last. You might find some helpful tips here: http://www.stopthethyroidmadness.com/

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  13. aimee on 10/08/2015 at 7:51 pm

    i have high estradiol (3.8) low progesterone (24) very low ratio pg/e2 (6) high testosterone (70). i am a 45 y/o woman. no medications. other numbers including cortisol and thyroid indicators are in low normal range. what do i do????? i am fat, losing my hair, fatigued, can’t sleep (especially between 2am and 5am), irritable, achey……I eat organic, grass fed, pasture raised, keto, blah blah blah. can you help me or make any suggestions?? thank you so much!!!!

    • Augie Galindo on 10/13/2015 at 8:44 am


      It sounds like you are doing all the right things diet-wise. The hormone ranges you have are different than what I am accustomed to looking at, but I gather that you are in a state of estrogen dominance. This could likely be helped with progesterone replacement. As for testosterone, evaluation of your free testosterone levels is very important.

      Furthermore, proper management of any thyroid insufficiency is paramount to you feeling better and metabolizing appropriately. Visiting a practice that can treat all of these issues with one comprehensive approach will likely be your best bet.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  14. Hope on 10/15/2015 at 9:56 am

    I am a 27 year old female. I’m 5’8″. 135 lbs and have a 1 year old.
    I have had excessive hair growth since my late teens early 20s and back around 2008/2009 it started to get worse so I ran around to a bunch of specialists and had a ct scan and a sonogram done on my adrenal glands and ovaries. My testosterone is always high. (70) the ct scan found a tiny lump on one adrenal gland so they sent me to a surgeon and he basically laughed and said it was so tiny that there was no reason to worry about it. My Gyn tried to say I probably had pcos but I’ve never had any symptoms besides excessive hair growth. I’m normal weight, normal periods every month, and was able to get pregnant in 3 months.
    I’m here because my hair growth again has been getting worse and growing faster…on my chin, neck. Stomach and chest. I feel like my testosterone has gotten even higher. Could it be an adrenal tumor growing? And what type of doctor should I see? An endocrinologist, or a gyn? It’s frustrating because I feel that each dr just tried to diagnose what they normally see instead of actually trying to find the cause? Is it possible that their is no cause…some people are just born with high testosterone?

    • Augie Galindo on 10/19/2015 at 10:00 am


      Thank you for visiting our site! Understand that I am limited here, but I will do my best to help. While I do not agree with the way it was handled, I think the decision to avoid surgery on a small lump, that may or may not be contributing to androgen excess, was probably the right decision. Your total testosterone appears to be at the top end of normal, but it’s your free testosterone that matters. Given that your menstrual cycle is normal and pregnancy was uneventful, the likelihood of you having a severe hormonal imbalance is unlikely. Without symptoms of PCOS, that is also unlikely.

      Checking your free testosterone and DHT levels would help shed some light on your situation. Definitely look for an endocrinologist that doesn’t “just” see diabetic patients, but endocrinology is the way to go. There are medications like spironolactone that are considered adrogen agonists that could help reduce the androgenic response. Evaluation of the entire hypothalamic-pituitary-gonadal(ovarian) axis may help also.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

      • Sara on 03/05/2017 at 12:39 pm

        Hey idk about comments and all.
        But the thing is i am just 16 and im suffering from pcos from last 3 yrs.
        I never stop bleeding from 3 yrs and its most of the time heavy n full of clots.
        I get checked all my hormones and my testosterone and insulin level were high. Dont know what to do.
        Leaving a rply with trust

        • Augie Galindo on 03/30/2017 at 5:27 pm


          Those do seem like classic PCOS changes. Has anyone screened you for progesterone deficiency?

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  15. Lisa on 10/23/2015 at 9:41 am

    I am a 34 year old female and lately I have not been feeling myself, Anxious, Rapid Heart Beat (On and Off) I have been checked for cardiac issues and nothing, they are saying it could be anxiety. I had some blood work done and it showed that my testosterone is high, could this have anything to do with the uneasy feeling and what could make my testosterone high? I have pretty normal menstrual cycles, some times a few days delayed, but I get one every month. I am over weight, carry a lot of belly fat, High blood pressure and have some of the symtoms of PCOS, but not all.

    Testosterone, Total: 54
    Testoseronce Calc Free: 10.6
    Testosterone Calc Free%: 2.0
    Testosterone Calc Bioavailable: 28.2
    Testosterone Calc Bioav% 52.3

    I would appreciate any insight, are these really out of range results and what should be checked.

    Thank You!

    • Augie Galindo on 10/28/2015 at 8:47 pm


      Assuming that your testosterone result is reported in ng/dl, your level is normal. Also, your calculated free testosterone seems inaccurate. In the same unit of measure, this number would be normal from 0.3-1.9. A result of 10.6 seems errant.

      Palpitations and anxiety are not symptoms commonly seen with a “high-normal” or mildly elevated testosterone level in women. I would be more concerned with thyroid over-activity, or potential cardiac issues. Furthermore, things like anemia should be considered. You should see your PCP for a full physical. Typical testing (labs & EKG) for a physical would reveal potential hyperthyroidism, anemia, or significant cardiac issues.

      With normal menstrual cycles, PCOS becomes less likely.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  16. tina on 10/26/2015 at 3:27 pm

    i have bad hirsutim my testosterone level is triple what it should be i get my periods i am a little over wieght but tht was because i was eating much junk i lost a alot of weight so does tht mean i have pcos the only thing i have is hirstism is tht a forever thing..can i get surgery i dont wanna be on meds for the rest of my life

    • Augie Galindo on 10/28/2015 at 8:54 pm


      Hirsutism alone certainly does not mean you definitively have PCOS. Also, be wary terms like “your testosterone level is triple what it should be”. It could be that your testosterone levels are just high-normal, and while this could certainly contribute to hair growth, there could be other, more prevalent, factors.

      Surgery should almost always be considered a last option. Find an experienced TRT/BHRT practice near you to get a more precise opinion of your testosterone levels.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  17. Alida on 10/26/2015 at 8:41 pm

    Thank you for taking the time to answer these questions that are thrown at you! You must be very dedicated, and I appreciate that.

    This page has helped me understand that my extremely elevated (427.5 ng/dL) testosterone levels (usual 47-48), could be problematic. Glad I pushed for blood draw to see where my level was..and off to have more testing done in the AM….

    Again Thank you!

    • Augie Galindo on 10/28/2015 at 8:57 pm


      Thank you so much for your comments! I am very happy that we were able to help. That is the goal of all the effort put into this site. Best of luck to you, and I too am glad that you pushed for labs to be done!

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  18. Kara on 11/02/2015 at 11:26 pm

    I had my hormones tested 4 months ago because I was convinced they were off since I always feel blah, I rarely feel actually happy, low energy, night sweats, low libido. But my levels were all in range except DHEA was out of range at 369. My doctor didn’t know what it meant. I scheduled a consultation with a compounding pharmacy that specializes in hormone imbalances. She said my DHEA was nothing to be concerned with. But my Testosterone was on the lower side Total was 25 (normal is 9-55) and Free was 2.5 (normal is 0.8-7.4). She said we could try taking Testosterone sublingual’s so I have for 3 months. I was told I would not notice any difference unless I was taking for low libido. It did nothing to help that! I saw a new doctor and got my levels rechecked now I’m worried. My levels are scary high Total is 983 and Free is 121.7. Would taking my medication close to my test time effect it and cause such elevated levels? Can I quit taking this immediately. The pharmacist I had met with told me to get retested in 1 year and I’m glad I only waited 3 months. Will my high levels cause any issues? What does it mean?

    • Augie Galindo on 11/04/2015 at 10:10 am


      I am always leery of the “all in range” report. There can be subtle changes in the levels of your hormones, and if your clinician is not looking at the right test, or the results in the right way, something could easily be missed. The extremely elevated levels you had were not the result of a single dose, or its proximity to you blood draw. Your dosing was too high. Also, assuming that all symptoms will be “fixed” with testosterone, especially for female patients, is just not sound medicine. Your testosterone, estradiol, progesterone, and thyroid levels need to all be considered.

      As for an elevated DHEA, it could be nothing, or it could be something. Essentially, DHEA is manufactured by the adrenals (it is made elsewhere in the body), and it can go up naturally or through supplementation. Some of the reasons it would elevated naturally could be related to blood sugar levels or stress responses. Here is a quote from a website that may be helpful: “High levels of DHEA can mean that the adrenal glands are increasing DHEA production on response to stress or high glucose levels, or that the ovaries are increasing the production of DHEA as part of the PCOS cascade. High levels of DHEA are often seen years before a female develops metabolic syndrome and should be used as a risk factor marker for insulin resistance.” ()

      Ultimately, you will need a better balanced approach to hormone replacement, with far more stringent monitoring protocols.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  19. LETY on 11/03/2015 at 11:20 am

    my daughter 18 years old been having this yeast infections for a long time she takes medication and goes away, lately she go it again but this time the medication did not work, she just went again to see a different doctor and she said that is it probably because of high testosterone the doctor saw her body and notice that my daughter is very hairy. Would you think that high testosterone would play a role on this????

    • Augie Galindo on 11/04/2015 at 10:37 am


      The relationship would be indirect, but it could certainly be there. Now, keep in mind that these are general statements, and only one, possible, explanation for these issues. Polycystic Ovarian Syndrome has been linked to higher glucose (blood sugar) levels, hirsutism (abnormal hair growth), and increased testosterone levels. High blood sugar levels are often implicated as a risk factor for recurrent (fungal) yeast infections. So, it is not likely that testosterone itself is the issue, but it is possible that there is a metabolic environment, which includes elevated testosterone, could be a factor.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  20. Elaine on 11/12/2015 at 3:55 pm

    I just saw a doctor about starting HRT. 58 years old. Been feeling HOT night and day for about a year. Blood work and saliva testing ordered by GYN doctor. Called today as bloodwork is back; said that my total testosterone is 1430 (ref range 2-4.5) and free testosterone is 161.6 (ref range 0.1-6.4). Wow! Not aware of any typical symptoms for this result. I’m having an ultrasound soon to rule out pelvic mass. I do have hashimoto’s thyroid. What are the odds that this is caused by cysts or tumors and what is a typical remedy? [Saliva tests are a few weeks from returning.]

    • Augie Galindo on 11/13/2015 at 8:43 am


      That is very interesting. While lab error could always be at fault for such an abnormal level, it certainly sounds like some investigation needs to be done. Symptoms that one might experience from such an elevated testosterone level include virilization and estrogenic issues (like hot flashes) due to testosterone’s conversion into estradiol. Now, Sertoli-Leydig cell tumors (SLCT) comprise less than 1% of all ovarian neoplasms. So, the diagnosis of one would be very rare, but not unheard of. It sounds like you are on the right track. Make sure to keep you follow up appointment.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  21. Megi on 11/17/2015 at 5:20 pm

    I am 26 and I have regular menses and I am normal weight.
    I just did my hormone test because of the excessive hair growth in my chin stomach neck and chest from my early teen years , and I have a lot of ingrown hair in my body.
    Im so tired to remove them black thick hair EVERY DAY with a tweezer. My gyn said that I have a high testosterone and told me to visit endocrynologist.
    What causes my testosterone high ? And how can I control it ?
    The results came out like this :

    FSH- 8,7
    LH- 33,4
    ESTRADIOL- 132,0
    Testosterone 3,14
    DHEA-S 3,13

    • Augie Galindo on 12/07/2015 at 6:59 pm


      There are many causes for elevated testosterone levels in women. One involving hursutism is polycystic ovarian synrome. If your gynecologist feels like and endocrinology workup is necessary, it may be to rule out other hormonal issues before evaluating the possibility of PCOS. Before you control the excess, it is best to see why the imbalance exists, for the cause may be treatable.

      Best regards,
      Augie Galindo, PA-C

  22. Nazleen on 11/17/2015 at 10:59 pm

    I am 24 years old south asian female. All my life I have had excessive hair growth on my body and on areas where women usually show less hair growth. Hair growth on my body shows male hair growth patterns i.e. excessive hair on abdomen and back, inner thighs and face. I have also suffered from acne for quite a while on all these areas. I think this is not genetics since no female in my recent family has had this problem. I recently got my testosterone levels checked on doctors recommendation. My test results show 78 ng/dL testosterone levels. I am already taking birth control pills which my doctor says has some anti androgenic effects. Can you please help me interpret these results and what steps should I take further.

    • Augie Galindo on 12/07/2015 at 7:03 pm


      Unfortunately it’s not that simple. Birth control pills could be causing more than the intended changes. Depending on the type, and your response, it could worsen androgenic effect. Also, if your testosterone levels are consistently high, then even normal amounts of estrogen and progesterone might not have a countering effect. Your total level does seem to be high, but your free testosterone levels are more important. You would probably be best served by seeing a clinician that specializes in hormonal treatment.

      Best regards,
      Augie Galindo, PA-C

  23. Joy Miller on 12/07/2015 at 8:25 am

    Recent blood work revealed my testosterone level was 1,451. I am 61 and do have Afib but other than that I am in great health. I have not experienced hair growth or thinning or acne or other symptoms. Could you offer a course of action?

    • Augie Galindo on 12/07/2015 at 7:20 pm


      Since units of measure and normal reference ranges differ, it is difficult to discern you best next steps by labs alone. However, abnormal labs without typical associated side effects are rarely cause for concern. Probably, the best place to start is with a repeat test to ensure you aren’t looking at some sort of fluke.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  24. Marie Gonzalez on 12/17/2015 at 1:10 pm

    Hi, I am 19 years old and about one year ago I started getting irregular period and now I don’t get it at all. my gyn and endo tried giving me birth control but I dont tolerate it since I suffer from migraine and both doctor have told me that I have high testosterone my gyn told me I have pcos but I don’t show any symptoms except the no show period what should I do to help my situation ? Oh and they are certain medication that I can’t get because of my heart condition

    • Augie Galindo on 12/17/2015 at 3:10 pm


      Personally, I never like to hear that somebody’s “hormonal issues” are being treated with birth control pills. Contraceptives were quite literally designed to disrupt normal bodily functions. If you are suffering from hormonal issues, it would be best to seek out a clinician focused on female wellness. It is possible to have PCOS without exhibiting all the symptoms, and the treatment of it can be quite complex. Still involve your PCP, but be leery of using BC’s as a band-aid.

      Best regards,

      Augie Galindo, PA-C
      Testosterone Centers of Texas – Founding Partner

  25. Cindy Garcia on 12/23/2015 at 8:04 am

    Hi, I am 23 years old i have a 3 year old i have been to my doctor because i haven’t had my period in some months sometimes it even takes 6 months to get a period they put me on birth control pills but when i got tested on my hormones the doctor told me my Testosterone is very high they requested a ultrasound of my ovaries and the ultrasound came as normal i am not diabetic and i will like to get pregnant but i am having so much trouble i don’t have hair growth in any part of my body and I am so frustrated because I dont know what type of doctor to visit with these problem. Please let me know what i should do in this case.

    Thank You

    • Augie Galindo on 12/30/2015 at 8:17 am


      These issues would likely be handled best by a fertility specialist. There are a slew of things that can be done outside of IVF and other artificial means of achieving pregnancy. I believe that the use of birth control pills is a poor answer to hormonal imbalance. Keep in mind, the purpose of oral contraceptives is to intentionally disrupt a naturally occurring, and normal, physiological function. Also, it may help to dig a bit further into what “high” means in relation to your testosterone levels. It is your calculated free testosterone, that probably was not measured, that would be most telling. If you had a clear ultrasound, then polycystic ovarian syndrome is much less likely, but that is not the only reason why you might have elevated testosterone levels.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  26. Melanie on 12/24/2015 at 3:35 pm

    When I turned forty I developed depression, anxiety and severe insomnia. I’ve been to numerous doctors. I’m still on birth control my Gyn said it would help me through menopause. My estradiol was 75, Total test was 32. My husbands dr thinks I need testosterone and it would solve all my problems. He’s a bio identical dr. I’m desperate to get my life back but scared to get pelleted do you think my symptoms could be alleviated by testosterone?

    • Augie Galindo on 12/30/2015 at 8:23 am


      It definitely sounds like you have symptoms consistent with testosterone deficiency, however, you could also be suffering with progesterone deficiency. Oral contraceptives are not a good “fix” for hormonal imbalance. Bioidentical hormone replacement for estrogen and progesterone deficiencies is very important, this is an essential non-issue when it comes to testosterone. That being said, it is likely that you need help balancing all three hormones. Furthermore, thyroid insufficiency could be an issue.

      I personally recommend against pellets because of the huge swings your levels take while on them. The marketing for them is great, but in reality, they just don’t live up to their promises, and that roller coaster ride ushers in a lot more risk than other methods of replacement. I treat my patients with weekly testosterone injections and manage their estrogen/progesterone deficiencies with bioidentical, topical medications. I do believe that you would benefit from a more thorough hormonal status evaluation than it sounds like you have received thus far.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  27. Elizabeth C on 12/27/2015 at 6:45 am

    Dear Augie,

    Battling my hormone imbalances for the past 15 years has been exhausting and disheartening. I’m picking up lots of valuable information to help unravel the mystery. Thank you for your kindness!


    • Augie Galindo on 12/30/2015 at 8:28 am


      I love to hear that, and you are absolutely welcome! Thank you very much for the feedback. I wish you the best in your quest for better health!!

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  28. MARY on 12/29/2015 at 5:17 pm

    I AM POSTMENOPAUSAL 70yrs old. I Have been on Testosterone since MY 51st Birthday, I Started with A compounding cream then One time with pellets, which did nothing for my labido. Now I am on testim 1% gel. I Still Cannot get my labido to come back like it used to be when I first started T. What can I do to bring it back?

    • Augie Galindo on 12/30/2015 at 8:42 am


      I am almost completely guessing here, but my assumption here would be that despite being on treatment, your free testosterone remains low. Too many times, clinicians base their decision making off of your total, and you end up without the symptomatic benefit you are needing. Also, it would still be prudent to evaluate your need for estrogen and progesterone if risk factors allow for their use. I would definitely recommend against pellets. My preferred methods are testosterone by injection, and estrogen/progesterone by bioidentical, topical administration.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  29. Nanci D. on 01/05/2016 at 1:58 pm

    For years I have had high testosterone, high cortisol, high DHEA and low hormones. I am 60 yrs old and post menopausal. Lately my blood sugar has gone up with a A1C of 6.3
    I have developed a high upper belly gut and have gained weight even though I don’t eat that much.
    I have been under severe duress for a long time due to health condition anxiety which involves a relapse of my NHL cancer and constant sciatica coming from my back after a fall on ice. I had back surgery but need a fusion. I am an emotional mess in constant anxiety and depression. I don’t smile or laugh anymore and live in a constant state of turmoil.
    I recently lost my smell and taste and have a constant dry stuffy nose and dry mouth and recurrent eye issues with severe itching and inflammation.
    I have a high RT3 yet any thyroid medication never gives me any relief or changes the numbers.
    one of the doctors I was seeing who is an integrative physician said the chemo altered my HPA axis and I will never be the same again.
    I suffer from constant muscle pains which has made my whiplash much worse.
    I never had any issues getting pregnant and am the mother of 3 grown children. In fact my reproductive system never gave me any trouble at all.
    now a rheumatologist tested me for Sjogren’s and other AI diseases which came back negative but he did an ultrasound and found a suspicious growth in my uterus and a thickening of the lining of the uterus. no mention of cysts on my ovaries.
    Any help you can offer would be greatly appreciated. I can’t remember a time I enjoyed good health and laughed.
    Thank you so much for your time.

    • Augie Galindo on 01/06/2016 at 2:30 pm


      Thank you so much for your submission. I am very sorry to hear about your health struggles, I can only imagine how difficult this battle has been for you. It sounds like you have been very thorough in your search for answers. I am glad that you have seen a functional medicine physician, and they have raised a good point. It is not at all uncommon for our environment alone to have an impact on our hypothalamic pituitary axis. And, since the pituitary gland secretes hormones that control ovarian, thyroid, adrenal, mammary, uterine, hemodynamic, and other physiologic function, an issue there can cause issues globally within the body.

      Keep in mind, too, total hormone levels won’t give you a complete picture. If you have abnormal elevations in certain binding globulins like thyroid binding globulin, and sex hormone binding globulin, you could have “normal hormone levels” (totals), but still have below normal free levels. That is, total testosterone or total T3 may be fine, but you could have symptoms of deficiency if your free testosterone and free T3 are low. Similar to the issue we see with elevation in RT3.

      Perhaps finding an endocrinologist that is trained in functional medicine would help?

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  30. solmaz on 01/06/2016 at 7:26 am

    hi. I have a very high level of testosterone which is due to PCOS. But I really don’t want to take pills like Spironolactone which have horrible side effects. What should I do? I’m becoming bald!!! :(((

    • Augie Galindo on 01/06/2016 at 2:36 pm


      Admittedly, PCOS is not my forte, but to I know of no natural way to significantly reduce androgenic effect of testosterone without pharmaceutical or surgical intervention.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

      • Gigi on 11/11/2016 at 1:01 am

        Vitamin B5 is a natural alternative to Spironolactone

  31. […] written on the causes of too much testosterone in women before, but here’s a crash course on the […]

  32. Nicole on 01/12/2016 at 8:19 pm

    Hello! I am 27 years old and trying to get pregnant. I have been going to a doctor who has told me that I have symptoms of PCOS… That being said she sent me for blood work and the results were astounding! My testosterone is 335 and my free testosterone was at 59.3! She said this is the highest she has ever seen and is sending me to an endocrinologist to find out more. I have not had any other weird symptoms other than weight gain but is there something that could cause numbers like this!? Thanks!

    • Augie Galindo on 01/12/2016 at 11:25 pm


      Thank you for your question! PCOS would definitely sit atop the list of likely causes. Your total testosterone is definitely high, but I am always skeptical of free testosterone levels if not done by calculation method, or equilibrium dialysis. That being said, I rely solely on a calculated free testosterone level where the normal range is 0.3-1.9 ng/dl. I believe your result is in a different unit of measure, and perhaps was done using different methodology. If a direct free testosterone test was ordered, I would recommend ignoring that reading. Repeat testing, and a calculated free testosterone measurement (requiring a total testosterone, SHBG/sex hormone binding globulin, and albumin), may shed more light on the subject.

      Other issues do need to be ruled out. Certain tumors of the adrenal glands or ovaries (namely stromal tumors) can cause similar responses. Make sure that your workup is thorough, and that no questions go unanswered.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  33. Lynn on 01/18/2016 at 7:19 am

    What conditions are high t and high cortisol associated with? NO OTHER abnormalities found from any other tests that were done to rule out PCOS ect. Only other condition is bouts of major depression. Is it possible that depression can increase both T and cortisol?

    • Augie Galindo on 01/19/2016 at 12:33 pm


      Stress and depression can definitely increase cortisol levels. Testosterone, on the other hand, may be a bit trickier to explain in this scenario. Typically you would see these two levels move in opposition to each other. However, there are some conditions that could stimulate the increase of both simultaneously. Hyperactivity of the adrenal cortex could explain such a finding. Particularly, Cushing’s disease/syndrome is one diagnosis that could be considered. ()

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding Partner

  34. Adrienne on 01/26/2016 at 10:05 am

    My daughter has been diagnosed with PCOS, which I know can cause increased testosterone levels. She seems to evudence a pattern that when she works out doing strenuous cardio, she develops something akin to “‘roid rage.” However, this doesn’t happen when she swims or does yoga. Is it possible that she has a large release of testosterone when she does cardio that could negatively affect her mood and reaction to things?

    • Augie Galindo on 01/26/2016 at 10:56 am


      That is possible, but the probability of her attaining “roid rage” levels is very low. But, any increase in testosterone will, by conversion (aromatization), cause a subsequent increase in estradiol/estrogen. This is can have a negative effect on mood. Too, you can consider hypoglycemia that could be workout-induced and lead to mood swings as well.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas – Founding PartnerI

  35. sarah on 02/01/2016 at 5:23 pm

    Hello, I just recently had blood work done for my testosterone levels and I found out today that it is at 110. My doctor was wanting me to see an endocrinologist but I haven’t scheduled the appointment as of yet. She checked my sugars and anything relating with diabetes and PCOS and said everything came back great. I was just curious what you thought about this

    Thank you so much,

    • Augie Galindo on 02/11/2016 at 12:41 pm


      PCOS is always a concern with elevated testosterone levels in females. Just make sure that you see an endocrinologist that treats/diagnoses PCOS regularly. Much of endocrinology is focused on diabetes these days, and while they have the knowledge base in the specialty, its rarely their forte. If all other parameters are normal, the likelihood of PCOS does drop.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  36. Jasmine on 02/02/2016 at 4:53 pm

    I got my period when I was 12 years old and have never missed a period cycle before. When i turned 20 I started taking sprinolactone because my dr told me that my testosterone levels were too high. After taking the medication for a couple months my period cycle changed. I began getting my period twice a month; once in the beginning and once in the end of the month so i stopped taking the medication. Its been 6 months since i stopped the medication but i haven’t gotten my period since. My dr and OBGYN don’t think that its the sprinolactone but i am CONVINCED that it is. I have looked on the web and seen other women complaining about not getting their periods after stopping the same medication. My OBGYN thinks i have PCOS…my free testosterone level is at 9.1 is this significantly high for me to have PCOS? and could me not getting my period for a long time be the result of the medication that i took?

    Thank you

    • Augie Galindo on 02/11/2016 at 12:59 pm


      Spironolactone is used in such scenarios because it blocks the androgenic effect of testosterone/DHT, but it does nothing to correct testosterone elevations. I am certainly suspicious of it too. Your free testosterone sounds like a “direct free testosterone” which is a test that is clinically useless. There are better ways to evaluate this metric. Make sure somebody looks at your entire hormonal profile before chalking this up to PCOS.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  37. Kim on 02/04/2016 at 12:23 am


    I went to my doctor this month to discuss three issues that have been bothering me lately: thinning hair; low libido; and excessive sleepiness/fatigue. I am a 26-year old Asian female, and I am 5’0 and 110 pounds.

    I had my testosterone levels checked, and my total is 126.90 ng/pl and my free testosterone level, which I just got today, is 1.7 pg/ml.

    Originally I had concerns about PCOS, but seeing that my free testosterone is within normal range, should I have nothing to be concerned about? Do I naturally just have a higher total testosterone level?

    • Augie Galindo on 02/11/2016 at 2:06 pm


      It’s very possible that this is just your “norm”. It is free testosterone that matter, both from a risk and benefit perspective. That being said, your unit of measure on your total testosterone indicates nanograms per picoliter, which I am assuming should be ng/dl or ng/ml. Just make sure to reconcile that to the reference range and that your free testosterone is derived by calculation and not direct (analog) analysis. Otherwise, if you are asymptomatic, I would not worry about those numbers.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  38. Amelia on 02/07/2016 at 1:14 am


    I’ve read all of this with great interest. I’m 44, seem to be having significant peri menopausal symptoms, and need insight about the effects my Norethindrone .35 mg mini pill may be having on my testosterone levels. There is no estrogen in this pill. I have taken it for years for endometriosis pain, but I have been experiencing male pattern hair loss, nausea, mood problems, hot flashes, and insomnia. No acne or additional hair growth, but no imptovement in my excess hair growth either.

    So I wondered how this medication may be affecting me now that I’m older. I had my levels tested a couple of months ago as I had tapered my dose, and my cortisol levels were high and testosterone a 23. It was the same on day 8 as day 22.

    The next cycle, I stupidly used some OTC bi-estro care cream ( no testosterone, just estrogens) just one pump on day 4 of my cycle last month, and it caused me a lot of hyper stimulation, racing heart, dry mouth, and a painful ovulation and period that followed. I went back on 1/2 pill of the norethindrone at that time, as I scared myself.

    Since then, I continued with the 1/2 pill, and my testosterone is now 31 on day 9. This is the cycle following the estrogen cream disaster. I wonder how high it got during the cycle with the cream??? I’m worried that my testosterone is actually rising as I’m coming off the pill. I also had an acne breakout, which is unusual.

    No doctors seem to agree on the effects of the Norethindrone mini pill on testosterone levels. One says its anti-androgenic and the other says it’s androgenic. It matters because I have androgenic alopecia. Also I have some excess hair growth from infertility treatments years ago that I don’t want to get worse. I do not have PCOS.

    What is the effect of norethindrone on testosterone blood testing? Could the one-time dose of the bi-estro care cream have elevated testosterone levels last month, causing the acne? Could there be excess hair growth from that cream that I still need to worry about? I’m trying to determine if this pill is helpful or harmful given my concerns about acne, hair loss, and excess hair growth, not to mention the anxiety and nausea, peri menopausal stuff, etc.

    Please help…

    • Augie Galindo on 02/11/2016 at 5:31 pm


      There are quite a few intersecting lines here. While Norethindrone is a “progestin only” OCP, that does not mean that it does not affect your estrogen levels. It acts by suppressing goandotropins. The pituitary gland, under command of the hypothalamus (one hormone called gonadotropin releasing hormone, GnRH) causes the secretion of two gonadotropins (luteinizing hormone & follicular stimulating hormone, LH & FSH) which in turn controls ovulation and production of estrogen/progesterone/testosterone. Additionally, other parts of the body produce sex hormones (adrenals & fat tissue).

      So, a medication that reduces gonadotropins, while only supplying a progesterone mimicker, can lower estrogen levels. By this mechanism, your body can react as if you have low estrogen levels, even if there is just an imbalance. This scenario is often called “progesterone dominance”. Also, your hypothalamus relies partially on estrogen (now suppressed), to decide how much testosterone to produce. And don’t forget that testosterone levels are supposed to fluctuate during your cycle. You will see a spike close to ovulation as your body seeks to capitalize on your fertility by increase libido (etc.). Total testosterone can sometimes be misleading, too. The better metric is a calculated free testosterone.

      With so many interfering factors, and if you can withstand the symptoms, it is probably best to see if you can take a drug holiday from the Norethindrone and test again in the mid-luteal phase.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Amelia on 02/11/2016 at 11:03 pm


        Thank you! I am so pleased to see your reply, and it is so very helpful. I understand what you’re saying about the relationship among the hormones, and it is complex.

        How long would the drug holiday need to be to get an accurate hormone retest?

        Also, is excess facial and body hair at all reversible with proper hormone balance? I hope it is.

        I think my estrogen may be relatively high compared to my progesterone as I have reduced the progestin pill, and perhaps this is also resulting in excess testosterone.

        Thank you again so much for your time and help…

  39. Jordan on 02/16/2016 at 1:36 pm

    For the past 7 years ive been on thyroid medication, last year i was having panic attacks, insomnia, etc. my pcp lowered the dosage but now im gaining major weight (20+ lbs in 2 months) and suffering from lots of unwanted facial hair growth. My testosterone came back at 551! I feel i do but dont fit the PCOS- maybe but i did suffer from it once when my thyroid was undiagnosed and at a 20… I dont feel those same symptoms now. Could this be something else making my levels so high? My TSH is 2.1 when i am normally .3-.8 im increasing on synthroid. Could switching to a Ndt like armour help vs synthroid? Could it be cushings? What other tests could i get to test for cushings? Ive done a dex test and it came back within range. ….? Any answers or suggestions? Thanks
    Cortisol 15.2 a1c 5.6 insulin 25.4

    • Augie Galindo on 02/17/2016 at 10:52 pm


      Adrenal, thyroid, and ovarian activity is controlled by the hypothalamus and pituitary gland. If Cushing’s is suspected, isolated cortisol, 24-hour urine cortisol, and the dexamethasone suppression tests would all be helpful. ACTH levels can be measured to see if a secreting pituitary tumor is involved, but this usually follows the diagnosis of Cushing’s. Since your dex test came back in range, an ACTH measurement is a non-invasive means of shedding a little more light on the subject. You might find THIS SITE helpful.

      I do recommend an NDT over Synthroid. My go-to medication is Nature-Throid. You can find a wealth of information HERE.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • jordan on 02/19/2016 at 11:53 am

        Thank you Augie! Super helpful. I will ask my doctor about those tests and also see if she is willing to get an NDT like Nature thyroid imported in for me. I’ve asked before and she needed a legitimate excuse to get it shipped in. (me going up and down ALL the time i think is a legitimate excuse) We are currently in Germany and there are (supposedly) no compound pharmacies near by.
        Thank you again for the response.

        • Augie Galindo on 02/23/2016 at 10:28 am


          No problem at all, best of luck to you!

          Best regards,
          Augie Galindo, MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  40. comfort on 02/23/2016 at 9:02 am

    Does high testosterone contribute to inability to gain weight?

    • Augie Galindo on 02/23/2016 at 10:29 am


      I would have to say that this would be atypical. Gaining weight, especially lean muscle, should be easier with higher testosterone levels.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  41. Ruth on 03/08/2016 at 1:48 pm

    My testosterone level has been increasing constantly and it is now up to 175. I have my ovaries, adrenal glands and cortisol tests and doctors cant explain why level is so high. I am losing hair and have facial hair, extreme fatigue and gain weight. Please advise best course of treatment and possible reason for such high testosterone level.

    • Augie Galindo on 03/19/2016 at 12:08 pm


      Without a full workup there are many assumptions that I have to make, but I would definitely be suspicious of polycystic ovarian syndrome. Also, total testosterone levels alone don’t tell the whole story. Testing your calculated free testosterone would lend valuable insight into androgenic influence. I would recommend seeing an endocrinologist that deals specifically with these types of hormonal issues.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  42. Jennifer on 03/12/2016 at 5:07 pm

    I have had low testosterone for at least the past 2 years. The highest total testosterone level tested in that time was 0.3 nmol/L (reference 0.5-2.6). My bioavailable testosterone was 0 (ref <1.0). I started on testosterone cream and my levels came up to 0.6 nmol/L and 0.1 (bioavailable). One month later, my total testosterone was 6.0 nmol/L! Bioavailable was 1.0 nmol/L, just the upper limit of normal. I've just been retested (6 months later) and my total T is still at 6.0 but my bioavailable T is now at 0.8. I have no symptoms of excess testosterone and still have issues with no libido, fatigue and weight gain.
    My Sex Hormone Binding Globulin is off the charts. I have never even approached "normal range". My results have ranged from 124 -236 nmol/L (reference 18-114). My last result was 163.
    What causes SHBG to be so elevated? I feel that's the root of my problems but i cannot find any information.

    • Augie Galindo on 03/19/2016 at 12:50 pm


      There are many factors that lead to increased SHBG production. One of them is estrogen levels. So, typically, when estradiol levels are high, SHBG levels will be high. With the total testosterone levels you have seen, it is likely that you are not absorbing the medication topically. We manage are male and female patients with injections, bypassing this issue. Furthermore, your total levels are barely normal, and with SHBG dysfunctions your calculated free testosterone levels (more specific than “bioavailable” testosterone levels) will never be normal. It’s your free testosterone levels that are most important.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Jennifer on 03/19/2016 at 1:08 pm

        Thank you for your response. I forgot to mention that I am also on estradiol patch (1.175 mg) and progesterone (day 13-27 of cycle).
        My last blood results (day 21)were:

        Estradiol 668 pmol/L (ref <1251 luteal)
        Progesterone 40.7 nmol/L (ref 5.3 -86.0)

        When you say i am not absorbing the medication topically do you mean the testosterone? My extremely low levels were PREVIOUS to starting testosterone–when i started the cream i went to 0.6 and then to 6.0 so i don't understand what you mean.

  43. Jasmine on 03/12/2016 at 10:31 pm

    Im almost 15 and haven’t gotten my first period yet. My mum had high testosterone levels, so do u think that might be why I haven’t gotten my period yet? Please reply I’m very worried!

    • Augie Galindo on 03/19/2016 at 12:51 pm


      It’s certainly possible. Unfortunately, the only way to know for sure is to see a specialist and have a workup done.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  44. LMO on 03/16/2016 at 6:23 pm

    I am a 42 year old perimenopausal woman. I am over weight, 192 lbs at 5ft 3in. I have had weight, depression, hair loss, acne, raging, many issues since my first son was born 11 years ago. I finally found a doctor that diagnosed me with hypergonadism, hyperprolactinemia, and hyperandrogenism. I got treatment with many different meds like spironolactone, steroids, HRT, Armour, estrodial, progesterone, depression meds, etc that helped some but was never balanced, it would fluctuate up and down. I was only able to lose 10 lbs. I stopped the meds for almost a year now and just got my labs redone. Ive gained almost 15 lbs since stopping the meds. My current labs are as follows:
    T, Serum 37 ng/dL (was as high as 62)
    T Free 4.4 pg/ml (high)
    DHEAS 246.7 ug/dL (was as high as 473.4)
    TSH 2.53 uIU/mL
    T4 Free 1.13
    Prolactin 7.6 ng/mL (was as high as 40.5)
    Previous glucose test run around 99-100
    A1C runs around 5.4-5.5
    Total cholesterol runs around 245

    My previous doctor ruled out PCOS and pituitary tumor and the other diseases. So what could be causing my problems? Is there any other therapy besides medications?

    I cannot lose weight and gain weight easily. I am tired. I have no energy. I am moody and angry. I am losing my hair so fast on the back of my head and the front. I am growing hair on my chin and upper lip and neck and lower stomach and thighs.

    Any advice?

    Thank you.

    PS I am in Houston if you have a recommendation for a doctor near me.

    • Augie Galindo on 03/19/2016 at 1:56 pm


      You are missing some key information in your labs. I consider your free T3 level most important to measuring thyroid efficiency, and free testosterone (calculated) most important for measuring androgen status. I am not sure, based on these labs, that you ever needed to be on spironolactone. Steroids (which I am assuming are prednisone and the like) cause many of the symptoms you were experiencing. Depression medication can also lead to weight gain and hyperprolactinemia. Often with TRT/BHRT, providers try to fix too many things at once. Perhaps taking it step by step would be a better option for you.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • LMF on 04/05/2016 at 9:25 am

        Thanks for the reply. My free T was 4.4 ng/dL (high) and my free T3 was 2.7 pg/ml. I am not on any of the depression meds or steroids or any other meds or supplements right now. And the labs were taken when I want taking any other meds too. I’m still waiting to see my doctor but I now am losing my eyebrows too especially the outer part. Any help is appreciated. Thanks.

        • Augie Galindo on 04/06/2016 at 8:41 am


          I am always suspicious of free testosterone levels when they aren’t specifically reported as a calculated free T. That being said, I would have that test repeated before making any decisions on it. If you are experiencing symptoms of thyroid deficiency, hair loss being one of them, I would likely consider starting therapy with free T3 level of 2.7 accompanied by symptoms.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  45. ifrah on 03/30/2016 at 5:55 am

    hiee…i have slight facial hair growth on face and neck but more on chin..i have a perfect normal weight ..n good dietary habits..
    for this concern i got my hormonal profile done on the second day of my periods and the details are as
    testosterone free serum is 2.45pg/ml
    testisterone total serum is 72.13 ng/dl
    FSH is 5.52mIU/ml
    LH is 2.18mIU/ml
    DHEA is 352.50 microgram/dl
    17alpha hydroxy progesterone is o.76ng/ml
    i also got my ultrasound of abdomen done..it was normal
    my doctor suspect of PCOD And says that i have high testosterone levels and has prescribed me with oral contraceptive tab Diane 35mg for three months..can u plzz suggest that what ahould i do?

    • Augie Galindo on 04/04/2016 at 11:58 pm


      I don’t see estradiol levels in your labs. Diane 35, is estradiol and raising that level should reduce testosterone levels, but that can be a tricky approach, especially with oral, synthetic estradiol. As long as your provider is monitoring your symptoms and levels closely, the current treatment plan seems reasonable.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  46. Misty on 04/12/2016 at 1:55 am

    My free testosterone is 23.9 PG/ML. And my testosterone is 136 NG/DL
    What could possibly be the cause of this beside PCOS?

    • Augie Galindo on 04/19/2016 at 10:35 pm


      There are issues that can occur with the adrenals, hypothalamic/pituitary/gonadal (ovarian) axis, and with the ovaries specifically, that could elevate testosterone levels without the presence of PCOS. This means things like ovarian tumors and Cushing’s disease have the potential to cause similar symptoms.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  47. Melissa on 04/21/2016 at 5:20 pm

    30 year old female
    estradiol 115
    fsh 11.1
    LH 22.2
    progesterone .7
    Ferritin 54
    free T 3.2
    DHEAS 354

    Facial hair, hair on stomach, my head hair grows really really fast. What do you think it could be? I am fixed. And I have regular periods every month. I have an apt with an endo but it takes a while to get in

    • Augie Galindo on 04/21/2016 at 9:15 pm


      Thank you for your question! The biggest variables here have to with what part of your cycle these labs were drawn in (specifically, how many days after the start of your period), and if your free T level is a calculated value (requiring an SHBG level), or a “direct” free T (which is clinically useless). Assuming that these are labs from the first half (follicular phase) vs. second half (luteal phase) of your cycle, could lead to some bad guesses.

      That being said, issues with excessive or male patterned hair growth is often linked to hyperadrogenism. The potential causes of this are numerous. You can read more on that HERE. I hope that helps!

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  48. Emily on 04/24/2016 at 12:12 pm


    I’m a 20 year old female. I’m 5’2 and 109 lbs. I have moderate to severe acne, irregular periods (28-65 days) and excessive hair growth on my stomach. I’ve been told my ovaries are fine. The only abnormal thing in my lab work is my testosterone. I’ve been told it is likely the cause of my issues, but I cannot imagine why only a single thing is elevated.

    Testosterone, Serum: 59 -High- (ng/dL)
    Free testosterone (Direct): 1.9 (pg/mL)
    TSH: 2.010 (uIU/mL)
    T4: 6.7 (ug/dL)
    DHEA-Sulfate: 332.9 (ug/dL)
    LH: 9.4 (mIU/mL)
    FSH: 5.8 (mIU/mL)
    ACTH: 7.9 (pg/mL)
    Prolactin: 23.0 (ng/mL)
    SHBG: 61.6 (nmol/L)
    Cortisol: 15.8 (ug/dL)

    Thank you very much.

    • Augie Galindo on 04/25/2016 at 8:29 am


      I don’t see anything in your labs that is particularly alarming. Your total testosterone level is on the “high side”, but depending on the reference range of the lab used, it is likely still normal. The “Free testosterone (Direct)” test is a deeply flawed and inconsistent lab assay, and actually should not be used clinically. Utilizing a calculated free testosterone or equilibrium dialysis method will give you the most accurate assessment of your free testosterone level. It is this level that is most important is determining your androgen exposure. There are conditions that can cause strict testosterone elevation, but things like ovarian thecomas are rare to begin with, and would be virtually unheard of in someone your age. I would start by taking a closer look at what your free testosterone. I don’t see your albumin level, but assuming that is is 4.1 (an average value for females), this would put your calculated free testosterone at 0.72 ng/dl, which is well within the normal range of 0.3-1.9. Finally, your symptoms may be a normal variant if you are not experiencing other symptoms of viriliaztion like deepining of the voice or clitoral enlargement. I hope this helps!

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  49. Andrea Herrera on 04/28/2016 at 4:30 pm

    My lab results came back different. I was in the follicular phase at time of testing and these are the numbers. Progesterone .6 EStradiol 31.Free T3:3.6
    Free T4: 1.3 sugar A1C: 5.7 SHBG: 102. Total testosterone: less than 20 and testosterone free calc. less than 5.0 they didn’t give a specific number but supposedly anything from 1.3 -9.2 is normal.

    • Augie Galindo on 04/28/2016 at 10:35 pm


      Forgive me, because variance in units of measure may create discrepancy, but when I measure a normal calculated free T for female patients, I am looking for a value between 0.3-1.9 ng/dl. Given your total testosterone (calculated at exactly 20, even though we know it is at least slightly less), and SHBG of 102, and a presumed albumin of 4.1 (pretty average for females): your cFT comes out to 0.17 ng/dl. This is low, even assuming your total T to be higher than it actually is. Also, the only good time to test estradiol and progesterone in a female patient who is still cycling, is in the middle of the luteal phase (days 18-22 after the start of your period). Your A1c appears to be high normal, suggestive of a chronically borderline high blood sugar level. Thyroid hormones appear to be normal as long as symptoms are in tact and your TSH is below 3.0.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  50. Maria on 04/30/2016 at 3:30 am

    Hai..Am 21yrs old. From the age of 13 i have been suffering from severe dandruff and acne.All treatments like nilac, coaltar have reduced it but have not cured it. My face gets oily within an hour after bath. Recently I read in the Internet that androgens are the reason. Is it true?. Also i have a pear shaped body, big lower body. Do i have PCOD ?. I get my periods regularly. Please help me…

    • Augie Galindo on 05/07/2016 at 2:04 pm


      Many other symptoms are typically seen with PCOS. To answer the question, you would need blood tests and sonograms. It is less likely that you would have PCOS given that your periods are regular, but it is still certainly a possibility.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  51. Kristi on 05/03/2016 at 9:36 pm

    Thank you for this article. I have been fighting with irregular menses, as far as going months in between. I’m 29, have acne, increased sappy essential, anxiety, increased facial hair and worse of all my hair started falling out at the front of my scalp. I had an ultrasound a few years ago to try to diagnose pcos after 6 months of no period and it came back normal. I went to a different doctor last week and he did a bunch of blood tests. The only one that came back abnormal was my free testosterone at 7.6. My 17 hydroxy was 46 which he said was normal but it seems to be borderline to me? Is there a way to get the testosterone to come down? I can’t take combined birth control due to migraine with aura and I really want my hormones figured out. Thanks!

    • Augie Galindo on 05/07/2016 at 1:57 pm


      It depends on the cause. Certain stromal cell irregularities of the ovary can cause it. There are treatment to damper down the effects of androgens, like using spironolactone. It sounds like you’ve already been on quite a journey with this, I hope you find some definitive answers soon!

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  52. Emily on 05/12/2016 at 10:00 am

    Hi! I am a 31 YO female and have Hashimotos and adrenal issues. At one point they thought I have PCOS after getting an MRI and seeing potential undeveloped follicles but I did an ultrasound and they did not see any cysts (except one small one). I follow a gluten free diet and mostly grain free and whole foods/unprocessed. My testosterone has been coming down for the last year, but recently shot back up to 81. I’m confused why it keeps jumping around and should I re-look into PCOS as a cause. As far as adrenals. I have never gotten them checked except with a saliva test which said I was low cortisol in the morning and afternoon and normal and getting higher at night. Any direction would be helpful!

    • Augie Galindo on 05/22/2016 at 10:32 pm


      Thank you for reaching out. As for testosterone levels, getting a handle on what your calculated free T is doing will provide much more insight that just monitoring the total. Testosterone production is quite dynamic, but large spikes in your total T may not have a big impact on the much more important free T. Adrenal issues, I hate to say, present a formidable conundrum. I typically don’t do much for adrenal issues medicinally, because I just don’t like the available treatments. I have found that optimizing women’s free testosterone, free T3 (extremely important with your history of Hashimoto’s), estradiol, and progesterone are the four pillars of hormonal health. Adrenal fatigue can often be addresses by behavior modification and dietary changes.

      Best regards,
      Augie Galindo, PA-C
      Testosterone Centers of Texas | Founding Partner

  53. Tim on 06/01/2016 at 10:59 am


    My daughter is wrestling with what seems to be PCOS. High school years had very irregular if any periods. High acne. Seemingly unexplained weight gain (she works out and watches her intake but with little success). She did have a cyst in ovary that was addressed.

    She had blood work done in past. They thought may be PCOS. She is on pregnitude and is now regular in periods, less acne. She is still struggling with weight gain especially in abdomen area. She has hair on stomach and back. We are assuming this is high androgen levels. She also has High Reverse T3.

    Questions …
    1) Thoughts?
    2) what levels should we ask to be drawn in order to best determine a next step?

    • Augie Galindo on 06/02/2016 at 9:36 pm


      A single ovarian cyst doesn’t seem consistent with PCOS, but I’m sure there is more to the story. Women can have hyperadrogenism without PCOS. It would be best for you to looks at her calculated free testosterone levels. This is a calculation that will require an albumin level (in a CMP or comprehensive metabolic panel), total testosterone, and SHBG (sex hormone binding globulin). If reverse T3 is high, she could be exhibiting signs of hypothyroidism with “normal’ thyroid labs. Look at her TSH and Free T3 and check out THIS SITE.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Tim on 06/24/2016 at 3:36 pm

        Thanks. We have received new results. I put all results together from past 3 years. Total T, free T, albumin, and SHGB all normal range. Her Reverse T3 dropped into high normal level this time. So … hmmm … are we just barking up the wrong tree?

        Numbers that are high are Glucose (102 mg/dL), BUN @ 23 mg/dL (she has been trying a low carb diet for last 2 months), BUN/Creatinine ratio @ 28, and B12 is very high (1220pg/mL – she is on pregnitude).



  54. Tania on 06/24/2016 at 4:45 pm

    Hi I am 20 and my testosterone is high I am having pcos my periods is irregular since I got to my teenage the doctor give me diantte for 6 months and I was getting my periods with bc pills but when I finished my 6 month of pills and did my ultrasund it was ok but I still didn’t get period after that doctor said u will get better after marriage now it’s been 8 months I haven’t got my periods I can’t wait till my wedding I am getting pcos again and all those unwanted hair on face and body please tell me what should I do should I start birth control pill again

    • Augie Galindo on 07/11/2016 at 2:08 am


      It’s really difficult to tell you what to do, without being able to fully assess medical history and labs. My best advice is to see someone who focuses on hormone therapy. Birth control pills are NOT the answer to all female hormonal issues.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Tania on 07/11/2016 at 4:07 am

        Hi thanks for your reply
        I was been in treatment for three years since my teenage the doctor said in the end u will get better after marriage and till marriage take diantte for three months once in a year I want to ask would I get better after marriage becuz I don’t know when I will get married I want my normal periods which are not coming without bc pills I am suck of my acne and unwanted hair growth on my face and other body parts

  55. Jennifer on 06/26/2016 at 12:24 pm


    I’ve recently learned that my testosterone level is elevated past the normal range. My symptoms are sudden acne and periods that have grown increasingly irregular or absent during the past year. Because I am 42 my GYN wasn’t immediately concerned about the latter, but due to the acne she now feels I have PCOS. My question is, how does a doctor distinguish between PCOS and issues with your adrenals, thyroid, pituitary gland (tumor?), or insulin levels? I am not at risk for diabetes, my cholesterol level is great, take no medication, and lead a healthy, health-conscious and active lifestyle. Why is my body producing more testosterone? How can I trust that my doctor’s diagnosis is correct? Would an endocrinologist be able to sort all this out? What is the right testing to get? Is it possible to balance my hormones naturally (herbs or acupuncture, et al) or is medication really the only thing that will help? Is it possible that this is caused from chemicals in certain hygiene products?

    • Jennifer on 06/26/2016 at 12:25 pm

      Thank you in advance for any information/insight you may provide!

    • Augie Galindo on 07/11/2016 at 2:31 am


      You are asking all the right questions, and you will know that you have received the proper diagnosis when the person making it can walk you through that entire differential diagnosis list. Most of those can be ruled out with labs, but proper interpretation is crucial. Even the diagnosis of high testosterone is often flawed. Read more about that HERE. Endocrinology is the right field, but most of those practices are dedicated almost entirely to diabetes and often don’t take the time to do this type of medical management well.

      Natural remedies, for the most part, over-promise and under-deliver. And, in my opinion, the smartest minds in the field do tend to implicate widespread environmental factors as a leading reason for such a dramatic shift in our endocrine health. This would certainly include chemicals found in things we use daily (such as hygiene products).

      I hope this helps.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Jennifer on 07/11/2016 at 8:48 pm

        Thank you so much, Augie, I appreciate your reply and the time you took to do so. I will certainly keep those things in mind when I visit my endo this week and gyno next month.

        It’s so important to have doctors you can trust and who you feel are thorough, and who can tell you how & why your body is doing this, so you’ll know how to correct it. Otherwise, what’s the point? Guessing games when consulting doctors is not fun.

        Thanks again.

        • Augie Galindo on 07/12/2016 at 3:12 pm


          You are most welcome. I couldn’t agree more. I very much hope that you find solid answers, and more importantly, solid solutions.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  56. Melissa on 07/12/2016 at 11:46 am

    Hi, My husband and I are trying to have a baby and so far we are experiencing difficulties. I did a blood test and was told my testosterone level is high. Could the cause of high testosterone, be the cause of fertility problem in a woman?

    • Augie Galindo on 07/13/2016 at 12:25 am


      Yes it could be, but before you accept that answer, make sure your calculated (not “direct) free testosterone level is evaluated. It is very likely that it is not high at all.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  57. Alice on 07/14/2016 at 2:15 am

    I am 28 years old I was diagnosed with PCOS when I was 17. I’ve had high testosterone levels since 13. I can grow a beard better then any man. Last year my high testosterone was causing me havic. I was having heart palpitations all the time anxiety very very high sex drive increased body oder. I was diagnosed with adnomiosis and endometriosis in September of last year. I ended up having a hysterectomy in March of this year I was left with just one ovary. Now 4 months later my testosterone is claiming back up the charts and I don’t know what to do. I can’t have any more kids and I’m still having an increase in medical problems due to my high T. I’ve taken every type of medication supplement shots over the years with no help. My adrenals are fine perfect labs. My thyroid is perfect. So now what do I do. Before surgery I was on fludimid for prostate cancer to bring down my T. Due to that my liver didn’t want to play nice and now here I am. Do I go and have the other ovary removed? Will my adrenal gland still over produce? I’m just ready to give up. Nothing has helped. I did 4 rounds of IVF with no results. I did get pregnant while on geonvi 2 years ago and have a perfect daughter. I had lots of doctors tell me all my problems would be reset after I had a child. They where wronge. My T level this month was 179 and my free T was 27. I’m stuck. I just want to be healthy and live a long life. I’ve been to tons of doctors that give up on me because I’m so different. They’ve given me progesterone to lower my T it made it go even higher. Please help.

    • Augie Galindo on 07/28/2016 at 2:18 pm


      I hate to hear that you have had such a difficult time addressing this issue. Unfortunately, I am no expert in PCOS, but it certainly sounds moving forward with removal of the remaining ovary is a plausible next step if your providers are suggesting it. One thing I would caution you about is to focus solely on your calculated free testosterone levels when assessing your androgen load. It will correlate most directly with your symptoms

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  58. Amber on 07/21/2016 at 9:39 am

    Hello. I am in desperate need of advice. I just had a baby 3 months ago. I have hashimotos and hypothyroidism. I started armour thyroid before pregnancy and although I have always had acne it got worse each time I increased my thyroid medications. I am now off the meds and thyroid levels are good. Now I am 3 months postpartum. Still struggling with acne. I have been on 100mg of spironolactone for 8 weeks. I just had a saliva hormone test done and results were: Estradiol .5 pg/ml
    Progesterone 32 pg/ml
    Testosterone 58pg/ml
    DHEAS 5.6ng/dl

    The test was done on day 22 of my period. but I started my period the next day as being on spironolactone I have been getting them twice a month. Testosterone is high. What are the factors looking for PCOS? I had an ovarian cyst rupture after the mirena last year but other than that ovaries were fine on ultrasound. I had my fasting insulin done and it was 70 (in range) and lh and fsh were in range as well. Before pregnancy and birth control I always had periods. I had regular periods for the 3 months after I stopped the pill before pregnancy too. So I do not understand why my testosterone is high. Is it possible that pregnancy has brought on pcos? I also noticed more hair growth on my face and abdomen while pregnant.

    • Augie Galindo on 07/28/2016 at 3:04 pm


      It is certainly possible that you underwent changes hormonally during and after pregnancy. However, the issue of testosterone levels in women is often misunderstood. Your total testosterone tells us very little. You need your SHBG and albumin so that your calculated free testosterone level can be checked to see if you are in fact suffering with elevated free testosterone levels. My assumption is that your sex hormone binding globulin levels will be high, when assessed, and that this is affecting how much testosterone and estradiol is actually causing any effect in your body. Spironolactone is used to block androgenic effects, but based on the labs you’ve given me, I don’t see definitive evidence that it is needed, especially if you are now having menstrual changes.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  59. Carol on 07/27/2016 at 2:42 pm

    Hi I am 23 I have high Testerone Level very high I was reading this and a lot of you don’t have their periods. When I have my periods it can last up to 2 months or more . They put me on some kind of brith control. Which they had to be careful on because I have a rare blood disorder. About month ago I had to be rush to the hospital because I start to have vaginal Hemorrhaging. It took the bleeding 2 weeks to stop. They think PCOS then they say cancer. I asked my doctor to see a Hormone specialist. What is going on doesn’t seem right at all. I am in a lot of pain most days. If you have any suggestion please let me know.

    Thank you

  60. Alison on 08/12/2016 at 7:05 pm

    I am 21 and I have excessive hair growth on my arms, stomach, and face. I have trouble losing weight, I have moderate to severe acne, and fatigue. I have a regular but heavy period. I just tested for high testosterone, and just had to go back in for more blood work. I thought it could be PCOS, but my doctor says that is impossible since I don’t have an absent period. Any help?

    • Augie Galindo on 08/22/2016 at 4:49 pm


      Keep in mind that I am no PCOS expert, but a couple of things are worth looking into more. First of all, hormonal imbalance can cause you to not have a period or not have a period regardless of whether PCOS is present. Also, total testosterone levels are often interpreted without calculated free testosterone levels being considered. This can make it seem like there is an androgen excess, when the opposite may be true. Not all PCP’s or even gynecologists have spent the necessary time to evaluate these types of hormonal issues properly. It may be time to seek out someone who specialized in that area.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  61. Manisha on 08/24/2016 at 6:19 am

    I have got my test results today and my testosterone level is 78.65 ng/dl. the average range suggested by the test lab is 14-76. Can you please suggest what are the problems associated with high testosterone and causes of it.
    Thanks Manisha

    • Augie Galindo on 08/25/2016 at 8:47 am


      With a borderline high number, the first thing to do is to repeat the test and make sure that your provider assesses your calculated free testosterone level. It is likely that despite having a slightly elevated total serum testosterone level, you still have a normal free testosterone.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  62. Stacey on 08/28/2016 at 12:06 pm

    Hi, this may seem like a silly question, but I’ve been told that a high level of testosterone can be signified by having ring finger that is longer than your index finger. Is there any truth in this or is it just a myth? I’d like to know if my testosterone levels were high but don’t like the idea of having blood taken, thanks

    • Augie Galindo on 09/03/2016 at 4:34 pm


      This definitely falls into the myth category. When you get curious enough, have your blood tested by a reputable and experienced provider.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  63. Heidi on 08/28/2016 at 6:02 pm

    HELP! Of course, I have PCOS. We do not have a R.E. within 100 miles of here. So after my visit and blood work with my family doctor, I have an appointment with one of two Endocrinologists in my area. My final goal is to conceive. However, my family doctor just keeps pushing birth control on me. I need advice on what to do! I don’t just want to mask the problem. Here are some of my blood results….

    Prolcatin: 13.0ng/ml
    TSH: 4.300
    Free T4 Level: 1.07 (0.82-1.77)
    Free Testosterone: 7.2pg/ml (0.0-4.2)
    Testosterone: 89ng/dL (8-48)
    DHEA-S: 302.0ug/dL (84.8-387.0)

    WBC: 12.4 (4.8-10.8) HIGH!
    RBC: 5.25 (4.2-5.4)
    HGB: 15.2 (12-16)
    HCT: 45.7 (37-47)
    MCV: 86.9 (80-99)
    MCH: 29.0 (26-35)
    MCHC: 33.3 (33-37)
    RDW: 13.7 (11.5-14.5)
    PLT: 326 (130-400)
    MPV: 7.7 (6.7-10.4)
    Segs: 74.1 (42.2-75.2)
    Lymph: 15.8 (20.5-51.1) LOW!
    Mono: 7.2 (1.7-10.0)
    Eos: 1.2 (0-7.0)
    Baso: 1.7 (0-2.0)

    1. I know with PCOS and high testosterone I can be put on B.C. to lower the number. But what can I do to FIX it?
    2. Why a high WBC? (No infection or inflammation that I know of)
    3. Why a low lymph count?

    29, F, PCOS, anxiety, pretty normal periods, mostly all the signs and sypmtoms of PCOS.

    Thank you so much, in advance!

    • Augie Galindo on 09/03/2016 at 4:45 pm


      If one of my patients desired to conceive, I would never recommend birth control. Also, your free testosterone level appears to be a direct or analog assay. The Endocrine Society recommends that this test not be used clinically. Have your total testosterone, SHBG (sex hormone binding globulin), and albumin tested so that you can calculated your free T. I THAT is elevated, then you have high testosterone levels. Fixing that can be difficult, and unfortunately, is not within my area of expertise. Increase WBC counts are often transient. I wouldn’t worry about that until it is confirmed by retest. When WBC counts are abnormal, it is entirely common to have single cell lines also be abnormal, but a low lymphocyte is pretty non-specific in this case. Finding your hormonal balance, specifically in the mid luteal phase will lend more insight. Best of luck to you!

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  64. Lisa on 08/28/2016 at 9:29 pm

    Hi, I have been suffering from a massive hair shed. I went off BC pills in December after being on them for 12 mos. I was prescribed them following a D&C for a thick ended endometrial lining, 6 mos daily DUB and simple hyperplasia. I stated to lose my hair in April. My hormone levels have been very volatile. My most recent levels are as follows

    Estradiol 370 PG/ML
    Estrone 185 PG/ML
    Testosterone 87
    Testosterone free 4.5
    SHBG 159 NMOL/L
    Progesterone 3.3
    LH 15.6 MIU/ML
    FSH 14.5 MIU/ML

    Sample collected day 20 of cycle

    I have seen an endocrinologist and he said he can’t help me. I have a 4mm microadenoma but he feels it’s not contributing and this is a peri menopause issue
    I am on 100mg of BHR cream daily. This raised my progesterone from <.5 to the current 3.3
    I have no symptoms other than hair loss.

    No one can figure out what is causing my high hormone levels. Can you please help me? Thank you for the gift of your time and knowledge.


  65. Amanda on 09/06/2016 at 7:46 pm


    I am a 29 year old female and have a 16 month old. I had saliva tests this summer after a couple months of no periods and feeling awful. This got worse after having Paragaurd inserted so I had it remove. I was diagnosed with PCOS before I had my son. I still have hair, anxiety, trouble sleeping, reactive hypoglycemia, and fatigue but no cysts on my ovaries like before. My saliva tested this summer showed very very low estrogen, high free test., and no DHEA. Prog was low as well. The cortisol looked high but wasn’t high and they suggested possible adrenal fatigue and this was hypoestronemia. Can I have PCOS without the cysts? What can cause hypoesteonemia? What can I do about the test? I just want to feel better-like myself before baby. I didn’t feel this bad with PCOS. Is this peri-menopause? The Dr. Just wanted to throw me on low-est birth control (that I haven’t done well on since I had my so-made me sick, emotional, and have PVCs ) and 100mg of DHEA. I tried 50 mg and couldn’t handle it- like drinking coffee. Any thoughts or advice is much appreciated!!

    • Augie Galindo on 09/20/2016 at 11:27 pm


      I am very sorry you have had to endure these struggles. First, I would recommend circling back to testosterone. Most providers only look at total testosterone, and when they do look at free, they often run the wrong test. Make sure someone checks your total, albumin, and SHBG. Start there, because if your calculated free T is low, it can be why your estrogen is low; aside from frank ovarian dysfunction.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  66. Jane on 09/10/2016 at 7:31 am

    Hello, I have struggled with irregular periods all my life, would get ones that would last a month sometimes and others only last a few days and sometimes I wouldn’t have one for as long as 6 months. I had a test done and the dr said I had high testosterone and said the only thing that would help was the pill(birth control) in regulating that if I wasn’t trying to get pregnant, i really didn’t want to take the pill and said that but it sounded like the only option. I originally wanted to get this done to make sure i would be able to get pregnant in the future (not right now) just to know so I wouldn’t stress about my periods. I do have rapid hair growth, I am 20 and 5″4 and weight is 120lbs, my acne is a little worse than the average person, but not too bad, mostly because I have a bad habit of picking at my face, but the dr said to me I might have to have help getting pregnant when I want to later on in life, she didn’t make it sound serious or that I would for sure need to have help but I just want to know, I had an ultrasound done as well and that was normal they showed me my eggs and what not so wouldn’t that mean I can get pregnant?

    • Augie Galindo on 10/02/2016 at 3:04 pm


      Achieving the delivery of a healthy baby is an incredibly complex and multifactorial process. Sonographically normal eggs are a promising sign, but are such a small part of the process at larger, that little can really be extrapolated from that. I also, though, am leery of statements like “the dr said I had high testosterone” because these levels are rarely evaluated appropriately. If you did not have your calculated free testosterone level checked, I wouldn’t trust the diagnosis. Also, I personally don’t see oral contraceptives as being a good option to treat elevated testosterone levels even when they are confirmed to be present.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  67. esthar on 09/14/2016 at 8:13 am

    hai..am 23 old..I have pcos and my testosterone level is 142.8 ng..also am having hypothyroid(6.28)..i have excessive hair growth in my chin,lip up,chest,legs..what is the solution to me?..how long which take to cure?please reply me..
    thank you

    • Augie Galindo on 10/02/2016 at 3:20 pm


      Unfortunately, treatment of testosterone excess is not my expertise. There are endocrinologists and gynecologists specialized in this area. Your best be would be seeking out such a practice.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  68. Alicia on 09/21/2016 at 10:54 am

    I have high testerone and I’ve been on two many birth controls the past couple of years finally stopped taking them almost a year….haven’t had a period in over two….what am I suppose to do….I’ve gained weight trying to have a baby and haven’t gotten pregnant….what can I do????

    • Augie Galindo on 10/02/2016 at 3:36 pm


      If you have gone more than three months without birth control and regular unprotected sexual intercourse, and have not become pregnant, your first step should be to see your ob/gyn and have them refer you to a fertility specialist.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  69. Kristin Schmidt on 09/27/2016 at 4:14 pm


    I’m 34 years old and about 2 years ago I started feeling not like my normal energetic self. I started suffering from anxiety, depression, panic, hot flashes/night sweats, lack of energy/motivation, etc. I chalked it up to my very high stress job. Dr. tried to put me on Pristiqe and said my blood work was just fine. I knew it was not as I felt like a complete crazy mess. Over the last year my symptoms have gotten worse and even debilitating. I have gained 20lbs out of no where and can’t lose it no matter what I do. After much research, I contacted a nutritionist and got my hormones tested. I’m just trying to get another opinion before I go see the nutritionist and go over the results. Results are:
    T4, free (Direct) 0.81
    Testosterone, total, LC/MS 41.4
    Free Testosterone (direct) 7

    After reading up, I don’t want to get mis-diagnosed with high T. Your comments have been really educational and I appreciate your any advice you might have! Thanks!

    • Augie Galindo on 10/02/2016 at 3:54 pm


      Thank you for your question! Your total does not appear to be high, but the free testosterone test they ordered is unfortunately, worthless. Also, for thyroid function, the most important number is your free T3. Your symptoms definitely warrant a thorough workup. Make sure that estradiol and progesterone levels are also evaluated, preferably in the mid-luteal phase.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  70. Lisa on 10/10/2016 at 1:25 pm

    My lab test say that my total serum testosterone level is 28 ng/dl and my free testosterone level is high at 46.85 pg/ml. This test was taken 2 days before my period. Do you levels raise just before your period and should I be worried that my free t is skyrocket high?

    • Augie Galindo on 10/10/2016 at 7:07 pm


      There is fluctuation during your cycle but not enough to cause that big of a discrepancy. My assumption is that they ran a “direct” free testosterone which is a study that is clinically useless.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  71. DebraK on 10/11/2016 at 9:57 pm

    Great reading. I’ve learned a lot by reading all the comments, questions, and replies. I am anxious to see my last test results as I know I have high testosterone, but not sure if I had the right tests done. I feel good about the info on this site though. Thanks!

    • Augie Galindo on 10/19/2016 at 8:26 pm


      Thank you so much for the feedback, Debra. My goal is to provide great information bout hormone therapy. I am very glad that you have found our site useful.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  72. Allison C on 10/12/2016 at 10:20 am

    Hi! I’m wondering if anyone can help me out here, as my doctors have no answers.

    30 y/o female, have been off birth control pills for 1.5 years. My testosterone levels are really high and my doc has no clue (nor does she care). I have some PCOS symptoms (thinning hair in male pattern + acne since going off pill) but very regular periods plus my OBGYN said my ovaries are non-cystic and I do ovulate. I have every symptom of hypothyroid but my numbers are all in range. T3 Free is 2.7, that’s the only one that seems like it’s close to off.

    What concerns me is the out of range numbers: (day 13 of my cycle)
    Testosterone Total: 106 (range is 2-45)
    Testosterone bioavailable: 8.9
    Progesterone: <0.1

    Other numbers:
    Testosterone free: 4.1. SHBG: 121. Albumin serum: 4.8. Estradiol: 52. Ferritin: 33

    I decided to restart BCP to treat the symptoms, but now I'm wondering if I should try Progesterone cream instead. Please help!

    • Allison C on 10/12/2016 at 10:43 am

      Oh and I should add, my worst symptoms are HORRIBLY low energy, depression, and major hair loss.

    • Augie Galindo on 10/20/2016 at 3:14 pm


      While your total testosterone is high, your Calculated Free Testosterone level is normal; mid-normal actually. The reference range is 0.3-1.9 ng/dl for females, and your level is 0.736 ng/dl. I look at thyroid function differently, and do not like seeing Free T3 levels that are barely normal. I am even more suspicious of thyroid insufficiency when TSH levels are above 3.0. I prefer to check progesterone levels as close to day 21 of your cycle, but it looks like you likely have progesterone deficiency as well. I personally do not like BCP’s effects on the body as their purpose is to disrupt a normally functioning body system, not treat an ailment. I hope this helps.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  73. Jason C on 11/17/2016 at 6:30 pm

    My 16-yr old daughter has not yet had a period and had blood work done last week. She is 5-7 125 lbs; very active with minimal acne although she takes an antibiotic for it; She had an ultrasound and uterus and ovaries were unremarkable; TSH 1.172; WBC 5.4; RBC 5.43; HGB 16.8; HCT 49.9; Prolactin 19.5; Free Testosterone 1.05; Testosterone Serum 55

    Her doctor considers her PCOS because her free T is > 0.9, the PCOS threshold and she has irregular or no menses along with acne. I don’t consider her acne to be more than typical for 16-yr old. Do you agree with the PCOS DX based upon these facts?

    • Augie Galindo on 11/22/2016 at 11:51 am

      Jason C,

      The limited information I have leaves me making many assumptions, but at first glance I would consider her likely low body fat percentage to have a bigger impact on her amenorrheic status than her testosterone levels. Pituitary control of ovarian production can and should be assessed.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  74. What Happens When Testosterone Is High on 11/25/2016 at 2:41 pm

    […] 4 Causes of High Testosterone in Women – These 4 causes of high testosterone in women might just be what’s making you feel the … this doesn’t happen for years because they’re misdiagnosed with high … […]

  75. Aimz on 11/25/2016 at 8:13 pm

    I was hoping you could help add some insight into my issues.
    I had a blood test on cycle day 3.
    My results are;
    Albumin 41 g/L (33-46)
    Fasting Glucose 5.2 mmol/L (3.6-6.0)
    Testosterone 1.1 nmol/L (<3.2)
    SHBG 53 nmol/L (20.0-110.0)
    Calculated free testosterone 15 pmol/L (3-37)
    DHEAS 12.1 umol/L (1.7-9.2)
    Oestradiol 638 pmol/L (110-180 follicular)
    FSH 4 IU/L
    LH 3 IU/L
    Androstenedione 10.0 nmol/L (1.6-11.8)
    Free T3 3.3 pmol/L (2.6-6.0)
    TSH 1.0 mIU/L (0.3-3.5)

    Symptoms; long cycles/missed periods, irregular cycles, (e.g 27 day,31,37,48,51 days etc last year missed 3 periods in a row)
    Unexplained weight/fat gain 55pounds, can't lose weight, loss of libido,irritated easily, fatigue, afternoon tiredness slump.

    I was not tested for progesterone. I am wondering what day of my cycle would i test progesterone,estradiol since my cycles are unpredictable and not a 28 day cycle.
    I take T3 as hypothyroid/ex thyca, so have had a TT, 20mcg x 3/day, endo has since added 50mcg of T4 once per day, from my blood results above and symptoms, but says i may be in early menopause? I am 38.
    I am wondering why my DHEAS is high/out of range, if Oestradiol is high for cycyle day 3 and if this means menopause? Would my weight gain and symptoms be due to testosterone? Or early menopause.
    Do women get hormone support for early menopause or just go through the motions?

    Thank you

    • Augie Galindo on 11/26/2016 at 5:53 pm


      There is quite a bit here, and I don’t have a great grasp on your whole clinical picture, but here are some thoughts. By the way I evaluated your testosterone levels (after conversion) you are on the low side of normal for your free testosterone, but normal (result 0.429 ng/dl, range 0.3-1.9). Your estradiol level is very high for day 3 of your cycle, but you can’t weight this too heavily given the history of irregular cycles. I don’t think your thyroid issues are impacting your cycle changes, it is much more likely to be progesterone deficiency, which of course was not checked. I also think the DHEA elevation is irrelevant to your symptoms. Finally, this is the opposite of a menopausal picture. With that, you would have a low estradiol level and elevated FSH/LH levels. Do some reading on estrogen dominance and/or progesterone deficiency and make sure they look into that for you.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Aimz on 11/27/2016 at 7:09 am

        Thank you for taking the time to reply and for your helpful suggestions. I really appreciate it,
        Kind Regards

        • Augie Galindo on 11/27/2016 at 2:50 pm


          You are most welcome! Best of luck in getting everything figured out.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  76. Camille on 01/24/2017 at 12:57 pm


    I am at a cross roads wondering if I should see a doctor for the following symptoms:

    -Brain fog (severe)
    -Excess hair growth on front of neck under chin
    -Weight gain
    -Irregular menstral cycle

    Could I bother you for your opinion?

    Thank you,

    • Augie Galindo on 02/06/2017 at 6:42 pm


      Knowing that these symptoms, while certainly not life threatening, can be very disruptive. Most of these do point to hormonal issues, so I would say that evaluation by an experienced provider would be appropriate in your case.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  77. Nadine Moore on 02/10/2017 at 8:37 am

    I am a 48 years old female with NO sex drive so I have been injecting myself with .2-.3 ml testosterone cypionate , into stomach fatty tissue, every two weeks for about a year now. I have had phenomenal results. I’m concerned with making sure my hormone levels are at safe levels. I get them checked twice a year. I’m due to go over most recent testosterone results. My most recent testosterone total lc/ms is 270.8
    Testosterone serum 210, free testosterone 2.8. Should I be concerned with the high serum level?
    T4 1.34, dhea 116.4, tsh, 1.440, Estradiol 107.9 , lipids were perfect. I get mixed reviews mentioning testosterone therapy to different doctors so hoping for insight from someone with your expertise . Thank you

  78. Rebecca on 03/09/2017 at 12:52 pm

    I am 33 almost 34 and have been treated for hyperthyroidism for 7 years. I have gained 25 lbs in the last 2 years and recently got married and have been trying for a baby. My cycles are now anywhere from 30-60 days apart so I was tested for my FSH and testosterone. My test level is at 211 and FSH is prepubertal levels. I have not been diagnosed with PCOS, but let’s just say I do have it and it’s the cause of all my symptoms. What can be done other than anti-androgens? I really would like to have another child and don’t want to be much older than I am now.

    • Augie Galindo on 03/30/2017 at 5:33 pm


      That is an incredibly complex problem to mitigate. If FSH levels are pre-pubertal, LH levels likely are too. A thorough workup of pituitary, ovarian, and uterine function is likely in order. Only using anti-androgens, isn’t likely to fix the hypothalamic-pituitary-ovarian axis issues that are present.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  79. jennifer43 on 03/31/2017 at 8:34 pm

    i just asking n affraid. im 43. iv gained so much weight. hair all over my body, face head belly back. i shave my body except back. mood swings. anger depresssion.didnt have period 7 years. about year n half ago i started back with periods. i had november december january. off 2 weeks. back february march non stop. periods dont stop at all. i had alot blood work done. so far far high testosterone. he didnt give me numbers.. i have apt. on 13th. any help or think might be my problem?

    • Augie Galindo on 04/13/2017 at 6:19 pm


      Those changes definitely point toward hormonal imbalance, but I am always hesitant to make a judgement on testosterone levels until a calculated free T is checked. You will need a thorough work up and likely a sonogram to rule out PCOS and find other possible causes.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  80. Angeline Cooper on 06/07/2017 at 11:53 am

    I am a 42 y/o woman. Currently being treated with Spironolactone 300mg for excessive hair growth (especially at chin) acne, and hyperhidrosis. I have a hx of irregular menses, and infertility. However I have had 3 pregnancies w/o the use of fertility meds. My testosterone Free level is at 8.0 w/o Spironolactone, and 3.4 with. I have been on this regimen for almost 4 yrs. We have ruled out an adrenal tumor. My Endo and Gyno would like to make the dx of PCOS, even without the presence of ovarian cysts on any ultra sound. My Tfree is at 3.5 currently, but in the past two weeks I have noticed an increase in facial hair, and acne. I’ve also had an increase in menses. I had a uterine ablation in 4/14 with no mense x1 yr. All other hormones seem to be within a good range. Progesterone is a bit low but still within range. Is there anything that my PCP, GYNO, and ENDO could be missing? Any and all help in this matter is greatly appreciated.

    Angel Cooper

    • Augie Galindo on 06/24/2017 at 7:07 pm


      Understand that the use of spironolactone in this setting is only to reduce androgenic influence, but does not significantly mitigate ovarian dysfunction. Pituitary involvement (FSH, LH, and Prolactin) should be evaluated. Also, comparison of progesterone and estradiol ratios at days 12 & 21 of your cycle (assuming a 28 day cycle) may prove more informative when evaluating progesterone deficiency.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Angeline Cooper on 06/25/2017 at 12:41 pm


        Thank you for the reply. If you could please, offer more information in regards to the other hormones that may be involved. I don’t have a “regular cycle”. I’ve had labs and an ultrasound several time , 21 days and 28 days after a menstrual cycle. We’ve not seen any change and with such irregular cycles it’s difficult to determine my follicular stage. I had a uterine ablation 3 years ago. After 1 year of D/C menses my cycle restared and was on a more regular cycle then it had ever been. But has retured to its unpredictable sequence. The only other lab result that has ever been out of its designated range is bilirubin. (I do not think that the two are correlated, just they are the only abnormal results). When would you suggest that I have labs run? My 17 y/o daughter has only 2-3 menses per year. 2yrs ago her labs were also normal. She was on the higher end of the normal range. Could this be a genetic trait that I carry?

  81. Charlotte on 08/28/2017 at 7:55 am

    Hello, I am writing because I got some alarming results back on a saliva hormone panel test I ordered. I am 28. I have had extremely sensitive/acne-prone skin since I was 19 and excessive hair growth (stomach, chin, etc.) but in the past year I quit smoking and went under a lot of stress and these problems got a lot worse. I have always had regular periods so my doctor said I don’t appear to have PCOS. I ended up ordering the saliva test and testing on day 20 of my cycle and got these results:
    Estradiol: 1.1 pg/ml range: 1.3-3.3 low
    Progesterone: 42 pg/ml range: 75-270 low
    Testosterone: 107 pg/ml range: 16-55 high
    DHEAS: 14.8 pg/ml range: 2-23
    Cortisol: 8.0 pg/ml range: 3.7-9.5 (morning)

    It shows slightly low estrogen and super high testosterone, so I am a bit alarmed. Any interpretations of this panel would be much appreciated. Thank you.

    • Augie Galindo on 08/31/2017 at 10:31 am


      Your calculated free T (cFT) level will be MUCH more telling than just looking at your total. A level of 107 could still yield a very normal cFT. Also, you must consider what day of your cycle estradiol and progesterone are measured on. In a textbook 28 day cycle, your estrogen peak is on day ~11-12 and progesterone on day ~18-22.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  82. Vanessa Gamez on 10/03/2017 at 6:25 pm

    I’ve had a few issues over the course of months to years and now weeks. After I had my last daughter 6 years ago my periods began to change from 7 days to barely 3. My OBGYN said it was nothing out of the ordinary. I’ve had issues loosing weight, i don’t go up but i can’t go down. At times I thought I was going through menopause since I would get occasional hot flashes and night sweats. My sex drive decreased this year along with breast tenderness. A few weeks ago I got onset anxiety and insomnia. I decided to get my hormones tested and these were the results. I’m 35 years old and never really had any health issues until this year.

    Total Testosterone 64.5 NG/dL
    Free Testosterone 0.9 NG/dL
    Dhea-sulfate, Serum 631.9 ug/dL

    • Vanessa,

      To properly evaluate your symptoms from a hormonal standpoint, you need to also look at your estradiol, progesterone, LH, FSH, and PRL levels. Also, make sure they are looking at your calculated free T. It will shed light on whether or not your total testosterone is truly leading to a free testosterone elevation.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  83. Alecia Kosark on 12/11/2019 at 11:05 pm

    I’m a 41 year old female. Iddm type 2, htn, ate my only health problems. I recently began having a receding hairline, facial hair, and body hair, not to mention mood swings. My TSH was normal my testosterone level is 194. Where should I begin? Gyno or endo? My pcp has told me before my hormones were “all over the place “ although he never offered a solution. I did have fertility trouble and took clomid I know it can increase chances of ovarian CA. Thank you for your time

    • Alecia,

      Thank you for your question. Let me preface with the acknowledgement that I am about to make a very generalized statement, but I have not come across many gynecologists that refrain from throwing birth control meds at every hormonal issue they see, and many endocrinologists become so focused on diabetes, that little attention is given elsewhere. I would recommend finding a provider who is well reviewed locally, and that has a practice focused on hormonal health. Measuring the TSH level doesn’t dive deep enough to fully assess the thyroid, even when it’s “normal”. Balancing testosterone, progesterone, and estrogen, along with your thyroid, takes some focused effort.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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