Healthcare provider with diagram talking about testosterone and female fertility with patient

Testosterone and Female Fertility: Is There a Connection?

Written on January 24, 2024 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Infertility impacts millions of people worldwide. The World Health Organization reports approximately one in six people of reproductive age around the world experience infertility in their lifetime.[1] Around 11% of women of reproductive age in the United States are estimated to experience fertility issues.[2]

The causes associated with female infertility can be challenging to diagnose and sometimes unknown.[3] If the cause of the infertility is known, treatment options could be available. However, many times, infertile couples may go on to conceive a child without treatment. The definition of infertility is an unsuccessful pregnancy with frequent, unprotected sex for at least a year. Continue reading to learn more about testosterone and female fertility issues.

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More About Infertility

The main symptom of infertility is the inability to get pregnant.[3] Other signs and symptoms of female infertility can involve a menstrual cycle that is longer than average (35 or more days), too short (less than 21 days), or irregular or absent. You may reach out to a healthcare provider for help with infertility if you or your partner have known fertility problems, you have irregular or painful periods, pelvic inflammatory disease, repeated miscarriages, or endometriosis.

For a successful pregnancy to occur, all steps in the human reproduction process will have to occur.[3] Female infertility occurs when there are disruptions in this process at any of the phases. Issues with reproductive hormone regulation can impact fertility. A condition known as polycystic ovary syndrome (PCOS) can cause hormone imbalances and lead to female infertility.[3,4] Disorders of the endocrine system that produce imbalances in the reproductive hormones can also cause female infertility.[1]

What Is Testosterone?

Testosterone is a reproductive hormone that is primarily known as a male sex hormone.[5] Though testosterone is a significant androgen hormone known to stimulate the development of male characteristics, it is also important for females. The majority of testosterone in women is produced in the ovaries, and it can be converted into the primary female sex hormone, estradiol.

Testosterone in women also impacts libido, bone and muscle health, mood and energy, menstrual cycles, and fertility.[6] Normal testosterone levels in females are based on age. Those less than 1 year old have a normal testosterone level of less than 21 ng/dL. Those who are 1 to 5 years old have less than 12 ng/dL. Children aged 6 to 10 years old have normal levels of less than 25 ng/dL. For the age range of 11 to 17 years, a normal testosterone level is less than 79 ng/dL. In those who are 18 years old up to 99 years of age, a normal testosterone level is less than 40 ng/dL.

Intersection of Testosterone Levels and Female Infertility

Your body's testosterone levels are controlled by your hypothalamus and pituitary glands, which are part of the endocrine system.[5] Normal testosterone levels are essential for many body functions and processes, including fertility in women.[4-6] Hormonal imbalance with high testosterone levels may be a sign of PCOS. PCOS is one of the most common causes of infertility in women and people assigned female at birth.[4] Low levels of testosterone in women are also a common sign of infertility or issues with conceiving.[6] Therefore, high or low testosterone levels in the blood could lead to women’s infertility.

Exactly how the testosterone hormone leads to fertility problems in women is not entirely elucidated and understood. In a study with animal models, data suggested that excess androgens (like high testosterone levels) may contribute to unregulated follicle growth, as seen in diseases such as PCOS.[7] Another study with a small number of patients aimed at characterizing the changes caused by long-term exposure to testosterone.[8] The results of the study imply that fertility in women with increased testosterone levels is potentially altered by blocked fallopian tubes that may cause impaired sex cell transport and survival.

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Several hormones have a role in affecting your menstrual cycle, ovulation, and ability to get pregnant. With the Women’s Fertility At-Home Lab Test, you can check five key hormone levels, including testosterone. The at-home test will provide detailed information on the five hormones measured and whether your levels fall within established normal levels or ranges.

This particular test can help with the initial steps in understanding reproductive and general health for people assigned female at birth. The five hormones include estradiol, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, and total testosterone level. The total testosterone level measures both the free testosterone in the body and testosterone that is bound to the albumin protein and sex hormone-binding globulin in the blood. These levels of hormones can help give you a broad overview of the hormones related to fertility and any potential hormonal imbalance that may be contributing to the ability to conceive.

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References

  1. Infertility. World Health Organization. Accessed January 19, 2024. https://www.who.int/news-room/fact-sheets/detail/infertility.
  2. How common is infertility? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Accessed January 19, 2024. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common.
  3. Female infertility. Mayo Clinic. Accessed January 19, 2024. https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308#overview.
  4. PCOS (polycystic ovary syndrome): Symptoms & treatment. Cleveland Clinic. Accessed January 19, 2024. https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos.
  5. Testosterone: What it is, Function & Levels. Cleveland Clinic. Accessed January 19, 2024. https://my.clevelandclinic.org/health/articles/24101-testosterone.
  6. Low testosterone in women: Causes, symptoms & treatment. Cleveland Clinic. Accessed January 19, 2024. https://my.clevelandclinic.org/health/diseases/24897-low-testosterone-in-women.
  7. Sen A, Prizant H, Light A, et al. Androgens regulate ovarian follicular development by increasing follicle stimulating hormone receptor and microRNA-125b expression. Proc Natl Acad Sci U S A. 2014;111(8):3008-3013. https://pubmed.ncbi.nlm.nih.gov/24516121/
  8. Dulohery K, Trottmann M, Bour S, et al. How do elevated levels of testosterone affect the function of the human fallopian tube and fertility?-New insights. Mol Reprod Dev. 2020;87(1):30-44. doi:10.1002/mrd.23291.

Sendra Yang, PharmD, MBA received her Doctor of Pharmacy and Master of Business Administration degrees from Wingate University School of Pharmacy. She is a skilled medical information professional with nearly 10 years of experience in the pharmaceutical industry, pharmacy education (including as an Assistant Clinical Professor at the Medical College of Wisconsin), and clinical practice. She has also been a medical writer and editor for consumer health and medical content. Sendra is passionate about translating complex medical concepts into simple and easy-to-understand information.

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