Increased testosterone levels in females

TestosteroneThe topic of increased testosterone levels in women has caught the limelight with the IAAF Caster Semeya-case. In light of this, Mari Hudson of RSG, interviewed Prof Kruger (Aevitas Fertility Specialist) and Dr Thinus van der Merwe (Lab Director of the South African Doping Control Laboratory) to look at three key topics: Conditions presenting with natural increased testosterone levels in women; The influence of high levels of testosterone on sporting performance; How can laboratories differentiate between natural and administered testosterone. Below is a summary of Mari Hudson’s interview with Prof Kruger, explaining some typical scenarios, where increased testosterone levels in women, are present.

  • PCOS. The most common condition presenting with increased testosterone levels in women, is Polycystic ovary syndrome (PCOS). In these cases, women often don’t ovulate, menstrual cycles are irregular, acne and increased facial hair might be present, as well as a slight increased testosterone level. The increased testosterone level is addressed as part of the treatment to assist these women to ovulate, so they can fall pregnant naturally.
  • Congenital adrenal hyperplasia. This condition is due to an enzyme deficiency, which can cause irregular or absence of menstruation cycles and increased testosterone levels in women. The diagnosis of this enzyme deficiency can be confirmed by performing a 17 hydroxyprogesterone test. Treatment is through means of cortisone, which can restore the natural menstruation cycle and these women are then able to fall pregnant naturally.
  • Complete androgen insensitivity syndrome (complete testicular feminisation). Usually these patients were raised female and look very feminine, however they never menstruated. Upon further investigation, doctors will discover that there is no uterus and the testis is usually intra-abdominal. Further testing will confirm that these patients have the genetic material of a male (46XY).
  • Partial androgen insensitivity syndrome (partial testicular feminisation).This condition also present with 46XY chromosomes. However, these patients don’t appear very feminine. They  usually present with  decreased breast development and a more muscular build, which will usually allow them to perform well in sport.

Should you wish to listen to the full interview in Afrikaans, follow the link and download the podcast: ‘Gesondheid 27 February 2019’