Female Hormone balance , Gynecology concept

Many of you have probably heard about sex hormones. Many also know that traditionally they are divided into “male” – androgens and “female” – estrogens. Interestingly, the notorious cholesterol is the precursor of both. Yes, it turns out that it is very important for our bodies. Therefore, if you do not have atherosclerosis, it is not recommended to completely exclude cholesterol-containing foods from the diet (for example, eggs, dairy products, meat, and poultry).

But even more interesting is that the role of androgens is also often underestimated. Androgens for the female body are much more important than it seems at first glance. After all, they are the immediate precursors of female sex hormones – estrogens.

First, during a series of transformations, androgens are formed from cholesterol: testosterone, androstenedione, and their derivatives. This process includes several stages – biochemical reactions. Testosterone, androstenedione, and their derivatives are converted into estrogens at the final stage. Estrone is formed from androstenedione, estradiol from testosterone, and 16-hydroxy estrone and estriol from their 16-hydroxy derivatives.

The main enzyme that converts male sex hormones into female ones is aromatase. The CYP19A1 gene encodes it, and the effectiveness of this transformation will depend on its work. Optimal aromatase activity is essential for women’s health. Its too high activity with a high sensitivity of a woman’s body to estrogen can be a factor that increases the risk of developing female cancers: breast, endometrial, and ovarian cancer. The weak activity contributes to a shift in the balance towards androgens, associated with certain undesirable consequences for a woman.

Too many androgens?

Androgens are our ambitions, character, self-confidence, and, by the way, libido. They also contribute to an increase in bone and muscle mass and hair growth.

But an excess of male hormones in the female body can lead to not the most pleasant consequences, such as a tendency to a male body type, acne, and excessive hair growth (hirsutism). Elevated levels of androgens, or hyperandrogenism, are directly related to a disease such as polycystic ovary syndrome.

Suppose it is present, in addition to the mentioned “cosmetic” manifestations. In that case, violations of the monthly cycle are added in severe cases – quite serious, which can even lead to the absence of ovulation. As the name implies, with this disease, on ultrasound of the pelvic organs, doctors observe cysts on the ovaries – formations like vesicles with liquid, benign but pathological and capable of causing certain problems.

What if you do without them?

However, at the same time, the female body cannot do without androgens. Firstly, as we have already said, androgens are the immediate precursors of estrogens, so if too few of the first is in the body, there is nothing to form the second form.

If aromatase normally works in the female body, androgens quickly turn into stores and do not have time to cause excessive effects. If its work is impaired (for example, due to genetic characteristics), androgens accumulate, contributing to an increased risk of developing hyperandrogenism. If aromatase, on the contrary, is too active, androgens turn into estrogens so quickly that an excess of the latter can develop, which also carries certain risks.

Another interesting aspect is the action of androgens in the female body. It has been shown that a certain amount of androgens in a woman’s ovaries is important to ensure normal sensitivity to follicle-stimulating hormone (FSH), one of the key regulators of the monthly cycle and ovulation. 

And finally, the cherry on the cake. Evidence shows that androgens play an important role by directly affecting the female body through their receptors. This is evidenced by the fact that the lack of sensitivity of these receptors to androgens (for example, as a result of mutations in the androgen receptor AR gene) can both increase the risk of developing certain diseases (for example, menopausal osteoporosis), and be associated with an increased risk of miscarriage and miscarriage.

Testosterone, not testosterone

If you thought that this was the end of testosterone surprises, you didn’t guess. For maximum effectiveness of its action, testosterone in the body turns into much more active dihydrotestosterone. The ability of dihydrotestosterone to bind to the androgen receptor is 2-3 times higher than that of its “parent.” Therefore, it is its action that contributes the most to the biological effects of testosterone.

As usual, a special enzyme is responsible for converting testosterone to dihydrotestosterone in our body – steroid-5-alpha-reductase. Insufficiently effective work of this enzyme can lead to hair loss, in a more unfavorable case – to insufficient hairline development. However, its excessive activity is also not the best option for a woman since it can lead to the same state of hyperandrogenism and all its unpleasant manifestations, including polycystic ovaries. Finally, if most of the testosterone is converted to another hormone, the body will have less material to synthesize estradiol!

Journey of testosterone through the body

It turns out that sex hormones, particularly testosterone, are not enough to synthesize. They also need to be delivered to the places of action. This is done by two proteins: sex hormone-binding globulin (SHBG) and albumin. At the same time, in women, 66–78% of testosterone is associated with SHBG, 20–32% with albumin, and only 2–3% of testosterone circulates in an unbound state (free testosterone). 

Calculation of free testosterone levels is considered clinically important. There is an opinion that the free hormone has a biological effect on the body. Testosterone associated with SHBG is not easy since this connection is quite strong. Therefore, with an excess of SHBG, hyperandrogenic states can be observed, and with its deficiency, hyperandrogenic states.

What affects testosterone levels?

The first is physical activity. With active physical exertion, the level of this hormone increases significantly. However, with normal hormonal metabolism, you don’t have to worry about this: aromatase will quickly make estradiol necessary for women from this androgen.

Foods rich in proteins and saturated fats also contribute to an increase in testosterol levels: seafood, especially oysters, again meat, and dairy products. Ginger, pomegranates, green leafy vegetables, oily fish and fish oil, and onions also help increase its production. But foods from cereals rich in fiber (grain bread, bran flakes) can cause a decrease in testosterone levels in the body.

 It is also important that the body receives enough essential vitamins and minerals, primarily vitamin D and magnesium. Well, in any case, to maintain a normal hormonal background, it is important to maintain normal body weight.


So, let’s summarize. Androgens, particularly improve the production of Testosterone naturally, play an important role in the female body. Their deficiency (of course, within the physiological norm for a woman) is no less undesirable than an excess. But recognizing this condition is not always easy since the symptoms may not be noticeable at first glance, both by the women themselves and by gynecologists. But you can learn about your innate predisposition to decreasing or increasing male sex hormones.

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