Women can lower testosterone through a combination of lifestyle changes, targeted supplements, and prescription medications, depending on how elevated their levels are and what’s driving the excess. Normal total testosterone for women falls between 15 and 70 ng/dL, and even modest elevations above that range can cause noticeable symptoms like excess facial or body hair, acne, thinning hair on the scalp, and irregular periods. The most common cause of high testosterone in women is polycystic ovary syndrome (PCOS), but insulin resistance, adrenal dysfunction, and certain medications can also push levels up.
Why Testosterone Gets Too High
Testosterone in women is produced by the ovaries, the adrenal glands, and through conversion in fat tissue. When something disrupts the normal feedback loop, production ramps up. In PCOS, which affects roughly 1 in 10 women of reproductive age, the ovaries overproduce androgens. But the story often starts with insulin. When your body becomes resistant to insulin, it compensates by pumping out more of it, and high insulin directly stimulates the ovaries to make more testosterone. This is why treatments that target insulin resistance are so effective at bringing testosterone down, even though they weren’t designed as hormone therapies.
Excess body fat also plays a role. Fat tissue is metabolically active and contributes to both insulin resistance and altered hormone metabolism. This creates a cycle: high insulin drives up testosterone, high testosterone promotes fat storage around the midsection, and that fat worsens insulin resistance further.
Weight Loss: The Most Effective Lifestyle Change
For women who are overweight, losing even a small amount of weight can meaningfully reduce testosterone. The NHS notes that a weight loss of just 5% can lead to significant improvement in PCOS symptoms and hormonal profiles. For a woman weighing 180 pounds, that’s only 9 pounds. The effect comes primarily from improved insulin sensitivity. As insulin drops, the signal telling the ovaries to overproduce testosterone quiets down.
The type of diet matters less than the consistency. What helps most is reducing refined carbohydrates and added sugars, which spike insulin more than other foods. Pairing this with regular exercise, particularly resistance training and moderate cardio, improves how your muscles take up glucose and further lowers circulating insulin. You don’t need extreme restriction or intense workout programs. Sustainable changes that you can maintain for months produce better hormonal results than short bursts of aggressive dieting.
Supplements With Clinical Evidence
A few supplements have enough research behind them to be worth considering, though none are as powerful as prescription options.
Inositol is one of the most studied supplements for women with PCOS. A specific combination of two forms, myo-inositol and D-chiro-inositol in a 40:1 ratio, has been shown to improve insulin sensitivity and lower androgen levels. The typical dose used in clinical studies is about 2 grams of myo-inositol twice daily. It works along the same pathway as insulin-sensitizing medications, making cells more responsive to insulin so the body produces less of it. The ratio matters: research in the International Journal of Molecular Sciences found that D-chiro-inositol taken alone at certain doses can actually increase testosterone rather than lower it, so combination products at the physiological ratio are preferred.
Spearmint tea has shown mild anti-androgen effects in small clinical trials. In one study, women with PCOS who consumed spearmint (either as tea or in capsule form) for 30 days showed reductions in free testosterone. The effect is modest compared to medications, but for women with mildly elevated levels or those looking for a gentle starting point, drinking two cups of spearmint tea daily is low-risk and may help with symptoms like excess hair growth over several months.
Prescription Medications
When lifestyle changes and supplements aren’t enough, several prescription options can substantially lower testosterone.
Birth Control Pills
Combined oral contraceptives (containing both estrogen and a progestin) are one of the most commonly prescribed treatments. They work through two mechanisms: suppressing the ovaries’ testosterone production and increasing a protein called sex hormone-binding globulin (SHBG) that binds to testosterone in the blood and makes it inactive. The net result is a reduction in free testosterone of approximately 50%. For many women, this is enough to clear hormonal acne, slow unwanted hair growth, and regulate periods. Some progestins have additional anti-androgen properties, so the specific formulation your provider chooses can make a difference.
Spironolactone
Spironolactone is an anti-androgen medication originally developed as a blood pressure drug. It both reduces testosterone production in the adrenal glands and blocks testosterone from binding to receptors in skin and hair follicles. This dual action makes it particularly effective for symptoms like facial hair growth, hormonal acne, and scalp hair thinning. Standard doses range from 100 to 200 mg daily, though some women see benefit at lower doses of 50 to 75 mg. Higher doses above 150 mg tend to produce stronger results, especially for hair-related symptoms. It typically takes three to six months to see noticeable changes, since hair growth cycles are slow. Spironolactone must be used with reliable contraception because it can affect fetal development during pregnancy.
Metformin
Metformin targets the insulin side of the equation. By improving how your body responds to insulin, it reduces the excess insulin that drives ovarian testosterone production. In a randomized study, women taking 1,500 mg daily saw their insulin levels drop by 25% and their testosterone levels drop by 23%. Lower doses of 1,000 mg daily produced only minor hormonal changes, suggesting that adequate dosing matters. Metformin is especially useful for women whose high testosterone is closely tied to insulin resistance, weight gain, or prediabetes. It’s often prescribed alongside other treatments rather than as a standalone option.
How Long It Takes to See Results
The timeline depends on the approach and the symptom you’re tracking. Blood testosterone levels can start shifting within weeks of beginning medication or making dietary changes, but the symptoms that bother most women take longer to respond. Acne typically improves within two to three months. Excess hair growth is the slowest to change because each hair follicle has its own growth cycle; expect at least six months before new growth slows noticeably, and existing hairs will still need to be managed with removal methods in the meantime. Menstrual regularity often improves within one to three cycles of starting treatment.
Scalp hair thinning is similarly slow to reverse. Hair grows roughly half an inch per month, so even after testosterone levels normalize, it takes six to twelve months to see visible thickening. Many providers recommend committing to a treatment plan for at least six months before evaluating whether it’s working.
Combining Approaches for Best Results
Most women get the best outcomes by stacking strategies rather than relying on a single one. A common and effective combination is a birth control pill to suppress ovarian androgen production, spironolactone to block the remaining androgens at the tissue level, and lifestyle changes to address underlying insulin resistance. For women who prefer to avoid hormonal contraception, metformin plus spironolactone plus inositol can cover similar ground. The right combination depends on your specific symptoms, whether you’re trying to conceive (since spironolactone and birth control pills aren’t options during pregnancy), and what’s driving the testosterone excess in the first place.
Tracking progress with blood work every three to six months helps you and your provider see whether levels are moving in the right direction, even before symptoms fully resolve. Total testosterone, free testosterone, and fasting insulin are the most useful markers to follow.