Does high testosterone cause fat gain?

In women, too much testosterone can cause insulin resistance and abdominal weight gain. That's why androgen excess is a factor in the weight gain associated with polycystic ovary syndrome (PCOS), menopause, and some types of birth control.

larabriden.com - How Testosterone Causes Weight Gain in Women - Lara Briden

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In women, too much testosterone can cause insulin resistance and abdominal weight gain. That’s why androgen excess is a factor in the weight gain associated with polycystic ovary syndrome (PCOS), menopause, and some types of birth control.

PCOS

The link between testosterone and insulin resistance is most clear with the hormonal condition PCOS, in which high androgens made (mostly) by the ovaries cause insulin resistance and impair ovulation. Impaired ovulation, in turn, causes low progesterone and therefore robs the system of progesterone’s beneficial anti-androgen effect. Which, in turn, causes more high androgens and more insulin resistance, creating a vicious cycle that I describe in my peer-reviewed paper. Natural progesterone can help to lower androgens, improve insulin sensitivity, and break the cycle of PCOS. That’s why Professor Jerilynn Prior’s protocol of cyclic progesterone therapy for PCOS is currently undergoing a clinical trial. 👉 Tip: There’s no progesterone in hormonal birth control. Contraceptive drugs are progestins, many of which are androgenic or testosterone-like (see below).

Menopause

With menopause, progesterone and estrogen drop away while androgens slightly increase before resuming their gradual decline with age (as happens in both men and women). The menopausal situation of relatively high testosterone paired with relatively low estrogen and progesterone causes a profound shift in fat distribution from gynoid (hourglass) to android (thicker waist and heavier upper body). Menopausal hormone therapy (estrogen and progesterone) can have a beneficial anti-androgen effect and improve insulin sensitivity. For example, estrogen therapy directly improves insulin sensitivity and lowers testosterone by increasing sex hormone-binding globulin (SHBG), the protein that binds and inactivates testosterone. Progesterone indirectly improves insulin sensitivity by stimulating metabolic rate and lowering testosterone. Taking testosterone or androgenic progestins can worsen insulin resistance and cause weight gain.

Birth control

Androgenic (testosterone-like) progestins can cause insulin resistance and weight gain. They include levonorgestrel, norethindrone, and etonogestrel, found in many pills, Nuvaring, Mirena IUD, and the Nexplanon implant. Anti-androgenic progestins can promote weight loss while they’re being taken but then cause rebound weight gain when they’re stopped. Anti-androgenic progestins include drospirenone, norgestimate, dienogest, and cyproterone.

The link between high testosterone and insulin resistance

There’s a bi-directional relationship between high testosterone and insulin resistance.

In one direction, insulin resistance or high insulin can stimulate ovarian cells to make more testosterone. That happens with PCOS and menopause. In the other direction, testosterone can cause or worsen insulin resistance. That happens with PCOS, menopause, and androgenic progestins. And all of it can lead to weight gain, acne, facial hair, irregular periods, and a long-term risk of diabetes. There are two parts to the solution: 1) reverse insulin resistance and 2) lower androgens, which, in turn, can improve insulin resistance.

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Are there any FDA approved testosterone boosters?

None of the FDA-approved testosterone products are approved for use in men with low testosterone levels who lack an associated medical condition. FDA-approved testosterone formulations include the topical gel, transdermal patch, buccal system (applied to upper gum or inner cheek), and injection.

fda.gov - Testosterone Information - FDA

Testosterone is a hormone essential to the development of male growth and masculine characteristics. Testosterone products are FDA-approved only for use in men who lack or have low testosterone levels in conjunction with an associated medical condition. Examples of these conditions include failure of the testicles to produce testosterone because of reasons such as genetic problems or chemotherapy. Other examples include problems with brain structures, called the hypothalamus and pituitary, that control the production of testosterone by the testicles. None of the FDA-approved testosterone products are approved for use in men with low testosterone levels who lack an associated medical condition. FDA-approved testosterone formulations include the topical gel, transdermal patch, buccal system (applied to upper gum or inner cheek), and injection. The manufacturers of two prescription topical testosterone gel products, AndroGel 1% and Testim 1%, were required to include a boxed warning on the products’ labels. The agency required this action after receiving reports of adverse effects in children who were inadvertently exposed to testosterone through contact with another person being treated with these products (secondary exposure).

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