Dihydrotestosterone (female)

Other names: DIHYDROTESTOSTERONE, LC/MS/MS, 5a-dihydrotestosterone, DH

Optimal Result: 4 - 22 ng/dL, or 40.00 - 220.00 pg/mL.

What Is Dihydrotestosterone (DHT)?

Dihydrotestosterone (DHT) is a potent androgen—a type of sex hormone—that plays a key role in the development of male sexual characteristics. It is primarily active during fetal development and puberty in individuals assigned male at birth, and it contributes to traits like body hair, prostate growth, and male-pattern baldness. While DHT is present in people of all sexes, its role is more prominent in male reproductive physiology.


How Is DHT Made?

DHT is produced when the enzyme 5-alpha-reductase converts testosterone into DHT in specific tissues. About 10% of testosterone in adults is converted into DHT each day. This conversion primarily happens in:

  • Testes and prostate (in men)

  • Ovaries (in women)

  • Skin, liver, and other peripheral tissues

DHT is significantly more potent than testosterone—it binds more strongly to androgen receptors, and many of testosterone’s effects in the body only occur after it’s converted to DHT.


What Does DHT Do in the Body?

In Males:

  • Fetal development: DHT is crucial for forming male external genitalia (penis and scrotum) and the prostate gland during gestation.

  • Puberty: DHT drives the growth of facial, pubic, and body hair, enlargement of the penis and scrotum, and prostate development.

  • Adulthood: It maintains some secondary sexual characteristics, contributes to prostate growth, and is the main driver of male-pattern baldness in genetically predisposed individuals.

In Females:

DHT exists in much lower levels. It contributes modestly to:

  • Development of pubic and body hair during puberty

  • Possibly influencing the timing of puberty onset

  • However, DHT doesn’t appear to be essential for normal female reproductive function, and loss of DHT function in females has minimal physiological impact.


What Are Androgens?

Androgens are a group of steroid hormones that regulate male traits and reproductive activity. They include:

  • Dehydroepiandrosterone (DHEA)

  • Androstenedione

  • Testosterone

  • Dihydrotestosterone (DHT)

Among these, DHT is the most potent. Unlike testosterone, DHT cannot be converted into estrogen, making it a “pure” androgen. It acts locally in the tissues where it is synthesized—a process known as paracrine signaling.


Where Is DHT Active?

DHT is not released in large amounts into the bloodstream. Instead, it is produced in peripheral tissues like the skin and prostate, where it acts directly. Because of this local action, DHT has very targeted effects in specific organs and does not circulate widely throughout the body like other hormones.


How Are DHT Levels Regulated?

DHT levels are tightly controlled by the body’s regulation of testosterone:

  1. When testosterone levels rise, more is converted into DHT.

  2. Testosterone production is controlled by the hypothalamus-pituitary-gonadal axis:

    • The hypothalamus releases GnRH, stimulating the pituitary to release luteinizing hormone (LH).

    • LH triggers the testes (or ovaries) to produce testosterone.

    • As testosterone rises, DHT levels increase.

  3. High testosterone/DHT levels then suppress GnRH and LH release through a negative feedback loop, maintaining hormonal balance.


What Happens When DHT Is Elevated or Deficient?

High DHT Levels Can Lead To:

  • Male-pattern baldness (androgenic alopecia)

  • Acne and excess oil production

  • Prostate enlargement (benign prostatic hyperplasia, BPH)

  • Hirsutism or unwanted hair growth in females

Low DHT Levels Can Lead To:

  • Incomplete development of male genitalia in infants (in cases of 5-alpha-reductase deficiency)

  • Underdeveloped secondary sex characteristics during puberty

  • Possible reduced libido or sexual function (in men)


Summary: Key Roles of DHT

Life Stage Role of DHT
Fetal development Development of male genitalia and prostate
Puberty (AMAB) Growth of facial/body hair, penis, scrotum, and prostate
Adulthood (AMAB) Prostate maintenance, hair loss, sebum production
Females Minimal role; some body and pubic hair development

 


References:

  1. Kinter KJ, Anekar AA. Biochemistry, Dihydrotestosterone. StatPearls, 2023. NCBI Bookshelf

  2. Swerdloff RS, et al. Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications. Endocr Rev. 2017.

  3. Marchetti PM, Barth JH. Clinical biochemistry of dihydrotestosterone. Ann Clin Biochem. 2013.

  4. Auchus RJ. The backdoor pathway to dihydrotestosterone. Trends Endocrinol Metab. 2004.

What does it mean if your Dihydrotestosterone (female) result is too high?

What Happens If You Have Too Much Dihydrotestosterone (DHT) as a Female?

Dihydrotestosterone (DHT) is a powerful androgen—a hormone that helps regulate traits typically associated with male development, such as body hair and skin oil production. While DHT is naturally present in people assigned female at birth (AFAB) in small amounts, elevated DHT can disrupt hormonal balance and lead to unwanted physical changes.

In females, excess DHT often results from increased testosterone levels, as DHT is produced by converting testosterone through an enzyme called 5-alpha-reductase.


Signs and Symptoms of High DHT in Women

When DHT levels are too high, it can lead to a range of androgenic (male-like) symptoms, including:

  • Hirsutism – Excessive facial, body, and pubic hair growth

  • Acne and oily skin – Caused by overstimulation of sebaceous (oil) glands

  • Irregular or absent periods (amenorrhea) – Due to disrupted hormonal cycles

  • Scalp hair thinning or androgenic alopecia – Patterned hair loss along the hairline or crown

  • Changes to external genitalia (in severe cases or congenital conditions) – Mild clitoromegaly or other structural changes


Health Conditions Associated With High DHT in Females

1. Polycystic Ovary Syndrome (PCOS)

  • One of the most common causes of elevated DHT in females.

  • PCOS occurs when the ovaries produce excess androgens, including testosterone and DHT.

  • DHT contributes to:

    • Hirsutism

    • Persistent acne

    • Menstrual irregularities

    • Infertility

2. Congenital Adrenal Hyperplasia (CAH)

  • A group of genetic conditions affecting adrenal hormone production.

  • Can cause elevated androgens (including DHT) from early life.

  • May result in early signs of puberty, excess hair, or ambiguous genitalia in more severe cases.

3. Androgenic Alopecia (Female Pattern Hair Loss)

  • High DHT levels can shrink hair follicles, especially in genetically susceptible women.

  • Leads to gradual thinning, particularly at the crown or widening of the part line.


Does High DHT Always Mean a Problem?

Not necessarily. DHT levels fluctuate and may be slightly elevated without causing significant issues. However, if you are experiencing symptoms such as excess hair growth, acne, or menstrual irregularities, it’s worth testing for elevated androgens—including testosterone and DHT.


How Is High DHT Treated in Women?

Treatment depends on the underlying cause but may include:

  • Hormonal birth control – To regulate cycles and reduce androgen levels

  • Anti-androgens (e.g., spironolactone or cyproterone acetate) – To block DHT’s effects on the skin and hair follicles

  • Lifestyle modifications – Weight loss and insulin regulation can help reduce androgen production, especially in PCOS

  • Topical treatments – For acne or hair loss (e.g., minoxidil)


Key Takeaways

  • High DHT in women is often linked to excess testosterone and conditions like PCOS.

  • Common signs include hirsutism, acne, menstrual irregularities, and scalp hair thinning.

  • Diagnosing and treating the root cause can help manage symptoms and restore hormonal balance.

What does it mean if your Dihydrotestosterone (female) result is too low?

What Happens If You Have Too Little Dihydrotestosterone (DHT) as a Female?

Dihydrotestosterone (DHT) is a potent androgen—a type of hormone involved in sexual development. In individuals assigned female at birth (AFAB), DHT is produced in small amounts, primarily through the conversion of testosterone in tissues like the skin, liver, and ovaries.

Unlike in males, DHT is not essential for female sexual development or fertility, and very low levels are generally not considered clinically concerning. However, DHT may play a subtle role in puberty timing and hair growth patterns.


Is Low DHT a Problem in Women?

In most cases, low DHT levels in women do not cause significant health problems. However, because androgens like DHT help regulate certain physical traits, a deficiency could be associated with:

  • Delayed onset of puberty (in rare cases)

  • Reduced body or pubic hair growth

  • Lower sebum (oil) production in the skin

  • Reduced libido (when associated with overall low androgen levels)

That said, these effects are often mild or overshadowed by changes in broader hormone levels (like testosterone or DHEA), which play a more central role in female hormonal balance.


What Causes Low DHT in Women?

Several factors can lead to low DHT, typically as part of overall low androgen levels rather than a DHT-specific issue:

  • Low testosterone: Since DHT is made from testosterone, low testosterone levels can result in reduced DHT.

  • Ovarian insufficiency: In women with diminished ovarian reserve or early menopause, androgen production may be lower.

  • Chronic illness or malnutrition: These can suppress hormone production across the board.

  • Genetic enzyme deficiencies (such as 5-alpha reductase deficiency) are extremely rare in females and typically do not lead to major developmental changes.


Do Women Need DHT for Fertility or Health?

Current research suggests that DHT is not essential for female reproductive function, and women with very low or undetectable DHT can still have normal menstrual cycles, ovulation, and fertility.

In fact, excess DHT is more often a concern in women, as it is linked to conditions like polycystic ovary syndrome (PCOS) and hirsutism (excess facial/body hair).


Should You Test DHT Levels?

DHT testing is not routinely recommended for women unless there are specific symptoms of androgen imbalance, such as:

  • Irregular or absent periods

  • Acne or oily skin

  • Excess or reduced hair growth

  • Low libido or energy

In most cases, your doctor will evaluate broader androgen levels—like testosterone, DHEA-S, and androstenedione—to assess hormone balance.


Key Takeaways for Women

  • Low DHT in women is rarely a clinical concern and typically doesn’t affect fertility or general health.

  • It may contribute to slight reductions in body hair, skin oil production, or libido, but these symptoms are usually tied to overall low androgens.

  • Routine DHT testing in women is uncommon and usually done only when there are signs of hormonal imbalance.

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