Testosterone

Testosterone is the primary and most potent androgen hormone, produced in small amounts by the ovaries and adrenal glands in women, where it plays important roles in bone health, muscle maintenance, energy, and sexual function. In PCOS, testosterone levels are typically elevated due to ovarian overproduction driven by excess insulin and abnormal LH signaling, causing symptoms like facial hair growth, acne, and scalp hair thinning. Both total testosterone and free testosterone (the biologically active portion not bound to proteins like SHBG) should be measured during PCOS evaluation, as some women may show normal total testosterone but elevated free testosterone due to low SHBG levels.