Lowering androgens typically requires addressing the root drivers, most commonly insulin resistance, while also reducing androgen activity at the tissue level. The approach that works best depends on what’s causing the excess in the first place, but most people benefit from a combination of dietary changes, exercise, targeted supplements, and sometimes medication. Results take time: visible improvements in symptoms like excess hair growth or hormonal acne generally take three to six months to appear.
Why Androgens Get Too High
For most women with elevated androgens, insulin is the hidden driver. When your body becomes resistant to insulin, it compensates by pumping out more. That excess insulin acts directly on the ovaries, stimulating the cells responsible for testosterone production. Insulin also works together with luteinizing hormone (LH) to amplify androgen output, creating a cycle where high insulin and high androgens reinforce each other. On top of that, chronically elevated insulin suppresses a protein called SHBG (sex hormone-binding globulin), which normally binds to testosterone and keeps it inactive. Less SHBG means more free testosterone circulating in your blood and reaching your skin, hair follicles, and other tissues.
This is why so many strategies for lowering androgens focus on improving insulin sensitivity. If you can bring insulin levels down, you reduce the signal telling your ovaries to overproduce testosterone, and you raise SHBG so that more of the testosterone you do produce stays bound and inactive.
Dietary Changes That Make a Difference
The most impactful dietary shift is reducing your glycemic load, meaning fewer refined carbohydrates and added sugars that cause sharp insulin spikes. Swapping white bread, sugary drinks, and processed snacks for whole grains, vegetables, legumes, and protein-rich foods can meaningfully lower fasting insulin over weeks to months.
Fiber deserves special attention. Research on men aged 40 to 70 found that higher fiber intake was directly associated with higher SHBG levels, which effectively lowers the amount of active testosterone in your system. Low-glycemic, high-fiber diets are consistently linked to better SHBG concentrations. Aim for a variety of fiber sources: vegetables, beans, lentils, oats, and seeds. Even moderate increases in daily fiber (adding 10 to 15 grams) can shift the balance over time.
There’s also some evidence that regular caffeinated coffee may help. Research in women over 60 found that drinking two or more cups of coffee per day was associated with higher SHBG levels, though this hasn’t been studied as extensively in younger populations with PCOS.
Exercise: Type Matters Less Than Consistency
Both resistance training and aerobic exercise improve androgen-related markers and metabolic health in women with PCOS. A study comparing the two approaches head to head found that both types improved body composition, metabolic dysfunction, and hyperandrogenism after the training period, with no significant difference between them. In other words, the best exercise for lowering androgens is whichever type you’ll actually do consistently.
That said, resistance training has an edge for long-term insulin sensitivity because it builds muscle mass, and muscle tissue is one of the main places your body uses glucose. More muscle means your cells respond better to insulin, which reduces the signal driving androgen production. A realistic starting point is three to four sessions per week of moderate-intensity exercise, mixing strength work with some cardio.
Supplements With Clinical Evidence
Inositol
Inositol is one of the most studied supplements for androgen excess in PCOS. The combination that appears to work best is myo-inositol and D-chiro-inositol in a 40:1 ratio, which mirrors their natural proportion in the body. In a clinical trial of overweight women with PCOS, this combination significantly reduced LH levels, free testosterone, and fasting insulin while increasing SHBG and restoring ovulation. Typical dosing in studies uses about 550 mg of myo-inositol and 13.8 mg of D-chiro-inositol twice daily, often paired with folic acid. Most commercial inositol supplements for PCOS now follow this 40:1 ratio.
Spearmint Tea
A 30-day randomized controlled trial found that drinking spearmint tea twice daily significantly reduced both free and total testosterone levels in women with PCOS compared to a placebo herbal tea. The effect is modest, but spearmint tea is safe, inexpensive, and easy to add to a daily routine. Two cups per day is the dose used in the trial.
Zinc
Zinc inhibits 5-alpha reductase, the enzyme that converts testosterone into its more potent form, DHT. DHT is the androgen most responsible for symptoms like acne, oily skin, and hair thinning. In lab studies using human skin tissue, zinc at moderate concentrations was a potent inhibitor of this enzyme, and the effect was enhanced when combined with vitamin B6. Getting adequate zinc through food (meat, shellfish, pumpkin seeds, chickpeas) or a modest supplement (15 to 30 mg daily) can help reduce androgen activity at the skin level, even if total testosterone doesn’t change much on blood work.
Saw Palmetto
Saw palmetto also works by inhibiting 5-alpha reductase. In a randomized trial, a saw palmetto herbal blend reduced tissue DHT levels by 32%. While this research was conducted in prostate tissue, the same enzyme operates in skin and hair follicles. Some women use saw palmetto for androgenic hair loss or acne, though evidence in female populations is more limited than for the other supplements listed here.
Medications for Androgen Excess
When lifestyle and supplement changes aren’t enough, prescription options can help. The two most commonly used are combined oral contraceptives and spironolactone.
Combined oral contraceptives work primarily by raising SHBG, often dramatically. A meta-analysis of women with PCOS found that SHBG levels increased significantly after three months to one year on the pill. Higher SHBG means less free testosterone, which is why hormonal birth control often improves acne and reduces excess hair growth. It also suppresses LH, which lowers the hormonal signal that drives ovarian androgen production.
Spironolactone takes a different approach. It blocks the androgen receptor directly, preventing testosterone and DHT from activating their effects in your skin and hair follicles. It’s commonly prescribed for hormonal acne and hirsutism. If combined oral contraceptives alone aren’t producing enough improvement after six months, adding spironolactone is a standard next step.
How Long Results Take
One of the most frustrating parts of lowering androgens is the timeline. Blood levels of testosterone and SHBG can shift within weeks of starting treatment, but the symptoms you can see in the mirror take much longer to catch up. This is because androgens affect slow-cycling processes like hair growth and sebaceous gland activity.
For hirsutism, expect a minimum of six months before noticing a meaningful reduction in new hair growth. Existing terminal hairs (the thick, dark ones) won’t disappear on their own, since they’ve already been “programmed” by androgens. Many people combine androgen-lowering strategies with hair removal methods like laser or electrolysis for visible results while waiting for hormonal treatment to prevent new growth. Topical treatments for facial hair, like eflornithine cream, can show gradual improvement in six to eight weeks, offering a faster visible change while systemic treatments catch up.
Acne tends to respond a bit faster, with many people seeing improvement within two to three months of starting treatment. Oily skin and scalp changes often follow a similar timeline. Hair thinning on the scalp is the slowest to reverse, sometimes requiring a year or more of consistent treatment before new growth becomes noticeable.
Putting It Together
The most effective approach layers multiple strategies. Start with the foundations: reduce refined carbohydrates, increase fiber, and exercise regularly. Add inositol in the 40:1 ratio if PCOS or insulin resistance is part of the picture. Consider spearmint tea and zinc for additional androgen-blocking effects at the tissue level. If symptoms persist after three to six months of consistent effort, prescription options like combined oral contraceptives or spironolactone can provide stronger hormonal correction. Track your progress with blood work (total testosterone, free testosterone, SHBG, fasting insulin) every three to six months so you can see what’s changing beneath the surface, even before the mirror catches up.