Can treatment for Small Intestine Bacterial Overgrowth (SIBO) cause a decrease in testosterone levels in a woman from a normal level to hypotestosteronemia?

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Last updated: April 17, 2025 • View editorial policy

From the Research

Treating SIBO can potentially explain the significant decrease in testosterone levels from 203 to 63 in a woman, as the normalization of gut bacteria and reduced inflammation can lead to more balanced hormone metabolism, which is likely beneficial for women, as elevated testosterone can cause symptoms like acne, hair loss, and menstrual irregularities. The gut microbiome plays an important role in hormone regulation, including testosterone production and metabolism, as shown in a study published in Nutrients in 2024 1. When SIBO is present, certain bacteria may convert hormones or their precursors abnormally, potentially leading to elevated testosterone levels in women. Some key points to consider include:

  • The role of the gut microbiome in hormone regulation, including testosterone production and metabolism
  • The potential effects of SIBO treatment on hormone levels, including the normalization of gut bacteria and reduced inflammation
  • The benefits of balanced hormone metabolism for women, including reduced symptoms like acne, hair loss, and menstrual irregularities
  • The importance of consulting with an endocrinologist to determine if the new testosterone level is healthy or requires further evaluation, as discussed in a study published in Obstetrics and Gynecology in 2021 2. Additionally, a study published in Revista de gastroenterologia del Peru in 2024 found that probiotics can be effective in treating SIBO, which may also contribute to the decrease in testosterone levels 3. It is also worth noting that hormone replacement therapy may be considered in some cases, as discussed in a study published in Best Practice & Research Clinical Obstetrics & Gynaecology in 2022 4, and that testosterone replacement therapy has been used to improve symptoms and signs of testosterone deficiency, as discussed in a study published in Andrology in 2020 5.

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