High SHBG in women: causes and what the result means
SHBG stands for sex hormone-binding globulin. It is a protein made mostly in the liver that carries sex hormones around the blood. A high result has several possible explanations, and one common one is the birth control pill. This page covers what a high SHBG can mean, how it affects testosterone and when to see a clinician.
SHBG
A single blood test for SHBG, the protein that carries sex hormones such as testosterone in the blood.
$69
See this test at HealthLabsPrice checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
What SHBG does
MedlinePlus explains that most testosterone in the blood is bound to proteins such as SHBG and albumin, and that bound testosterone is not as easy for the body to use as free testosterone. A 2025 review describes SHBG as a protein that controls serum sex hormone levels and, by affecting how much hormone is available, regulates their effects.
So when SHBG is high, more testosterone is held by the protein and less is free. The review gives a clear example: combined birth control pills raise SHBG and lower both total and free testosterone, with free testosterone dropping about twice as much as total.
A published range for women
Ranges depend on the lab and method, so use the range on your own report. For a published example, one national reference lab lists these female ranges:
| Age | Female SHBG range (nmol/L) |
|---|---|
| 20 to 49 | 24.6 to 122.0 |
| 50 and over | 17.3 to 125.0 |
Source: Labcorp test directory, SHBG. A result inside or outside a range does not diagnose anything. Talk with a clinician about your own result.
The same source lists no range for women under 20.
What can raise SHBG
The sources describe these causes of higher SHBG in women:
- The combined birth control pill. The lab information lists women using oral contraceptives, and the review says the pill raises SHBG. The effect is larger with a higher dose of the estrogen component.
- Estrogen and thyroid hormones. The lab information says SHBG is under the positive control of estrogens and thyroid hormones.
- Hyperthyroidism (an overactive thyroid). Both sources list it.
- Pregnancy. The lab information lists it.
- Weight loss and fasting. The review lists both.
- Anorexia nervosa. The review says eating disorders such as anorexia nervosa tend to raise SHBG, which may also affect hormones and periods.
Other factors push SHBG down. The review says overweight and obesity tend to lower it.
What a high result does not tell you
SHBG is not a PCOS test. The review notes that SHBG is not included in the Rotterdam diagnostic criteria for PCOS, and the international PCOS guideline recommends other tests for the diagnosis. Many things raise SHBG, so the number alone does not point to one cause.
Which test to order
The SHBG test shows only SHBG. If you want to see how it relates to your hormones, add a testosterone result.
- Free and total testosteroneTotal and free testosterone on one order $99 See this test at HealthLabs
- Total testosteroneTotal testosterone only. The lower-priced start $49 See this test at HealthLabs
Sold by HealthLabs. Prices checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
Follow the preparation instructions on your lab order if you have one.
When to see a clinician
Show a high result to a clinician, especially if you do not take the pill or other hormones, or if you have symptoms such as changes in your periods or weight. They can look for causes that the SHBG number cannot show, and they know which medicines you take. Do not stop a medicine on your own because of an SHBG result.
SHBG
$69
See this test at HealthLabsPrice checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
Keep reading
- Testosterone test for women: which one to order
Women make testosterone too. See what the test measures, total versus free, a published range for women, and which blood test is the lowest-priced fit.
- High testosterone in women: what a high result can mean
A high testosterone result in a woman can have several causes, from PCOS to adrenal or ovarian conditions. See what it can mean and when to see a clinician.
- Low testosterone in women: what a low result can mean
Testosterone is low in women by nature. See what a low result can mean, why a single number rarely explains symptoms, and when to talk to a clinician.
- PCOS tests: which blood tests doctors order and which fit
No single blood test diagnoses PCOS. See how the international guideline diagnoses it, which labs are typically ordered, and the lowest-priced fits.
Sources
- Sex Hormone Binding Globulin (SHBG) test information and reference range (Labcorp test directory)
- New Insights in the Diagnostic Potential of Sex Hormone-Binding Globulin (SHBG): Clinical Approach (Biomedicines, 2025)
- Testosterone Levels Test (MedlinePlus)
- Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (J Clin Endocrinol Metab, 2023)