Algerian boxer Imane Khelif's swift defeat of her Italian opponent at the Paris Olympics 2024 sparked a huge row after she was disqualified from a previous competition over reportedly high levels of testosterone. Khelif stepped into the ring to fight Angela Carini of Italy for the opening Paris Olympic boxing match, on Thursday. However, the bout ended in less than a minute, due to Carini quitting only 46 seconds into the first round after getting punched in the nose by Khelif.

Controversy has now erupted, sparking a widespread debate over gender eligibility in the world of boxing. Last year, the International Boxing Association disqualified the 25-year-old from the 2023 world championships after the Algerian failed gender eligibility tests, news reports said. Khelif was also stripped of the medals she had won in the women’s competition.

However, many came to Khelif's defence claiming that she has a rare medical condition – hyperandrogenism - a condition characterized by abnormally high androgen levels in her blood, leading to elevated testosterone and the presence of XY chromosomes.

This controversy has highlighted a broader discussion about the role of testosterone in sports. Testosterone is a sex hormone produced by both men and women. However, in men, the level of this hormone produces up to 20 times more - primarily in the testicles. Women make far less, in the ovaries and adrenal glands.

According to doctors, a normal level of testosterone for men is estimated to be 10-35 nanomoles per liter in blood. For women, it is between 0.5-2.4 nmol per liter.

Experts say testosterone levels can also vary widely by age and time of the year.

Too much testosterone causes symptoms that affect a woman’s physical appearance including:

• Excess body hair, specifically facial hair
• Balding
• Acne all over the face
• Enlarged clitoris
• Decreased breast size
• Deepening of the voice
• Increased muscle mass
• Irregular menstrual cycle
• Low libido
• Changes in mood

In more severe cases of testosterone imbalances in women, high testosterone can cause infertility and obesity.

Doctors say a few health conditions and hormonal disorders lead to hormonal changes in women, a few of these are:

It is a hormonal condition that causes the growth of unwanted hair on the back, face, and chest. The amount of body hair growth is highly dependent on genetics, but this condition is primarily caused by an imbalance of androgen hormones.

PCOS is a hormonal disorder caused by an excess of androgen hormones in women. It causes irregular periods, unwanted body hair growth, and enlarged ovaries that may not function properly.

CAH directly affects the adrenal glands and the production of the body’s hormones. It leads to infertility, masculine characteristics, early appearance of pubic hair, and severe acne.

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