Testosterone levels in women is a subject that is often misunderstood. Throughout their lives, men are often familiarized with the concept and importance of testosterone, yet women may not have learned about its significance in their own bodies. Despite being primarily recognized as the key reproductive hormone in males, testosterone is also naturally produced by women, albeit in smaller amounts. Women generate testosterone within their ovaries and adrenal glands and it’s just as important of a hormone for a female’s health and wellness as is it is to a man’s, so it’s valuable to know what normal testosterone levels in women are.

During menopause, women may experience a decline in testosterone production, potentially resulting in symptoms such as decreased libido, diminished muscle mass and strength, disrupted sleep patterns, mood fluctuations, and even osteoporosis. These are just a few of the potential negative impacts that Low T can have on a woman.  Fortunately, Research indicates that supplementing testosterone levels through Hormone Replacement Therapy for Women (HRT) can effectively alleviate these specific symptoms associated with testosterone decline during menopausal hormonal changes. Discover more about testosterone for women and the advantages of HRT in alleviating menopausal symptoms. While TRT is a common treatment option for men, less is known in the general public about the benefits of testosterone therapy for women. Top of Form

While the precise role of testosterone in women remains somewhat enigmatic, its impact on sexual function is undeniable. Testosterone levels play a crucial role in various aspects of female sexual health. It contributes to the sexual development of vulva and vaginal tissues, as well as influences brain functions related to sexuality. Moreover, testosterone plays a significant role in shaping female sexual behavior, particularly in terms of desire and the arousal response. Understanding these dynamics sheds light on the intricate interplay of hormones within the female body.

Why is your Testosterone low?

In women, testosterone levels may be low in individuals who have undergone bilateral oophorectomy (removal of both ovaries) or whose ovarian function is compromised due to factors such as chemotherapy. Additionally, testosterone levels tend to decrease across the lifespan of females, with midlife women exhibiting lower levels compared to those in their 20s and 30s. In women, testosterone levels usually reach their peak in the mid-20s and gradually decline over time. By the age of 50, testosterone levels are typically only about half of what they were in the 20s. This decline in testosterone is a significant factor contributing to the profound physical and mental changes experienced during menopause. While estrogen and progesterone are commonly viewed as the primary hormones associated with menopausal symptoms, it's crucial not to overlook the significance of declining testosterone levels.

Furthermore, women affected by adrenal gland disorders may also experience diminished testosterone levels. In women, approximately 25% of androgen production takes place in the adrenal glands, another 25% in the ovaries, with the remaining being produced peripherally. The primary prohormones, including DHEA-S, DHEA, and androstenedione, are converted peripherally into active androgens like testosterone and dihydrotestosterone.

Sexual function in women: The Role of Testosterone

While it's true that low testosterone levels in women can sometimes adversely affect female sexual function, this represents just a portion of the overall picture. Female sexual function is a multifaceted issue influenced by various factors, including physical and emotional well-being, the dynamics of their relationships, past sexual encounters, history of trauma, and more. These elements intertwine in a complex manner. So, even though a decreased sex drive can stem from various causes, for women over 40, low testosterone levels emerge as a significant risk factor for diminished libido in women. Studies have demonstrated that restoring testosterone to normal youthful levels can effectively reverse this loss of libido and restore normal sexual desire.

In addition to impacting sexual desire, low testosterone levels can also diminish clitoral size and sensitivity, making it challenging to achieve orgasm or even resulting in a loss of orgasm potential. By replenishing testosterone levels to normal, these changes can be reversed, restoring the ability to experience orgasm.

Women who restore their testosterone levels to youthful norms often report heightened overall sexual satisfaction and an enhanced quality of life. This satisfaction extends beyond the realm of sexuality, positively influencing relationships with intimate partners and leading to improvements in mood, self-image, reduced anxiety, and overall well-being. Women facing challenges with their sexual function should seek evaluation from a medical professional specializing in this area, such as a gynecologist, endocrinologist or hormone replacement specialist. A comprehensive assessment should encompass all potential factors influencing sexual function, including testosterone levels.

Low testosterone in women

Determining what constitutes low testosterone, or hypogonadism, in women lacks a definitive range. Lab reference ranges commonly used in blood tests, mostly apply and cater to treating older menopausal women, so these ranges tend to lean towards lower levels found in older women. The aging process significantly contributes to the onset of low testosterone or testosterone deficiency in women. Usually, when a woman reaches 40 years of age, there is a significant decline in testosterone levels in their bloodstream. Menopause, a natural phase of aging for women, often results in reduced testosterone production by the ovaries. This decline is frequently associated with changes in sexual desire among women.

In addition to aging and menopause, certain medical conditions and medications may precipitate a decrease in testosterone levels in women, including:

  • Oophorectomy (surgical removal of the ovaries)
  • Adrenalectomy (surgical removal of the adrenal glands)
  • Adrenal disease
  • Pituitary disease
  • HIV infection
  • Premature ovarian failure
  • Turner's syndrome
  • High-dose corticosteroids
  • Specific estrogen preparations

Some of the various and common symptoms of low testosterone in women may include:

  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Fatigue
  • Dry skin
  • Mood changes
  • Hair thinning
  • Muscle weakness

Testing Testosterone Levels In Women

A testosterone test evaluates the levels of the hormone testosterone in your body. While testosterone is primarily known as the main sex hormone in men, it's important to note that women also have testosterone present in their bodies and should be checked to evaluate their overall hormonal health. These sex hormones play crucial roles in sexual and reproductive development, as well as influencing sexual drive.

Optimal bodily function is maintained within a specific range of testosterone levels. Whether you're male or female, having testosterone levels that are too low or too high can lead tohealth issues. Your healthcare provider may recommend a testosterone test if you're experiencing symptoms suggestive of either high or low testosterone levels.

What does a testosterone blood test reveal? Testosterone in your bloodstream exists in two forms: free testosterone (unbound) and bound total testosterone (attached to proteins). Free testosterone is more readily available for use by your body.

Women’s age in years

Testosterone levels measured in ng/dl

0-9 years old

7–20 ng/dL

10-11 years old

7–44 ng/dL

12-16 years old

7–75 ng/dL

17-18 years old

20–75 ng/dL

19 and older

8–60 ng/dL

Testosterone Therapy for Women

When women exhibit low testosterone levels accompanied by the standard signs and symptoms, healthcare providers may contemplate testosterone therapy. Research has indicated that testosterone therapy can enhance sexual function in postmenopausal women experiencing reduced desire for sexual activities without a clear medical or psychiatric cause. This effect has been consistently observed across numerous clinical trials. Testosterone therapy for women remains an off-label medication in the United States. Physicians are legally permitted to prescribe medications off-label, a term denoting the scientific evidence supporting a drug's efficacy for a particular condition despite lacking FDA approval for that specific use, dosage, or formulation.

Nevertheless, numerous professional societies, such as the International Menopause Society, advocate for cautious and monitored testosterone administration in postmenopausal women to enhance their sexual desire, provided there are no underlying medical or psychiatric conditions contributing to the issue. The objective of treatment in these cases is to elevate testosterone levels to those typically observed in younger women prior to menopause. Hormone Therapy is a very common and useful option for many women and has been able to help alleviate many of the forementioned symptoms.

After starting testosterone therapy, women may see improvements in sexual symptoms, if they occur, typically within approximately four weeks, with maximum benefits realized around the 12-week mark. However, if there is no noticeable change in sexual function after six months, discontinuation of testosterone therapy to combat those specific symptoms may be advised, and alternative explanations for the sexual issues should be explored.

How is testosterone administered to women?

There are various methods for administering testosterone treatment or HRT for women. Applying testosterone to the skin in a cream or gel is considered the preferred method as it poses fewer adverse effects, particularly on liver function and cholesterol levels. Additionally, testosterone therapy administered via the skin has a lesser impact on blood pressure. One concern associated with oral testosterone therapy in men is an elevated risk of blood clots, a risk that seems to be less prominent with skin application and remains theoretical for women. Typical protocol involves once or twice daily application in either the morning or evening to a dry patch of skin on an area like the lower back or inner thigh.

Your doctor can advise as to what method may be best suited for you and why they believe it would be advantageous to take one form over the other. Preparations of testosterone, such as creams/gels, injections and patches, are available. Many healthcare providers opt to utilize testosterone formulations approved for men, albeit at a dosage typically one-tenth of the male dose, for women.

It's advisable to steer clear of testosterone pills due to their potential to cause liver issues and reduce high-density lipoprotein (HDL) cholesterol, commonly known as the "good" cholesterol. Testosterone injections administered into the muscle may result in excessively high testosterone levels and often cause significant discomfort due to their painful nature. Elevated testosterone levels from injected testosterone can trigger adverse effects such as irritability, acne, excessive facial or body hair growth (hirsutism), and hypersexuality. Similarly, the use of testosterone pellets and implants is discouraged as they can also lead to excessively high testosterone levels. Once a pellet is implanted, it will remain under the skin releasing hormones for a while, so its extremely difficult to make any changes in dosing if needed, which is why the daily application of a cream is suitable for patients who may need to optimally balance their hormones which are fluctuating greatly to begin with.

Before initiating testosterone therapy in women, healthcare providers should conduct baseline testosterone level assessments to ensure they are not already elevated. Throughout testosterone therapy, women should undergo testosterone level checks every six months. The objective of monitoring testosterone levels is not to achieve a specific target level for treatment efficacy but rather to prevent testosterone levels in women from becoming excessively high.

When administered in low doses as recommended, testosterone typically yields minimal side effects, such as mildacne and slight body or facial hair growth in some women. However, excessive doses may lead to hair loss, genital enlargement, and changes in voice pitch. Any such alterations should be promptly reported to a healthcare provider. Treating Hormone imbalances in women is complicated and requires the knowledge of an experienced healthcare professional.

To schedule a FREE initial consultation with Dr. Mackey, a specialist in HRT for women, please fill out our new patient intake form online and we’ll reach out to get you on the calendar. In the meantime take a look at some of our five-star Google reviews here!


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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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