Testosterone in Women: It's Not Just a Male Hormone

A woman's ovaries and adrenal glands make testosterone every day. In fact, women produce more testosterone than estrogen by amount — just far less than men do.

Testosterone levels in women gradually decline over time.

• Levels are typically highest in a woman's 20s
• They slowly decrease through the 30s and 40s
• Surgical removal of the ovaries can cause a sudden drop
• Natural menopause usually causes a more gradual change

In women, testosterone is part of normal hormone physiology. It plays a role in:

• Sexual desire and sexual function
• Maintaining muscle mass and strength
• Normal bone health
• Overall hormone balance alongside estrogen and progesterone

Important: Knowing that testosterone has a natural role in the body is different from proving that testosterone therapy treats a symptom. These are two separate questions.

Current international consensus supports testosterone therapy primarily for appropriately evaluated postmenopausal women with hypoactive sexual desire disorder (HSDD) — persistent low sexual desire that causes personal distress.

Evidence is currently insufficient to support testosterone therapy for:

• Fatigue or low energy
• Brain fog
• Weight gain
• Depression or mood symptoms
• General aging or disease prevention

These symptoms don't diagnose a hormone problem, but they may be worth discussing with a provider:

• Low or decreased sexual desire that is bothersome
• Changes in sexual function or satisfaction
• Perimenopause or menopause symptoms
• Changes in strength or exercise recovery

Many of these symptoms have other possible causes, such as thyroid issues, sleep, stress, or medications.

After a thorough evaluation, testosterone may be considered when:

• Symptoms fit an evidence-supported reason, such as HSDD after menopause
• Other causes have been reviewed and addressed
• Benefits and risks have been discussed together
• Ongoing monitoring is possible

Testosterone blood levels alone don't define a diagnosis in women. There is no single "normal" number that predicts symptoms. That's why your provider looks at your symptoms, health history, and lab results together.

When doses are kept within the normal female range, side effects are less likely. Possible side effects include:

• Acne or oily skin
• Increased facial or body hair
• Hair thinning (less common)
• Voice deepening or clitoral enlargement with excessive doses

Appropriate dosing and follow-up lab monitoring help keep levels in a safe, physiologic range. Products designed for men should not be used at male doses.

Therapy may not be appropriate if you:

• Are pregnant, trying to conceive, or breastfeeding
• Have certain hormone-sensitive cancers
• Have symptoms without an evidence-supported reason for treatment
• Prefer to address other contributing factors first