Women's Health

What Are the Signs of Low Testosterone in Women?

The female androgen sex hormone responsible for longevity, sexual health and so much more.
Dr. Nayan Patel
PharmD

We’ve all heard of testosterone, but did you know this hormone is present in both men and women? While it’s often thought of as a men’s hormone, testosterone also plays a critical role in women’s health, too. Here are a few signs of testosterone imbalances and what you can do get back on track.

Why Is Hormone Balance Important?

Our bodies run on hormones. Whether we’re talking about sex hormones like testosterone, stress hormones like cortisol, or metabolism hormones like insulin, there’s no denying that hormones are the cornerstone of holistic health.

Yet, our hormones are so easily thrown out of balance. Lack of sleep, diet choices, and even environmental toxins can affect our hormone levels from day to day. And if you’re a woman, your hormone levels will also change during your menstrual cycle.

To achieve optimal hormone health, it is important to take personal responsibility and educate oneself on the hormones - like testosterone - that contribute to our bodily makeup, and know the signs to look out for when things are off balance so you can seek medical help or make necessary lifestyle changes. If you’re still reading this, then congratulations for taking the first step in optimizing your hormones so you can feel your best.

What Is Testosterone? 

Testosterone is a sex hormone primarily produced in the testicles (in men) and ovaries (in women), although smaller amounts are also produced in the adrenal glands. 

This steroid hormone plays a crucial role in male puberty. Men can credit testosterone for the development of male reproductive parts, such as the testes and prostate gland, as well as secondary sexual characteristics, such as growth in facial and body hair, increased muscle mass, and voice deepening. 

While women typically have much lower levels of testosterone than men, it’s still an important hormone for women’s overall physical and sexual health. Remember, an imbalance of any hormone in the body can create a cascade of health effects. For instance, testosterone contributes to bone density and red blood cell production, while also impacting the regulation of mood, energy, and sex drive. Testosterone’s role in both mental health and the health of internal bodily functions is vital to the way we feel, our longevity and so much more.

Why Is Testosterone Important for Women?

Testosterone is an important androgen hormone for women’s health, and is responsible for helping to maintain bone density. Because of this, the effects of testosterone deficiency in women can lead to osteoporosis, a condition where the bones become more prone to fracture. If you enjoy high-impact activities like running, dancing, or even playing with your dog, testosterone health is crucial to avoid bone breakage and injury, especially with age. 

Katie Jo Dixon, Nurse Practitioner at Thrivelab shares, “​​We notice that in our female clients there is a loss of muscle mass, we call that sarcopenia in medicine, where you start to lose your muscle plumpness. And that loss of muscle mass contributes to the risk of decrease in your bone density. As women age, bone density is essential. Studies indicate that if you fall and you have a hip fracture and you're over the age of 65, your risk for death within one year is highly increased. So many individuals think hormone replacement is a vanity, but it's not only what we're seeing on the outside, the outside reflects what's happening on the inside.”

Testosterone is also the hormone behind desire and arousal with your partner. Women with low testosterone levels may experience a decrease in sexual desire, experience vaginal dryness and have difficulty achieving orgasm - which can be frustrating both interpersonally and amongst your relationship.

Aside from the physiological functionalities of testosterone in the female body, testosterone is a dominant hormone impacting mental health and overall well-being in women. Optimized testosterone levels can improve energy levels, mood and brain health, while low testosterone levels in women have been associated with fatigue, depression, and decreased cognitive function.

What Are Some Causes of Low Testosterone in Women?

There are several possible causes of low testosterone levels in women, from aging to side effects of certain medications. “Even in the early 20s, early 30s, women are showing signs of a testosterone deficiency. I think there is a trigger point where it has gotten worse, whether it's adrenal stress and burn up, high stress jobs, lifestyles and especially birth control.” says Brittany Meeker, Nurse Practitioner for Thrivelab.

Aging

Testosterone levels naturally decline as women age, with levels decreasing by approximately 50 percent between the ages of 20 and 40.

Polycystic Ovary Syndrome (PCOS)

This is a hormonal disorder that typically causes high testosterone, often resulting in facial hair, weight gain, and mood swings. However, some women with PCOS may have low testosterone levels due to abnormalities in the condition.

Menopause

Menopause is characterized by a decline in estrogen and testosterone levels, which can lead to symptoms such as hot flashes, vaginal dryness, and a decrease in libido.

Adrenal Gland Disorders

The adrenal glands produce small amounts of testosterone, and disorders such as Addison's disease, adrenal insufficiency, adrenal dysfunction and congenital adrenal hyperplasia can affect their ability to produce hormones. About a quarter of a woman’s testosterone is produced in the adrenal gland, so any dysfunction with the adrenal glands could potentially impact testosterone production.

Medications and Birth Control

Hormonal birth control in women can often have the unintended side effect of lowering testosterone levels. It’s worth noting that some hormonal contraceptives are also designed to “pause” ovarian function, which can also result in progesterone and estradiol imbalances. “The pill makes your hormones a pancake. They suppress your hormones to a subpar physiological level and you can start to experience symptoms of hormone deficiency” says Katie Jo.

What Is Considered Low Testosterone?

The normal range of testosterone levels in women varies depending on age, stage of the menstrual cycle, and other factors. Generally, total testosterone levels in women should be between 15-70 ng/dL (nanograms per deciliter). However, the reference range can vary between different laboratories and testing methods.

It is important to note that the symptoms of low testosterone levels can vary widely between individuals, and a diagnosis of low testosterone levels should not be based solely on blood test results. 

Why? Women have naturally low levels of testosterone, and these levels fluctuate throughout the menstrual cycle. Testosterone peaks during ovulation and remains elevated during the last half of the menstrual cycle. Testosterone in women also varies by hour, peaking in the morning and slowly declining throughout the day.

Unless your provider asks you to test at a specific time of day during a specific point in your menstrual cycle, you may not get an accurate result. “There is not a lab value on traditional labs that's specific for women and testosterone. There's not even a diagnostic code for suboptimal testosterone for women. There is for men, but for women, there's not a diagnostic code. We get to be the pioneers of testosterone health through hormone replacement therapy” says Meeker.

Women experiencing symptoms of low testosterone levels should consult their healthcare provider for medical advice and treatment options. 

How Is Low Testosterone Treated in Women?

Hormone replacement therapy (HRT) is a treatment that involves supplementing the body with bioidentical hormones to address hormonal imbalances. These hormones are structurally identical to the hormones your body naturally produces, which means they blend in seamlessly with your hormonal ecosystem.

Thrivelab offers personalized hormone replacement therapy with physicians who are committed to helping you feel your best. The process is simple and affordable and can be done from the comfort of your own home, thanks to telehealth visits and accessible patient care 24/7. 

When to seek help for low testosterone

Low testosterone levels can lead to numerous health problems that can take a serious toll on a woman’s day-to-day livelihood. If you are experiencing any of the symptoms listed above, it's important to talk to a licensed and trusted healthcare provider to determine the underlying cause. With the right treatment options, women with low testosterone can improve their quality of life and maintain their overall health and well-being.

Looking for a healthcare professional that will listen to your concerns and help you take action to feel better? Thrivelab makes hormone health assessment safe, affordable, and effective with bioidentical hormone replacement therapy solutions right from the comfort of your own home.

To find out if Thrivelab is right for you, take our free assessment and after we’ve evaluated your symptoms, book a consultation with one of our board-certified providers. Hormonal freedom takes time, but we’ll be there every step of the way.

References

1. Association between testosterone levels and bone mineral density in females aged 40–60 years from NHANES 2011–2016 | PubMed 

2. Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care | PMC

3. Testosterone Information | Mount Sinai New York 

4. Experiencing Vaginal Dryness? Here's What You Need to Know | ACOG 

5. The Intricate Web of Fatigue in Women | MDPI 

References
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