By: Jason VanBennekom

Testosterone is generally thought of as a “male sex hormone,” but it is a normal hormone for women as well, though it’s produced at 20-40 times lower levels than in men. In women, the majority of testosterone is produced in the ovaries, with some also produced by the adrenal glands or by the conversion of other hormones in the body.

Symptoms of low testosterone

In general, testosterone can affect muscle and bone growth, hair growth, sex drive/libido, and metabolism. In women, the symptoms of low testosterone can be subtle, and include decreased sex drive or decreased sexual satisfaction, fatigue, and low energy.

Causes of low testosterone

Low testosterone can occur at any age, but it is seen more often as women age, particularly after menopause, when ovarian function normally declines.

Low levels of testosterone are most often from decreased production of the hormone but can also be seen with some medical conditions or with some medications, such as some antidepressants, pain medications, hormone medications, and chemotherapy drugs.

Diagnosing low testosterone

Diagnosing low testosterone requires simple blood work to check for testosterone levels, typically looking at total and free testosterone levels. Depending on the suspected reason for the low testosterone, other lab work may be useful for diagnosis.

Treatments for low testosterone

Treatment options for low testosterone in women have evolved. They include:

  • DHEA is a precursor to testosterone and is available in an over-the-counter supplement form. Often adequately replacing DHEA will allow natural testosterone production to improve and relieve symptoms.
  • Prescription testosterone in combination with estrogen is available in a pill form for postmenopausal women, though it may be better to supplement testosterone with injectable or topical forms due to problems with the metabolism of oral forms.
  • Prescription testosterone cream is available in doses that are safe for use by women.
  • Testosterone injections and testosterone implantable pellets are also available.

Whichever form of treatment is used, it is important to be closely followed by your healthcare provider. Too much testosterone can cause other problems such as abnormal hair growth (face, neck, chest, and trunk), receding hairline, acne, deepening of the voice, and changes in liver function and lipid levels—some of which can be irreversible. It is important to watch for any of these symptoms and to follow labs to check your testosterone levels and liver function.

High testosterone in women

Excess testosterone can sometimes be seen in conditions such as PCOS (Polycystic Ovary Syndrome), inherited conditions such as Congenital Adrenal Hyperplasia, with some medications, and in association with obesity. Treatment is typically targeted at the condition causing the excess.

Low testosterone is a common issue for women. It is important to discuss any possible symptoms with your Women’s Care provider and seek a referral to a specialist if needed.