As a woman, you may be more focused on your estrogen levels than testosterone. After all, estrogen and progesterone are your prominent hormones – or at least, that’s what popular medicine tells you.
However, even though your testosterone levels play second fiddle to estrogen, you will notice if your levels are imbalanced because testosterone plays an important role in the human body.
Are you experiencing the signs of menopause earlier than you should? Here’s what you need to know about low tesosterone levels in women.
Do Women Have Testosterone?
Popular media – and even a poorly informed doctor – may say that estrogen is for women and testosterone is for men. It’s the equivalent of saying men are from Mars and women are from Venus.
Here’s the problem: women also have testosterone. They don’t have the same amount: women’s bodies only produce five to ten percent of what men do. But it’s still there and it’s still important.
At the same time, not all women have the same levels of testosterone. Some have more and some have less. The same is true of estrogen: some women have higher and lower levels of all sex hormones.
Does the fact that women have testosterone mean men have estrogen? It doesn’t mean anything, but men and women do share many of the same sex hormones. The major female sex hormones are:
- Other androgens
Male’s sex hormones include:
- Estradiol and other estrogen
However, as we explain later, your bodies use hormones differently.
What Does Testosterone Do for Women?
Like all hormones, testosterone plays a role in multiple bodily processes. For men, it plays a role in mood, sex drive, sperm production, muscle growth, bone density, and red blood cell production.
The same is true in women (bar the sperm production).
It helps you maintain bone density as you age and, of course, helps you increase and maintain muscle mass. Testosterone also contributes to your red blood cell production. It can also help you lose body fat (once you pass menopause).
And of course, it plays a role in your sex life: it both encourages a healthy sex drive and decreases the likelihood of vaginal atrophy (again, in post-menopausal women). It even promotes breast health and fertility.
The difference is that your body doesn’t use testosterone with the same mechanisms as men do. A female body converts it (along with other androgens) into female sex hormones. Along with having significantly lower levels of testosterone, this is why your body doesn’t develop male characteristics. Your body transforms it into estrogen.
As a result, you are likely to notice if your testosterone drops below normal levels (or goes into hyperdrive, which is less likely).
What Are the Symptoms of Low Testosterone in Women?
When your testosterone drops lower than 15 ng/dL, you will likely see changes. Because it’s lower than normal, you aren’t dealing with potential changes that reflect male characteristics, like facial hair or muscle growth. Instead, you experience issues like:
- Loss of bone mass and osteoporosis
- Decreased muscle tone
- Thin hair
- Dry skin
- Irregular menstrual cycles
- Vaginal dryness
Perhaps the most recognized side effect of low T among men and women is that your sex drive may come to a grinding halt, in part or in addition to the development of sexual dysfunction.
The primary type of sexual dysfunction caused by low T is called hypoactive sexual desire disorder or HSDD.
HSDD is characterized by a distinct lack of interest in sex – at all. That means a lack of interest in sex itself or even fantasies or masturbation. You might also experience symptoms like low self-confidence and self-worth as well as depression and fatigue.
Low T doesn’t guarantee HSDD, nor does HSDD meant hat you have low testosterone levels. The link (like so much of women’s sexual health) is poorly understood thanks to a lack of research. As a result, there isn’t a single testosterone level that guarantees HSDD.
As a result, low T isn’t just a hormone issue. It can impact your overall health and wellbeing, including your physical, psychological, and spiritual health.
Why Might Your Testosterone Drop?
Like men, women are more likely to experience low T both as part of aging or as a result of a medical condition or as a side effect of medication. By the time a woman is 40, her hormone production falls by around half.
Even still, testosterone drops when a center of hormone production suffers. Your ovaries are the biggest producer of testosterone, but it also comes from your adrenal glands and peripheral tissues.
As a result, when your ovaries undergo changes, you are more likely to experience hormonal fluctuations, including a drop in your T levels.
First, let’s talk about hormonal birth control. Many women begin hormonal contraception during late adolescence and remain on it over long periods of time. The use of medications like the pill or the patch change your hormonal balances and can lead to a drop in your testosterone later in life.
What could birth control do to your testosterone production? Some of the testosterone produced by your ovaries and adrenal glands binds to the serum hormone bonding globulin (SHBG), which is a protein. If the testosterone binds to SHBG, then it is inactive testosterone. Only free, unbound testosterone increases your libido. Some forms of hormonal birth control increase SHBG, which means more testosterone binds to it, leaving less behind in the active form.
The higher SHBG levels don’t occur in every woman nor do they occur with every form of birth control. However, women on hormonal contraceptives do have less free testosterone on average. Additionally, low testosterone also coms with fatigue and poor mood, which does little for what’s left of your libido.
Another cause is ovarian failure.
The culprit behind most cases of ovarian failure is menopause, but it can also be the result of ovarian cancer and chemotherapy or radiation treatment as well as eating disorders. It goes without saying that an oophorectomy (the removal of your ovaries) also results in changes in your testosterone by removing your biggest production center.
Finally, issues with your pituitary gland or thyroid, like a tumor, can cause changes in your hormone levels including your testosterone.
How to Diagnose Low T in Women
The signs and symptoms of low T in women are under- or misdiagnosed – or even ignored entirely. Stress, weight gain, and a lack of interest in sex are both also symptoms of menopause and also not also taken as seriously among women as they are in men in part due to gender biases and perceptions about what a woman’s sex drive is and isn’t.
Indeed, women may be less likely to self-report the signs of low testosterone by either assuming that it is perimenopause or because of perceptions that a decreasing women’s sex drive
Once suspected, however, the test for low T is fairly simple – at least on the surface.
A blood test measures your testosterone levels but determining what is low in general and whether you have low T is more difficult.
The accepted ratios differ depending on labs and providers. One of the most accepted levels indicating low T is:
- Under 25 ng/dL in women under 50
- Under 20 ng/dL in women over 50
However, you will need more than one test to successfully determine what your testosterone levels are. Women’s hormone levels fluctuate daily and reach peaks and troughs at different times during their menstrual cycle. As a result, you need to time these tests very well.
Finally, labs can produce different measurements that vary wildly. The difference is a result of the method used, but it may appear to be a change in the testosterone levels themselves.
Why You Should Get Tested for Low Testosterone
Getting tested is important for several reasons. First, it confirms the presence of abnormal hormone levels and confirms whether or not the issues you face are hormonal in nature.
Second, if your hormonal levels do appear far lower than what is normal for your age, it is an impetus to seek out any potential underlying medical conditions that cause it.
You are more likely to know about underlying causes before you experience low T (such as the removal of your ovaries) or experience low T as a part of normal aging. However, every woman’s medical history is different, so it is worth getting checked out anyway.
Coping with Low T: The Treatments Available
Surprise, surprise: because low T in women isn’t as commonly studied as it is in men, there isn’t a wealth of information available on the potential treatments nor their efficacy. As a result, doctors may recommend various treatments to women with the same symptoms, which makes it difficult to identify the most appropriate and effective treatment. For women
Testosterone replacement therapy is a potential treatment for the issue, and it is the one with the most widespread use. The premise is simple: doctors administer testosterone injections (or patches or gels) to replace the missing testosterone. However, these therapies remain geared towards men, who have higher overall levels of testosterone compared to women even when struggling with low T.
In most cases, the drugs are an off-label use of the same formulations prescribed for men.
Another potential therapy is Estratest, which caters to women who complete menopause. It has both estrogen and testosterone, but the drug is synthetic and may not be an effective replacement.
Getting the dosage right is important because you can have too much testosterone. When you have too much testosterone, you might experience acne, excess unwanted hair, and male-pattern balding. You might even start to see some physical characteristics associated with masculinity start to develop.
Is TRT Safe for Women?
TRT is considered safe for women, as long as it is prescribed in a way that suits women’s testosterone needs. The FDA does continually warn about the off-label use of TRT.
Additionally, if you use testosterone improperly, then you could raise your testosterone too much, which could cause you to take on male characteristics like:
- Deepening voice
- Unwanted hair growth
- Male pattern baldness
- Reduced good cholesterol
If you try TRT, you will receive regular testosterone tests that usually prevent these symptoms from occurring.
Who Shouldn’t Try Hormonal Replacements
You should always talk to your doctor and get a diagnosis before taking any androgens – testosterone, estrogen, or any other supplement. Replacements can interact with other medications, which can cause severe side effects. Additionally, it’s better to understand the cause of your low T to treat the underlying condition, if applicable.
Women who are pregnant or actively trying to become pregnant aren’t candidates for testosterone medications. You also can’t take them inf you’re breastfeeding because the medication will enter your breastmilk.
Do You Have Questions About Low Testosterone in Women?
Has your sex drive bottomed out and been accompanied by moodiness, lethargy, osteoporosis, and weight fluctuations?
Although these are also signs of menopause, they can be signs of low testosterone in women. Low T requires a different form of treatment than the symptoms of menopause, and it can change your life.
Do you have questions about your testosterone levels or the potential helpfulness of TRT? Click here to learn more about the role of testosterone and book a test to measure your T levels.