A woman’s testosterone levels naturally change throughout her life, her menstrual cycle, and even at different times of the day.
Low testosterone in women
A woman with low testosterone does not contain enough to help produce new blood cells, maintain sex drive, or boost levels of other reproductive hormones.
Testosterone belongs to a group of hormones known as androgens. Testosterone levels affect:
- sex drive;
- red blood cell production;
- muscle mass and fat distribution.
Most people think of testosterone as a male sex hormone, but everyone requires a certain amount. While males have more testosterone than females, female adrenal glands and ovaries produce small amounts of this hormone.
According to the University of Rochester Medical Center, a woman should have a total of 15–70 nanograms per deciliter (ng/dl) of testosterone in her blood. At this time, there are no conclusive guidelines for what should be considered “low” testosterone levels in women.
A woman with low testosterone may feel tired and lethargic. Low testosterone can cause one or more of the following symptoms in women:
- muscle weakness;
- sleep disturbances;
- reduced sex drive;
- decreased sexual satisfaction;
- weight gain;
- fertility issues;
- irregular menstrual cycles;
- vaginal dryness;
- loss of bone density.
Because the symptoms linked to low testosterone are so common, a doctor will look for signs of other issues or conditions before making a diagnosis.
The doctor may check for:
- chronic stress;
- thyroid disease;
- transition to menopause.
The two main causes of low testosterone are:
- diminishing levels of the hormone as a normal result of menopause and aging;
- problems with the ovaries or the pituitary or adrenal glands.
Testosterone decreases naturally as a woman ages. Levels of other hormones, such as estrogen, also reduce over time, especially when a woman reaches menopause.
Around the time that menopause begins, a woman may be more likely to have less testosterone because the ovaries are producing fewer hormones.
Medications that combat the side effects of menopause can lower testosterone levels. One such medicine is oral estrogen.
Problems with the ovaries and adrenal glands can also cause lower levels of testosterone. A woman may have reduced levels if her ovaries have been removed, for example, or if she has adrenal insufficiency, which means that the adrenal glands do not work correctly.
High testosterone in women
Too much testosterone can cause symptoms that affect a woman’s physical appearance including:
- excess body hair, specifically facial hair;
- enlarged clitoris;
- decreased breast size;
- deepening of the voice;
- increased muscle mass.
Overly high levels of testosterone in women can also cause:
- irregular menstrual cycles;
- low libido;
- changes in mood.
In more severe cases of testosterone imbalances in women, high testosterone can cause infertility and obesity.
Diagnosing high testosterone
If you notice any of the symptoms listed above, you should talk to a doctor.
A doctor will perform a physical examination based on your symptoms to determine whether or not you need additional tests. During the examination, a doctor will look for these symptoms:
- abnormal facial hair;
- excess body hair.
If your symptoms seem to be abnormal, a doctor will suggest a testosterone test to measure hormone levels in your blood. To perform this test, a doctor will draw some of your blood and have it examined for hormone levels.
The test is typically performed in the morning when testosterone levels are at their highest. Prior to performing this test, a doctor may ask you to stop taking any prescriptions that could affect the test results.
Causes of high testosterone in women
Various diseases or hormonal disorders can cause hormonal changes in women. The most common causes of high testosterone levels in women are hirsutism, polycystic ovary syndrome, and congenital adrenal hyperplasia.
Hirsutism is a hormonal condition in women that causes the growth of unwanted hair, specifically on the back, face, and chest. The amount of body hair growth is highly dependent on genetics, but this condition is primarily caused by an imbalance of androgen hormones.
2. Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is another hormonal disorder caused by an excess of androgen hormones in women. If you have PCOS, you may have irregular or prolonged periods, unwanted body hair growth, and enlarged ovaries that may not function properly. Other common complications of PCOS are:
type 2 diabetes
3. Congenital adrenal hyperplasia
Congenital adrenal hyperplasia (CAH) is a disorder that directly affects the adrenal glands and the production of the body’s hormones. In many cases of CAH, the body overproduces androgen.
Common symptoms of this disorder in women include:
- masculine characteristics;
- early appearance of pubic hair;
- severe acne.
Treatment for low testosterone in women
Testosterone Replacement Therapy (TRT) is a treatment typically marketed to men. However, women also produce testosterone, although in smaller amounts than men. When these levels dip below normal for women, it can negatively impact their health.
TRT can be indicated for the treatment of low testosterone in women to improve their daily lives and overall health outcomes. Many women have reported positive changes in their lives by increasing levels of testosterone.
What does testosterone do for a woman?
Though women naturally produce less testosterone than men, in small amounts, the hormone is essential in the support of several body functions. Normal, sustained female testosterone levels in women can help:
- support the maintenance and healthy growth of bone tissue;
- increase and maintain muscle mass;
- decrease the amount of fat storage (particularly in post-menopausal women);
- promote a healthy sex drive or libido;
- decrease the risk of vaginal atrophy.
There is some research to suggest that normal testosterone levels in women can even help support cardiovascular health. As such, this is more than just a “sex hormone” – it plays an integral role in overall good health and longevity.
Too little testosterone can directly contribute to a variety of health conditions, including:
- pelvic floor insufficiency;
Testosterone Replacement Therapy Benefits in Women
There is promising evidence that Testosterone Replacement Therapy can have several benefits for women, such as:
A Healthier Heart
We know that low testosterone levels can increase the risk of cardiovascular issues, but can TRT help with your risk of heart disease or stroke? Evidence suggests that it might. Testosterone helps boost healthy red blood cell production, and a recent study of 83,000 men found men with low levels of testosterone who returned to normal levels decreased their risk of heart attack by 24%, and risk of stroke 36%. It’s not known if these results are generalizable to women.
Decreased Risk of Obesity
Women naturally have less muscle mass than men, and testosterone is linked to increased muscle mass. A leaner body naturally helps control weight and increases energy. TRT can help decrease fat levels while promoting muscle mass and strength.
Testosterone levels are directly linked to bone density, and low T directly correlates with the risk of osteoporosis in both men and women. Clinical trials show TRT can help boost bone mineral density in both the hip and spine. Additionally, studies of females transitioning into males found that TRT treatments naturally improved bone density in participants.
Possible Improvements in Cognition
There is promising research in men that shows men with higher total testosterone have a reduced risk of Alzheimer’s disease. Testosterone has also been to important thinking abilities such as improved verbal memory, processing speed, and spatial memory. Again, while this research has been predominantly on men, it is likely that it would similarly affect women.
The most promising evidence regarding TRT and women relates to libido. In both men and women, appropriate testosterone levels contribute to healthy sexual arousal and activity. Numerous studies show that testosterone replacement therapy can improve sexual performance and activity in both men and women. Boosting testosterone can have an almost immediate effect on your sexual health.
People with low T report troubling symptoms such as fatigue, irritability, and depression. TRT may be able to improve mood, well-being, and promote healthy energy levels. The natural consequence of feeling more energy can also boost moods.
Are there risks to testosterone replacement therapy?
Like any medication, testosterone replacement therapy has its risks and benefits. You should discuss all the possible side effects of taking testosterone based on your unique health history. For some people, such as those with blood clotting disorders, testosterone replacement may not be appropriate.
Some of the most common side effects of TRT include:
- increase in acne, particularly cystic acne;
- increased urine output;
- fluid retention;
- enlargement of the breasts (gynecomastia);
- an increase in aggression;
- mood swings.
Can women get testosterone?
Currently, there are several different ways that a man or woman can receive testosterone replacement therapy. One is not necessarily better than the other; the formulation you use will depend on your physician’s recommendation and personal preferences.
Remember, the FDA has not approved testosterone preparations for use in women. This means when testosterone is prescribed, it’s for off-label use and the prescription must be filled by a compounding pharmacy.
How is testosterone compounded for Women?
Today, men and women have a variety of options for compounded testosterone replacement products, such as:
- topical gels or creams;
- transdermal patches;
- oral formulations, such as pellets and trochees.
Once you start testosterone replacement therapy, you will likely notice the effects within just a few days. Within a few weeks, many women report feeling increases in sexual drive, libido, performance, and mood. Additionally, people undergoing TRT have reported feeling more energetic within the first few days.
Treatment for high testosterone in women
Treatment for high testosterone depends on the cause but generally includes medication or lifestyle changes. Medications used to treat high testosterone include:
- oral contraceptives;
Oral contraceptives have been shown as an effective treatment for blocking testosterone, but this treatment method will interfere if you have immediate plans to get pregnant. According to research from the American Academy of Family Physicians, low-dose birth control that uses low levels of norgestimate, gestodene, and desogestrel are the best choices. All of these medications are only available by prescription.
Making certain lifestyle changes can also affect testosterone levels. Starting an exercise or weight loss program can help because losing weight can improve symptoms. Some women choose only to treat their symptoms, including shaving or bleaching hair and using facial cleansers for acne or oily skin.
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