Understanding the role testosterone plays throughout a woman's life.
Do women produce testosterone?
Yes.
Although testosterone is often thought of as a "male hormone," women naturally produce testosterone throughout their lives. It is made by the ovaries and adrenal glands and plays an important role in many aspects of health and well-being.
Most women are surprised to learn that during their reproductive years, they naturally produce significantly more testosterone than estradiol. While the two hormones serve different functions and are measured in different units, testosterone is an essential hormone for women's health—not just men's health.
Like estrogen and progesterone, testosterone levels generally decline gradually across adulthood rather than dropping abruptly at natural menopause. Levels can decrease more significantly following surgical removal of both ovaries.
What does testosterone do?
Testosterone is an important hormone in women, with androgen receptors located in tissues throughout the body. Testosterone has physiologic effects on sexual function as well as muscle, bone, brain, and other tissues.
Testosterone contributes to:
Sexual desire and arousal
Energy and motivation
Muscle strength and maintenance
Exercise recovery
Bone health
Cognitive function
Mood and sense of well-being
Every woman experiences hormone changes differently, and not every symptom is related to testosterone.
When symptoms improve with appropriately prescribed testosterone therapy, some women may experience meaningful improvements in overall well-being and quality of life.
What symptoms may lead to an evaluation of testosterone in women?
Changes in testosterone occur throughout a woman's life, but there is no single symptom or laboratory value that establishes testosterone deficiency in women.
Symptoms that may prompt a broader hormone and health evaluation include:
Reduced libido
Decreased sexual satisfaction
Fatigue
Reduced motivation
Loss of muscle mass or strength
Difficulty building or maintaining muscle
Decreased sense of well-being
These symptoms should always be evaluated in the context of your overall health rather than attributed to testosterone alone.
How is testosterone evaluated in women?
There is no single testosterone level that determines whether a woman needs testosterone therapy.
Laboratory testing can, however, provide useful clinical information when interpreted alongside symptoms and the overall health picture.
A thoughtful evaluation considers:
Your symptoms
Medical history
Current medications
Total and Free Testosterone
Sex Hormone Binding Globulin
Other hormone levels
Overall health goals
Treatment decisions should never be based solely on a laboratory number.
Can testosterone therapy help?
For many women in perimenopause and menopause, testosterone therapy may improve symptoms related to testosterone deficiency.
Current clinical guidelines support testosterone therapy for women with hypoactive sexual desire disorder (HSDD) after a comprehensive evaluation. Some clinicians also consider testosterone as part of an individualized treatment plan for women experiencing other symptoms, recognizing that research in these areas is still evolving.
The decision to prescribe testosterone should always be individualized and based on a careful discussion of potential benefits, risks, and treatment goals.
Is testosterone therapy safe?
When prescribed in appropriate physiologic doses and carefully monitored, testosterone therapy appears to be well tolerated by many women.
Potential androgenic side effects can include acne and increased facial or body hair. Excessive doses may increase the risk of additional side effects.
Because there is currently no FDA-approved testosterone formulation specifically for women in the United States, treatment commonly involves carefully adjusted doses of formulations originally manufactured for men or individualized preparations.
Ongoing monitoring is important to assess symptoms, side effects, and testosterone levels.
Key Takeaways
✓ Women naturally produce testosterone throughout their lives, and testosterone has physiologic roles beyond sexual function.
✓ Testosterone generally declines gradually with age rather than abruptly at natural menopause.
✓ There is no single testosterone level that diagnoses testosterone deficiency or determines whether a woman needs treatment.
✓ The strongest evidence for testosterone therapy in women is for appropriately diagnosed HSDD; research into other potential benefits continues to evolve.
✓ Treatment should be individualized, appropriately dosed, and monitored.
When to Consider an Appointment
If you've noticed changes in libido, energy, motivation, muscle strength, exercise recovery, or overall well-being, it may be worth discussing whether hormones could be contributing to your symptoms. A personalized evaluation can help determine the underlying causes and whether testosterone—or another treatment approach—is appropriate for you.
Reviewed by Shaune Bullock, FNP-C
Founder of Shine Vitality | Women's Hormone Health & Healthy Aging
This information is for educational purposes and does not replace individualized medical advice.