low testosterone in women

Low Testosterone in Women

Dr. Jenell Ruth Decker
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All articles by the author

Understanding Low Testosterone in Women

Although testosterone is primarily a male hormone, there is no denying that its advantages in women cannot be overlooked. The androgen hormone testosterone in women’s ovaries and adrenal glands can help keep their bones healthy, promote cognitive health and even improve their sex drive. With these benefits, it is not hard to acquiesce that there will be myriads of negative effects when the testosterone levels are very low in women. The low levels are caused mainly by reduction in the level of the hormone as a result of menopause and aging issues with the ovaries or the adrenal or pituitary glands. Although often underdiagnosed or misdiagnosed, when properly diagnosed it can be treated with the help of a qualified medical practitioner as the effect of incorrect supplements and replacement therapies may cause more unpleasant side effects than they relieve.

WHAT IS TESTOSTERONE?

Testosterone is primarily a male sex hormone that is generated in both men’s testicles and women’s ovaries. It also controls fertility, muscle mass, fat distribution, and the synthesis of red blood cells. High or low testosterone levels can cause dysfunction in regions of the body that are normally regulated by the hormone. For example, when testosterone levels fall below healthy levels, it can cause hypogonadism or infertility. As people get older, their testosterone levels naturally decline. Low testosterone is diagnosed using a blood test that measures the level of testosterone in the blood. Because testosterone levels fluctuate throughout the day, it may take many measurements to determine if a patient has low testosterone. In the morning, about 8 a.m., testosterone levels are at their maximum. This is why doctors like to take testosterone measurements first thing in the morning.

TESTOSTERONE IN WOMEN                             

Women generate the androgen hormone testosterone in their ovaries and adrenal glands, however not in the same quantities as males. It’s a little element of the hormone mix that keeps women’s moods, energy levels, sex drive, and body functions in check. Female bodies convert testosterone and other androgens produced into female sex hormones very quickly. This sex hormone synthesis aids in the development of secondary sex traits. Because testosterone and other androgens operate differently in females’ bodies and are quickly converted to estrogen, most females do not develop male traits.

Normal levels of testosterone have multiple functions on the overall health of women:

It promotes bone health: While the right amount of testosterone promotes bone growth and strength, too much or too little can be harmful. A review published in the journal Clinical Interventions in Aging in November 2016 demonstrate that both testosterone and estrogen are required for bone growth.

It is beneficial to cognitive wellbeing: Testosterone has a neuroprotective impact in women, according to guidelines published in the Journal of Clinical Endocrinology & Metabolism in October 2014. According to one study, postmenopausal women with Alzheimer’s disease had lower testosterone and estrogen levels than those in the control group. Another study indicated that premenopausal women with greater testosterone levels in their plasma performed better on mathematics and spatial-relations tests.

It maintains sex drive: Although testosterone is commonly thought of as a male sex hormone, women also have quantities of the hormone in their bodies, just as men do. According to Aaron Spitz, MD, assistant clinical professor in the department of urology at the University of California in Irvine, the hormone is part of what drives desire, fantasy, and thoughts about sex, and even helps provide the energy for sex in women.

Other benefits of testosterone in normal levels include breast health, fertility, menstrual health, and vaginal health.

SYMPTOMS OF FEMALE LOW TESTOSTERONE

Levels of testosterone and other androgens can be measured with a blood test. In women, normal testosterone levels range from 15 to 70 nanograms per deciliter (ng/dL) of blood. If the testosterone level in a woman is lower than than 15 ng/dL, it may cause:

  • reduced sex drive
  • weight gain
  • fertility issues
  • irregular menstrual cycles
  • vaginal dryness
  • decreased sexual satisfaction
  • loss of bone density
  • sleep disturbances
  • sluggishness
  • muscle weakness
  • fatigue

CAUSES OF LOW TESTOSTERONE IN WOMEN

Low testosterone is caused by two main factors:

  • reduction in the levels of the hormone as a result of aging and menopause
  • issues with the ovaries or the adrenal or pituitary glands.

As a woman gets older, her testosterone levels naturally drop. Other hormones, such as estrogen, decrease over time as well, especially as a woman approaches menopause. Because the ovaries produce fewer hormones around the time menopause occurs, a woman’s testosterone levels may be lower. Additionally, drugs used to treat the symptoms of menopause might suppress testosterone levels. Oral estrogen is one such medication.

Low testosterone levels can also be caused by issues with the ovaries and adrenal glands. If a woman’s ovaries have been removed, for example, or if she has adrenal insufficiency, which means her adrenal glands aren’t working properly, she may have lower amounts.

Low testosterone in women can also be caused by the following factors:

  • taking oral estrogen therapy, as estrogen inhibits testosterone production
  • history of oophorectomy, or the surgical removal of the ovaries
  • hypopituitarism
  • early menopause

DIAGNOSIS OF LOW TESTOSTERONE IN WOMEN

Low testosterone symptoms in women are frequently misinterpreted or underdiagnosed. Low testosterone can be confused for a variety of diseases, including stress, depression, and the side effects of menopause changes in women.

A blood test can be used to determine a woman’s testosterone levels. The values used to assess whether a woman’s testosterone levels are high or low differ depending on the laboratory. A woman’s plasma total testosterone level of less than 25 ng/dL in women under 50 years old is considered low, according to the Boston University School of Medicine in 2002. Testosterone levels in women over 50 years old are considered low when they are less than 20 ng/dL.

Because women’s hormone levels change on a regular basis, doctors may have difficulties diagnosing low testosterone levels in them. If a woman is still on her menstruation, the blood testosterone test should be taken 8 to 20 days after her menstrual period begins.

TREATMENTS OF LOW TESTOSTERONE IN WOMEN

Medical professionals haven’t done a lot of research on treatments for low testosterone in women. While doctors are familiar with the effects of too much testosterone in women, they are less familiar with the signs of too little testosterone. As a result, doctors’ treatment plans for low testosterone levels aren’t usually consistent.

In postmenopausal women, a medicine called Estratest may be prescribed by their doctors. This drug contains both estrogen and testosterone. The testosterone type, on the other hand, is synthetic and may not be as useful in addressing low testosterone levels.

Doctors can also give testosterone injections, and medical experts are investigating the effects of testosterone patches and pellets that are implanted under the skin. Compounding pharmacies may be able to provide testosterone gel formulations to some ladies. These gels, on the other hand, have typically been reserved for men with significantly greater testosterone levels than women.

Taking a DHEA supplement is an over-the-counter option. Because DHEA is a precursor to testosterone, it is thought that taking it will boost the quantity of testosterone in the body. Before taking a DHEA supplement to address low testosterone, see your doctor.

Too much testosterone in the body can potentially have negative consequences. Excess testosterone use in women has the following side effects:

  • Acne
  • Deepened voice
  • Fluid retention
  • Facial hair
  • Male-pattern balding
  • reduced HDL (good) cholesterol

At HRT doctors, all of our female protocols, including ones with testosterone, are 100 bio-identical hormones and no synthetic hormones. We also utilize a variable dosing methodology to ensure that estrogen and testosterone peak around day 14-15 + progesterone peaks around day 21.  These are to revert the patient to a 28-day lunar cycle and biorhythm.

It is because of this peculiarity when adjusting testosterone levels in women that it is highly advisable to do so with a doctor’s recommendation and guidance throughout the process. Being specialist, HRT doctors will ensure you get a normal level of testosterone with no unpleasant side effect that may be counterproductive. Without a doctor’s approval, never use testosterone replacement treatment. Supplements and replacement therapy may exacerbate rather than alleviate unpleasant side effects.

Click for more information about our protocols that address low testosterone in women.

REFERENCES

Davis SR, Wahlin-Jacobsen S. Testosterone in women–the clinical significance. Lancet Diabetes Endocrinol. 2015 Dec;3(12):980-92. doi: 10.1016/S2213-8587(15)00284-3. Epub 2015 Sep 7. PMID: 26358173.

Mohamad NV, Soelaiman IN, Chin KY. A concise review of testosterone and bone health. Clin Interv Aging. 2016;11:1317-1324. Published 2016 Sep 22. doi:10.2147/CIA.S115472

Margaret E. Wierman, Wiebke Arlt, Rosemary Basson, Susan R. Davis, Karen K. Miller, Mohammad H. Murad, William Rosner, Nanette Santoro, Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 99, Issue 10, 1 October 2014, Pages 3489–3510, https://doi.org/10.1210/jc.2014-2260

Nall, R. (2018, August 30). Low testosterone in women: Causes and treatments. Healthline. Retrieved June 12, 2022, from https://www.healthline.com/health/low-testosterone-in-women

Popat VB, Calis KA, Kalantaridou SN, et al. Bone mineral density in young women with primary ovarian insufficiency: results of a three-year randomized controlled trial of physiological transdermal estradiol and testosterone replacement. J Clin Endocrinol Metab. 2014;99(9):3418-3426. doi:10.1210/jc.2013-4145

Gleicher, N., Kushnir, V.A., Weghofer, A. et al. The importance of adrenal hypoandrogenism in infertile women with low functional ovarian reserve: a case study of associated adrenal insufficiency. Reprod Biol Endocrinol 14, 23 (2016). https://doi.org/10.1186/s12958-016-0158-9

Review published in the journal Clinical Interventions in Aging in November 2016 –  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036835/

Guidelines published in the Journal of Clinical Endocrinology & Metabolism in October 2014 – https://academic.oup.com/jcem/article/99/10/3489/2836272?login=false