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Testosterone in women

Testosterone in Women: The Overlooked Hormone That Matters

Testosterone is often associated with men, but it plays a vital role in the female body too. Produced primarily in the ovaries and adrenal glands, testosterone influences everything from libido and mood to muscle and bone health. Understanding how this hormone works, what happens when levels are too low or too high, and how to optimize it can dramatically improve quality of life in women.



1. What Testosterone Does in the Female Body

  • Libido & Sexual Function: Testosterone boosts sexual desire and arousal.
  • Mood & Cognition: Supports dopamine production, mental clarity, motivation, and mood stability.
  • Bone Health: Helps maintain bone density.
  • Muscle Mass & Strength: Essential for lean body mass and physical energy.
  • Immunity: Plays a regulatory role in immune balance.
  • Ovarian Function & Ovulation: Supports follicular development and normal ovulatory cycles.



2. Where Testosterone Is Made in Women

  • Ovaries (main source before menopause)
  • Adrenal glands (backup source, especially postmenopause)
  • Peripheral conversion from DHEA and androstenedione



3. Signs & Symptoms of Low Testosterone in Women

  • Low libido
  • Fatigue
  • Depression or apathy
  • Muscle weakness
  • Poor concentration
  • Bone loss
  • Menstrual irregularities



4. Symptoms of High Testosterone in Women

  • Acne (especially along jawline)
  • Androgenic alopecia (male-pattern hair thinning)
  • Hirsutism (excess body hair)
  • Oily skin
  • Polycystic ovarian syndrome (PCOS)-like symptoms
  • Irregular periods
  • Infertility or anovulation



5. Testing Testosterone in Women

  • Total Testosterone (ng/dL)
  • Free Testosterone (pg/mL) – more reflective of active hormone
  • DHEA-S: upstream adrenal androgen
  • SHBG: sex hormone binding globulin, binds testosterone; low SHBG increases free testosterone



6. Causes of High Testosterone in Women

  • PCOS
  • Insulin resistance
  • Congenital adrenal hyperplasia
  • Stress (cortisol dysregulation)
  • Tumors (rare)
  • Over-supplementation with DHEA or testosterone



7. Treatment Options for Low Testosterone

  • Testosterone Replacement:
  • Topical gels or creams (e.g., 0.25 - 1 mg/day)
  • Injections (very low doses)
  • Pellets (long-acting, but more difficult to titrate)
  • Precautions:
  • Monitor for virilization (deep voice, hair growth)
  • Check levels every 3–6 months



8. Natural Ways to Support Testosterone

  • Exercise, especially strength training
  • Adequate sleep
  • Stress reduction (lowers cortisol, which competes with testosterone)
  • Micronutrients:
  • Zinc
  • Vitamin D
  • Magnesium
  • Omega-3s
  • DHEA supplements (in carefully monitored doses)



9. Suppressing Excess Testosterone

  • Spironolactone: blocks androgen receptors (used for acne, hair loss)
  • Mostly works at the skin/hair follicle level, not systemic testosterone reduction
  • Oral contraceptives: raise SHBG, lowering free testosterone
  • DIM (Diindolylmethane): may support estrogen metabolism, indirectly influencing androgen levels
  • Anti-inflammatory diet: reduce insulin resistance and systemic inflammation



10. Hormonal Interactions

  • Estrogen: testosterone converts to estradiol via aromatase; low E can alter T balance
  • Progesterone: often deficient in high-androgen states like PCOS
  • Insulin: excess insulin increases ovarian androgen production



11. Fun Facts

  • Testosterone levels naturally decline after age 30 in women.
  • Women make about 0.3 mg of testosterone per day (a fraction of male production).
  • Testosterone replacement has been shown to improve sexual satisfaction in postmenopausal women.
  • The only FDA-approved testosterone therapy for women is in Australia, not the U.S.



Conclusion

Testosterone in women is more than just a "male hormone" – it plays a vital role in vitality, mood, sexual health, and physical strength. Whether too low or too high, imbalances can deeply affect quality of life. A functional and personalized approach can help optimize levels and restore hormonal harmony. If you're experiencing symptoms, talk to a hormone-literate provider to explore testing and safe treatment options

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