Testosterone and Women
Testosterone in Women: Breaking the Taboo and Reclaiming Vitality
When most people hear the word testosterone, they immediately think of men, muscles, and aggression. What rarely enters the conversation is how vital this hormone is for women’s health and well-being. The taboo surrounding testosterone in women has kept countless patients suffering in silence—misdiagnosed, misunderstood, or dismissed altogether. It’s time we shift the narrative.
Why Women Need Testosterone Too
Testosterone is classified as an androgen, a type of sex hormone typically associated with male physiology. However, women naturally produce testosterone in their ovaries and adrenal glands. In fact, women produce three to four timesmore testosterone than estrogen before menopause (Davis & Wahlin-Jacobsen, 2015).
Testosterone plays a key role in:
Supporting lean muscle mass and bone density
Regulating mood, confidence, and cognitive clarity
Enhancing libido and sexual response
Promoting metabolic function and fat distribution
Sustaining energy and motivation
As women age, particularly after their mid-30s and more rapidly post-menopause, testosterone levels decline. This can be exacerbated by oophorectomy, adrenal dysfunction, or chronic stress.
How Low Testosterone Feels in Women
Symptoms of testosterone deficiency in women are often vague but profoundly life-altering. These may include:
Persistent fatigue and lack of motivation
Decreased libido or sexual pleasure
Loss of muscle tone and difficulty building strength
Brain fog, irritability, and even symptoms resembling depression
Weight gain or difficulty losing fat despite exercise
Unfortunately, these symptoms are often dismissed as part of aging or attributed solely to estrogen loss. Yet, testosterone deficiency can exist even when estrogen levels are normal.
A pivotal study in the Journal of Clinical Endocrinology & Metabolism found that low testosterone in women is associated with reduced sexual desire, impaired well-being, and fatigue (Wierman et al., 2014).
The Benefits of Testosterone Supplementation in Women
Testosterone replacement therapy (TRT) is not just for men. In appropriately selected women, low-dose testosterone therapy can have profound effects:
Improved sexual function: Multiple randomized controlled trials confirm testosterone significantly improves sexual desire, arousal, and satisfaction in postmenopausal women with hypoactive sexual desire disorder (HSDD) (Witherby et al., 2021).
Mood and energy enhancement: Testosterone has been shown to enhance motivation, decrease anhedonia (loss of interest or pleasure), and support emotional resilience (Davis et al., 2019).
Muscle and metabolic health: Studies show that testosterone helps maintain lean muscle mass and insulin sensitivity, reducing the risk of sarcopenia and metabolic syndrome (Huang et al., 2015).
It’s crucial to understand that women require much lower doses than men, and therapy must be monitored closely to maintain physiologic—not supraphysiologic—levels.
Challenging the Stigma
Fear, misinformation, and regulatory barriers have made access to testosterone therapy difficult for women, despite decades of research supporting its safety and efficacy. The reluctance to prescribe it often stems from outdated gender norms rather than science.
A global position statement by Davis et al. (2019) concluded:
“Testosterone therapy for postmenopausal women with HSDD is effective and safe in the short to medium term and should be considered in appropriate candidates.”
Final Thoughts
Women deserve access to the same hormone optimization that men receive—without stigma. Testosterone is not a male-only hormone. It is essential to female vitality, strength, mood, and sexuality. If you suspect you may have a hormone imbalance, seek out a knowledgeable practitioner who will look beyond estrogen and assess the full spectrum of your hormonal health.
References
Davis, S. R., & Wahlin-Jacobsen, S. (2015). Testosterone in women—The clinical significance. The Lancet Diabetes & Endocrinology, 3(12), 980–992. https://doi.org/10.1016/S2213-8587(15)00286-4
Wierman, M. E., Arlt, W., Basson, R., Davis, S. R., Miller, K. K., Murad, M. H., & Rosner, W. (2014). Androgen therapy in women: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 99(10), 3489–3510. https://doi.org/10.1210/jc.2014-2260
Witherby, S., Johnson, M., Davis, S. R., & Parish, S. J. (2021). Testosterone therapy in women: A review of efficacy, safety, and guidelines. Journal of Women’s Health, 30(8), 1041–1050. https://doi.org/10.1089/jwh.2020.8890
Davis, S. R., Baber, R., Panay, N., & Worsley, R. (2019). Global consensus position statement on the use of testosterone therapy for women. Climacteric, 22(4), 372–389. https://doi.org/10.1080/13697137.2019.1637074
Huang, G., Basaria, S., Travison, T. G., Ho, M. H., Davda, M. N., Mazer, N. A., & Bhasin, S. (2015). Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: Effects on sexual function, body composition, muscle performance, and physical function in a randomized trial. Menopause, 22(6), 612–620. https://doi.org/10.1097/GME.0000000000000351
