Low Testosterone Symptoms in Women: What To Expect
Testosterone is a naturally occurring androgen. Here, we discuss some of the effects of low testosterone levels in women and what to do.
Testosterone is often considered a male-only hormone. While this androgen sex hormone is much higher in men, women also produce testosterone.
Testosterone is essential for maintaining the body’s overall hormone levels — for both men and women. Testosterone imbalances can have a big impact on women’s health.
But what happens when testosterone levels are too low? In this article, we will discuss the role of testosterone in women’s bodies and some of the symptoms to watch out for when testosterone levels get too low.
A Closer Look at Testosterone
For many, testosterone conjures up images of macho men and bodybuilders. But this essential hormone has received a bad rap. Testosterone is extremely important for men and women alike, but each body's role differs.
The majority of testosterone is produced by the gonads — the testes in men and ovaries in women. It is also produced in smaller quantities by the adrenal glands. The hypothalamus and the pituitary gland control testosterone production.
What Does Testosterone Do in a Woman’s Body?
Women have three sex hormones, estrogen, progesterone, and testosterone, with estrogen being the primary sex hormone. Like testosterone for men, estrogen plays a key role in the maturation of female reproduction and sexual development.
Although it isn’t nearly as abundant as estrogen, testosterone still plays a part in women’s physical and emotional health.
Androgen in women affects the reproductive system, mood, cognition, and more. Here are a few examples of normal levels of testosterone's role in women’s health.
- Support cognitive health - Normal testosterone levels have a neuro-protective effect in women, which helps to support cognitive health. One endocrine study compared cognitive performance between postmenopausal women and premenopausal women. Those who performed higher on cognitive tests also showed high testosterone levels.
- Supports bone health - Testosterone is known for its crucial role in bone health. This applies to both men and women. Both testosterone and estrogen work together to support healthy bone formation and maintenance.
- Supports healthy sex drive - Testosterone is key in supporting normal sexual function. It is well known as the driving force behind male libido, but it also helps maintain a healthy sex drive in women.
What Causes Low Testosterone in Women?
Although it is not talked about as much, low testosterone (Low T) in women can be just as devastating as it is for men. For adult women, low testosterone is considered anything below 15 nanograms per deciliter (ng/dL). The causes of testosterone deficiency in women are numerous, but the most common cause of hormone imbalance is aging.
The first natural testosterone decline occurs during this perimenopausal phase, as the menstrual cycle slows. Testosterone levels slowly wane as women near menopause, decreasing between the ages of 20 to 50.
By age 50, the amount of testosterone in women is roughly half what it was at 25. The levels continue to drop for postmenopausal women.
Aside from aging, other conditions contribute to low levels of testosterone. Here are a few of the possible causes:
- Primary adrenal insufficiency (AI) - Although it is a rare condition, primary adrenal insufficiency is marked by the adrenal gland's inability to produce sufficient amounts of cortisol. Steroid hormones like testosterone are likewise low.
- Pituitary gland dysfunction - As stated above, the pituitary gland is crucial to testosterone production. In women, it releases a hormone known as luteinizing (LH), signaling the ovaries to produce testosterone. Issues with this cycle can lead to low testosterone (hypopituitarism).
- Bilateral oophorectomy - This refers to a procedure that removes both ovaries. It is common among those with ovarian cancer. Removing the ovaries causes most testosterone production to cease.
- Medications - Since they contain estrogen and progesterone, some side effects of medications like oral contraceptives include lowering testosterone. As sex hormone-binding globulin increases, free testosterone in the body decreases. The same applies to medications relating to oral estrogen therapy.
What Are the Symptoms of Low Testosterone in Women?
Physical Symptoms
Numerous physical symptoms are associated with low testosterone in women; it is a common risk factor for other conditions. The most common physical signs of low testosterone include but are not limited to:
- Fatigue and sluggishness - Low testosterone often includes a sharp drop in energy levels for both men and women. Feelings of fatigue and sluggishness are common.
- Weight gain and reduced muscle mass - Research has shown that testosterone levels and obesity are closely linked. Low testosterone levels are linked to an increase in body fat and a decrease in lean muscle mass.
- Risk of bone loss - Testosterone helps maintain bone mass in men and women. When the levels of testosterone in the body are insufficient, conditions like osteoporosis can arise, resulting in a loss of bone density.
- Potential hair loss - For women, testosterone can come with hair growth, like facial hair and body hair. This does have merit as it relates to very high levels of testosterone. However, low testosterone levels can contribute to body hair loss and even baldness in women.
- Vaginal dryness - One byproduct of testosterone deficiency is vaginal dryness. Aside from being uncomfortable, this condition can make intercourse painful. Many turn to creams or gels to combat this irritating symptom.
Mental Symptoms
In addition to the physical symptoms associated with low testosterone, there are also some mental symptoms to watch out for. For example, anxiety is a common complaint among many women struggling with low testosterone.
This is related to testosterone’s role in mood regulation. Irritability and mood swings are also very common among women with low testosterone.
Concentration can also be affected. This brain fog is often associated with hormonal imbalances.
Sexual Symptoms
Low sex drive is very common among women dealing with low testosterone. Low libido (hypoactive sexual desire disorder) is a common symptom of testosterone deficiency among men and women.
Furthermore, testosterone has a role to play in fertility. For example, testosterone helps increase circulation to the pelvic region, stimulating cervical mucus production. This is important for fertility.
On the flip side, high testosterone levels above 70 ng/dL, like those seen in polycystic ovarian syndrome (PCOS), are also known to contribute to infertility.
How Does a Low Testosterone Diagnosis Work?
The only way to verify if you have lower testosterone is by consulting a healthcare provider. Aside from a physical examination and detailed medical history, healthcare professionals can perform a blood test. This testosterone test is used to confirm total testosterone levels.
How Can You Treat Low Testosterone in Women?
The research into the treatment of low testosterone in women is still ongoing. While procedures like testosterone replacement therapy are common for men, the Endocrine Society does not recommend hormone replacement for women due to a lack of research.
Besides hormone therapy, medications like Estratest have been prescribed to post-menopausal women to help increase both estrogen and testosterone levels.
Furthermore, over-the-counter (OTC) dehydroepiandrosterone (DHEA) supplements are also an option since DHEA is a precursor to testosterone. But make sure to consult your healthcare provider first.
Lifestyle changes like eating a healthy diet, regular exercise, and stress management are simple ways to help boost testosterone levels.
Conclusion
Testosterone is not a male-only hormone. This androgen is crucial for women’s and men’s overall health and well-being.
Testosterone levels tend to drop as women age and get closer to menopause. A testosterone deficiency can bring many physical, mental, and sexual symptoms.
It’s best to consult your healthcare physician, who can offer medical advice, run the proper tests, and give you the best treatment options.
Sources:
Reproductive Hormones | Endocrine Society
A concise review of testosterone and bone health | PMC
Testosterone and obesity | NIH