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Testosterone In Women

Author: Dr. George Shanlikian, M.D.  |   Last Updated: November 28th, 2023

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In women, testosterone is present in smaller amounts. It functions to maintain sex drive, keep bones healthy, manage pain levels, and preserve cognitive health. It also gives women a sense of motivation, assertiveness, and a feeling of well-being.

Testosterone is produced in various locations in a woman’s body. One quarter of testosterone is produced in the ovaries, a quarter is produced in the adrenal glands, and one half is produced in the tissues of the ovaries and adrenal glands.

The testosterone level in women is highest around age 20 and slowly declines until it is half as high in their 40s. For those who had their ovaries removed, testosterone production significantly drops by half, sometimes resulting in less than the normal blood testosterone levels. This in turn causes various unpleasant symptoms such as reduced sexual desire, depression, extreme fatigue, and mood changes.

Overall Health Benefits

  • Improves Reproductive Health/Fertility [1-4]
  • Lowers Risk of Heart Disease [5-10]
  • Prevents Cancer [11-12]
  • Helps Lose Weight [13-15]
  • Boost Brain Power [16-18]
  • Treats menopausal symptoms [19-34]
  • Improves mood [35-43]
  • Improves bone heath [44-53]
  • Improves body composition [54-56]
  • Protects against rheumatoid arthritis [57-60]

Proven Health Benefits

Improves Reproductive Health/Fertility

A number of high-quality studies suggest that testosterone plays an integral role in women’s reproductive health:

  1. A study showed that low-dose testosterone therapy is efficacious in restoring women’s sexual interest. [1]
  2. In premenopausal women, testosterone therapy improved well-being, mood, and sexual function. [2]
  3. In women with poor ovarian response to in-vitro fertilization (IVF), testosterone therapy increased the success rate of IVF. [3]
  4. In women with poor response to assisted reproduction, pre-treatment with testosterone improved live birth rates. [4]

Lowers Risk of Heart Disease

Studies also show that testosterone can help protect women against cardiovascular disease:

  1. A study showed that low total testosterone concentration in women was associated with an increased risk of heart disease. [5]
  2. In postmenopausal women, low testosterone levels were associated with a higher risk of heart dysfunction, coronary artery disease, and other heart problems. [6-10]

Prevents Cancer

A good deal of evidence suggests that testosterone has anti-cancer properties:

  1. In women with breast cancer, testosterone prevented the recurrence of the disease. [11]
  2. A study showed that long term therapy with subcutaneous testosterone lowered the incidence of invasive breast cancer in women. [12]

Helps Lose Weight

Studies suggest that testosterone can help improve body composition by promoting weight loss:

  1. In mid-life women, higher blood testosterone levels were associated with low total body fat percentage. [13]
  2. In obese postmenopausal women, testosterone replacement therapy promoted weight loss. [14]
  3. In obese children, normal levels of testosterone were associated with weight loss. [15]

Boosts Brain Power

Studies also found that testosterone plays an integral role in cognitive health:

  1. In women with low testosterone levels, short term administration of testosterone was associated with improvement of cognitive function. [16]
  2. A study showed that postmenopausal women had better improvement in verbal learning and memory after receiving testosterone gel. [17]
  3. In healthy women, testosterone administration improved spatial cognition involving 3D-visualization. [18]

Treats Menopausal Symptoms

A number of convincing evidence found that testosterone replacement therapy can help treat a wide array of menopausal symptoms:

  1. In women with surgical menopause, testosterone replacement therapy reduced menopausal symptoms. [19]
  2. In women diagnosed with hypoactive sexual desire disorder, continuous testosterone therapy produced significant benefits on menopausal symptoms. [20]
  3. In both pre- and post-menopausal women, continuous testosterone alone, delivered by subcutaneous implant, relieved hormone deficiency symptoms. [21-22]
  4. In postmenopausal women, testosterone replacement therapy increased bone mineral density and lean body mass, reduced hot flashes, and improved well-being. [23]
  5. In women with surgical menopause, treatment with testosterone alone improved sexual function. [24]
  6. In women with hypoactive sexual desire disorder, treatment with transdermal (patch) testosterone improved sexual function as evidenced by reports of satisfying sexual episodes and sexual desire. [25]
  7. In postmenopausal women, administration of testosterone patch improved sense of well-being. [26]
  8. Studies suggest that adding testosterone to hormone therapy has a beneficial effect on sexual function in postmenopausal women. [27-28]
  9. In women with or without oophorectomy (surgical removal of the ovaries), testosterone administration for 24 weeks improved several domains of sexual function, lean body mass, and exercise performance. [29-34]

Improves Mood

Studies found that testosterone has anti-anxiety and antidepressant properties:

  1. In postmenopausal women, administration of testosterone pellet implants reduced symptoms of depression. [35-36]
  2. In women who had premenstrual syndrome-type symptoms, skin application of testosterone reduced depressive symptoms. [37]
  3. In women with treatment-resistant major depressive disorder, administration of a low dose of testosterone significantly improved ratings of depression. [38]
  4. In women, sublingual administration of a single dose of testosterone reduced anxiety in the fear-potentiated startle response. [39]
  5. In women experiencing age-related declines in androgens, skin application of testosterone significantly improved mood and psychological well-being. [40]
  6. Studies found that salivary testosterone levels were lower in female patients with depressive disorders, generalized anxiety disorders, and phobias. [41-42]
  7. A study reported that testosterone supplementation in women has positive effects on depression, libido, and energy. [43]

Improves Bone Heath

Several lines of evidence suggest that testosterone can help women combat age-related bone loss and other bone disorders:

  1. In older women, higher blood levels of free testosterone were found to be associated with greater bone mineral density. [44-45]
  2. In women, testosterone hormone deficiency is linked to the development of osteoporosis. [46]
  3. In postmenopausal women, testosterone replacement therapy prevented bone loss associated with low bone mineral density. [47]
  4. In androgen-deficient women, testosterone replacement therapy increased bone mineral density in the hip region. [48]
  5. In normal postmenopausal women, testosterone replacement therapy prevented osteoporosis, with improvement in bone density and reduction in vertebral fractures. [49]
  6. In postmenopausal women, the combination of testosterone with estrogen increased bone mineral density at different skeletal sites by suppressing bone breakdown. [50-53]

Improves Body Composition

An increasing body of clinical evidence suggests that testosterone can help improve body composition by increasing lean muscle mass in women:

  1. In women with eating disorders, treatment with low-dose testosterone for 12 months increased lean body mass. [54]
  2. In HIV-positive premenopausal women, administration of transdermal testosterone patch increased overall mean body weight and body mass index. [55]
  3. In postmenopausal women, treatment with concurrent estrogen-testosterone therapy increased fat-free mass ratio. [56]

Protects against Rheumatoid Arthritis

Testosterone has also been found to beneficial in women with rheumatoid arthritis:

  1. In postmenopausal women with rheumatoid arthritis, administration of testosterone replacement reduced the symptoms of the disease. [57]
  2. A study found that testosterone replacement therapy in postmenopausal women with rheumatoid arthritis reduced the levels of inflammatory substances. [58]
  3. Testosterone replacement therapy in postmenopausal women with rheumatoid arthritis was also found to reduce the risk of disease activity. [59]
  4. In postmenopausal women with active rheumatoid arthritis, testosterone replacement therapy resulted in improved general well-being. [60]
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FAQ

How does the level of testosterone change throughout a woman's life?

The level of testosterone in women undergoes changes throughout their life. Here’s a general overview:

Puberty: Testosterone production increases during puberty, contributing to the development of secondary sexual characteristics such as the growth of pubic and underarm hair, breast development, and increased bone density.

Reproductive Years: During a woman’s reproductive years, testosterone levels remain relatively stable, with slight fluctuations throughout the menstrual cycle. Testosterone plays a role in maintaining sex drive, bone health, and overall well-being.

Perimenopause: As women approach perimenopause (the transition period before menopause), which typically occurs in their 40s, testosterone levels gradually decline. This decline may contribute to symptoms such as reduced sexual desire, mood changes, and fatigue.

Menopause: After menopause, which is marked by the cessation of menstrual periods for at least 12 consecutive months, testosterone levels continue to decline. Women may experience further decreases in testosterone production, potentially leading to additional symptoms such as decreased bone density and changes in cognitive function.

It’s important to note that individual variations exist, and not all women will experience the same changes or symptoms related to testosterone levels throughout their life. Additionally, factors such as medical conditions or certain medications can influence testosterone levels in women. Consulting with a healthcare professional can provide personalized information and guidance regarding testosterone and its effects at different stages of a woman’s life.

Where is testosterone produced in a woman's body?

Testosterone in women is produced in various locations in the body. Here’s a breakdown of testosterone production sites:

Ovaries: About one-quarter of testosterone in women is produced in the ovaries. The ovaries contain small structures called ovarian follicles, which are responsible for the production and release of hormones, including testosterone.

Adrenal Glands: Another quarter of testosterone production occurs in the adrenal glands. These small, triangular-shaped glands located on top of the kidneys produce various hormones, including testosterone, cortisol, and other adrenal hormones.

Peripheral Tissues: The remaining half of testosterone production takes place in peripheral tissues, which include both the ovaries and adrenal glands. Tissues within these organs contribute to the synthesis and release of testosterone.

It’s important to note that testosterone production in women is significantly lower compared to men, as it is a primary male sex hormone. However, women still require small amounts of testosterone for various physiological functions and overall well-being.

If you have concerns about testosterone production or any related issues, consulting with a healthcare professional can provide more specific information and address any individual questions or considerations.

What are the overall health benefits associated with testosterone in women?

Improved Reproductive Health/Fertility: Testosterone plays a role in women’s reproductive health, enhancing sexual interest and function, and increasing the success rates of in-vitro fertilization (IVF) and assisted reproduction.

Reduced Risk of Heart Disease: Adequate testosterone levels in women are associated with a decreased risk of heart disease, including heart dysfunction, coronary artery disease, and other cardiac issues.

Cancer Prevention: Testosterone has shown potential anti-cancer properties, such as preventing the recurrence of breast cancer and lowering the incidence of invasive breast cancer in women.

Weight Management: Testosterone contributes to improved body composition by promoting weight loss and reducing body fat percentage, particularly in mid-life and postmenopausal women.

Enhanced Brain Power: Testosterone has been linked to cognitive health, including improvements in cognitive function, verbal learning, memory, and spatial cognition in women.

Management of Menopausal Symptoms: Testosterone replacement therapy has been found to alleviate a wide range of menopausal symptoms, such as reduced sexual function, hot flashes, and hormone deficiency symptoms.

Mood Improvement: Testosterone therapy has shown anti-anxiety and antidepressant properties, providing benefits in reducing symptoms of depression, and anxiety, and improving mood and psychological well-being.

Improved Bone Health: Testosterone helps maintain bone mineral density, preventing bone loss and reducing the risk of osteoporosis, particularly in postmenopausal women.

Favorable Body Composition: Testosterone contributes to favorable body composition by increasing lean muscle mass and improving fat-free mass ratio in women.

Protection against Rheumatoid Arthritis: Testosterone has been associated with protective effects against rheumatoid arthritis in women.

It’s important to note that individual responses to testosterone therapy may vary, and the benefits should be assessed on a case-by-case basis. Consulting with a healthcare professional is crucial to determine the appropriateness and potential benefits of testosterone therapy for specific health concerns in women.

How does testosterone contribute to weight loss in women?

Increased Lean Muscle Mass: Testosterone promotes the development of lean muscle mass in both men and women. Muscles are metabolically active tissues that burn more calories compared to fat tissue. By increasing lean muscle mass, testosterone can boost the basal metabolic rate (BMR), leading to more calories burned even at rest.

Enhanced Fat Oxidation: Testosterone has been shown to stimulate the breakdown of stored body fat and enhance fat oxidation. This means that the body is more efficient at utilizing fat as a fuel source, potentially leading to greater fat loss.

Improved Insulin Sensitivity: Testosterone can improve insulin sensitivity, which is the body’s ability to effectively utilize and regulate blood sugar. When insulin sensitivity is enhanced, it becomes easier for the body to control blood glucose levels, reducing the risk of insulin resistance and subsequent weight gain.
Reduced Fat Storage: Testosterone may help inhibit the conversion of excess calories into fat and reduce fat storage in certain areas of the body, such as the abdomen. This can result in a more favorable body composition and reduced accumulation of visceral fat.

Increased Energy and Physical Activity: Testosterone has been linked to increased energy levels, motivation, and assertiveness. These factors can positively influence physical activity levels and overall engagement in exercise, contributing to weight loss efforts.

It’s important to note that individual responses to testosterone and weight loss can vary, and the impact of testosterone on weight management should be considered in conjunction with other lifestyle factors such as diet and exercise. Consulting with a healthcare professional can provide personalized guidance on the potential role of testosterone in weight loss and its suitability for individual circumstances.

How does testosterone therapy help manage menopausal symptoms in women?

Improved Sexual Function: Testosterone plays a crucial role in women’s sexual health and desire. Testosterone therapy can enhance libido, increase sexual interest, and improve sexual function, addressing symptoms of low sexual desire and arousal associated with menopause.

Reduction in Hot Flashes: Testosterone therapy has been shown to reduce the frequency and severity of hot flashes, a common symptom of menopause. By regulating hormone levels, including testosterone, the intensity and frequency of hot flashes can be minimized.

Alleviation of Hormone Deficiency Symptoms: Testosterone therapy can help relieve various hormone deficiency symptoms associated with menopause, including fatigue, low energy levels, decreased motivation, and overall well-being. Testosterone supplementation can restore hormone balance and improve overall quality of life.

Increased Bone Mineral Density: During menopause, women are at an increased risk of developing osteoporosis due to declining hormone levels. Testosterone therapy has been found to increase bone mineral density, leading to stronger bones and reduced risk of fractures.

Improved Mood and Well-being: Testosterone therapy has been associated with improvements in mood, including reductions in depressive symptoms and anxiety. By restoring hormone levels, testosterone therapy can positively impact mental well-being and emotional stability in menopausal women.

Enhanced Cognitive Function: Some studies suggest that testosterone therapy may have cognitive benefits for menopausal women. It can improve cognitive function, memory, and overall cognitive performance.

It’s important to note that testosterone therapy for managing menopausal symptoms should be approached cautiously and individualized to each woman’s specific needs. It is recommended to consult with a healthcare professional experienced in hormone therapy to assess the potential benefits and risks of testosterone therapy based on your unique circumstances.

How does testosterone therapy impact body composition, specifically lean muscle mass, in women?

Testosterone therapy can impact body composition, particularly by increasing lean muscle mass in women. Here’s how testosterone therapy may influence body composition:

Muscle Protein Synthesis: Testosterone plays a role in stimulating muscle protein synthesis, which is the process by which new muscle tissue is built. With adequate testosterone levels, the body is more efficient at synthesizing proteins and building lean muscle mass.

Muscle Strength and Power: Testosterone has been shown to enhance muscle strength and power, leading to improved physical performance. By increasing testosterone levels through therapy, women may experience greater strength gains and improved muscular performance.

Metabolism and Fat Burning: Testosterone can influence metabolism by increasing the basal metabolic rate (BMR). A higher BMR means that the body burns more calories, including fat, even at rest. By promoting fat oxidation and reducing fat storage, testosterone therapy can contribute to a more favorable body composition with a lower percentage of body fat.

Body Shape and Distribution: Testosterone therapy may influence body shape by promoting more lean muscle development. Increased muscle mass can help sculpt and define the physique, leading to a more toned and athletic appearance. Additionally, testosterone therapy can help counteract the shift in fat distribution commonly seen during menopause, such as increased abdominal fat, by promoting a more favorable fat distribution pattern.

It’s important to note that the impact of testosterone therapy on body composition can vary between individuals. Factors such as dosage, duration of therapy, exercise regimen, and individual response can influence the outcomes. Testosterone therapy should be approached under the guidance of a healthcare professional experienced in hormone therapy to ensure safety and optimal results.

How does testosterone therapy help manage menopausal symptoms in women

Improved Sexual Function: Testosterone plays a crucial role in women’s sexual health and desire. Testosterone therapy can enhance libido, increase sexual interest, and improve sexual function, addressing symptoms of low sexual desire and arousal associated with menopause.

Alleviation of Low Mood and Depression: Menopause is often accompanied by mood changes, including increased risk of depression and anxiety. Testosterone therapy has been shown to improve mood, reduce depressive symptoms, and enhance overall psychological well-being in menopausal women.

Reduction in Hot Flashes: Testosterone therapy has been found to reduce the frequency and severity of hot flashes, a common symptom of menopause. By regulating hormone levels, including testosterone, the intensity and frequency of hot flashes can be minimized.

Increased Energy and Vitality: Testosterone therapy can help alleviate symptoms of fatigue, low energy levels, and decreased motivation associated with menopause. By restoring hormone balance, women often experience improved energy levels and an overall sense of vitality.

Bone Health and Osteoporosis Prevention: During menopause, women are at an increased risk of developing osteoporosis due to declining hormone levels. Testosterone therapy has been shown to increase bone mineral density, leading to stronger bones and reduced risk of fractures.

Cognitive Function: Some studies suggest that testosterone therapy may have cognitive benefits for menopausal women. It can improve cognitive function, memory, and overall cognitive performance.

It’s important to note that testosterone therapy for managing menopausal symptoms should be approached cautiously and individualized to each woman’s specific needs. It is recommended to consult with a healthcare professional experienced in hormone therapy to assess the potential benefits and risks of testosterone therapy based on your unique circumstances. Hormone therapy should be monitored regularly to ensure its efficacy and safety.

Can testosterone provide protective effects against rheumatoid arthritis in women?

Anti-Inflammatory Effects: Testosterone has anti-inflammatory properties that may help modulate the immune system and reduce inflammation associated with RA. It can inhibit the production of pro-inflammatory cytokines and suppress immune responses that contribute to joint inflammation.

Impact on Joint Health: Testosterone may have a positive effect on joint health by promoting cartilage integrity and preventing the breakdown of joint tissues. It may help maintain joint function and reduce the severity of RA symptoms.

Influence on Disease Activity: Studies have reported that women with higher levels of endogenous testosterone tend to have a lower risk of developing RA or experiencing milder disease activity. This suggests that testosterone may have a protective effect against the development and progression of RA in women.

Response to Treatment: Some research suggests that women with RA who have higher testosterone levels may have a better response to certain RA treatments, such as disease-modifying anti-rheumatic drugs (DMARDs) and biological therapies. Testosterone may enhance the efficacy of these treatments and improve outcomes in women with RA.

It’s important to note that the relationship between testosterone and RA is complex, and more research is needed to fully understand the mechanisms and clinical implications. Additionally, individual responses to testosterone and its potential protective effects may vary. Consulting with a healthcare professional who specializes in rheumatology can provide further guidance on the role of testosterone and its potential benefits for women with RA.

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  40. Giltay EJ, Enter D, Zitman FG, Penninx BW, van Pelt J, Spinhoven P, Roelofs K. Salivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort study. J Psychosom Res. 2012 Mar;72(3):205-13. doi: 10.1016/j.jpsychores.2011.11.014. Epub 2012 Jan 11. PMID: 22325700.
  41. Studd J, Panay N. Hormones and depression in women. Climacteric. 2004 Dec;7(4):338-46. doi: 10.1080/13697130400012262. PMID: 15799605.
  42. Rariy CM, Ratcliffe SJ, Weinstein R et al. Higher serum free testosterone concentration in older women is associated with greater bone mineral density, lean body mass, and total fat mass: the cardiovascular health study. Journal of Clinical Endocrinology & Metabolism. 2011;96(4):989–96.
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At the age of 60, I look and feel better than I ever have in my entire life! Switching my health program and hormone replacement therapy regimen over to Genemedics was one of the best decisions I’ve ever made in my life! Genemedics and Dr George have significantly improved my quality of life and also dramatically improved my overall health. I hav...
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