A woman’s testosterone levels naturally change throughout her life, her menstrual cycle, and even at different times of the day. A woman with low testosterone does not contain enough to help produce new blood cells, maintain sex drive, or boost levels of other reproductive hormones.
Testosterone belongs to a group of hormones known as androgens. Testosterone levels affect:
- sex drive
- red blood cell production
- muscle mass and fat distribution
Most people think of testosterone as the male sex hormone, but everyone needs a certain amount. While men have more testosterone than women, women’s adrenal glands and ovaries produce smaller amounts of the hormone.
According to the University of Rochester Medical Center, a woman’s total blood testosterone should be 15-70 monograms per deciliter (ng/dl). At this time, there are no definitive guidelines for what should be considered “low” testosterone levels in women.
Symptoms of Low Testosterone
Low testosterone can cause one or more of the following symptoms in women:
- muscle weakness
- sleep disturbances
- reduced sex drive
- decreased sexual satisfaction
- weight gain
- fertility issues
- irregular menstrual cycles
- vaginal dryness
- loss of bone density
It is important to note that research in this area is still limited.
Because the symptoms associated with low testosterone are so common, a doctor will look for symptoms of other problems or conditions before making a diagnosis.
A doctor may check for:
- chronic stress
- thyroid disease
- transition to menopause
Causes of Low Testosterone
There are two main causes of low testosterone:
Decline in hormone levels as a normal result of menopause and aging
Problems with the ovaries or pituitary or adrenal glands.
Testosterone naturally decreases as a woman ages. Levels of other hormones, such as estrogen, also decline over time, especially as a woman reaches menopause.
At the onset of menopause, a woman is more likely to experience low testosterone because the ovaries are producing fewer hormones.
Also, medications to combat the side effects of menopause can lower testosterone levels. One such drug is oral estrogen.
Problems with the ovaries and adrenal glands can also cause low testosterone levels. A woman’s levels may be low if her ovaries have been removed, for example, or if she has adrenal insufficiency, which means the adrenal glands don’t work properly.
Diagnosis of Low Testosterone
There is currently a lack of research into the treatment of low testosterone in women. Many doctors are very concerned about testosterone levels that are too high.
In 2014, a task force recommended against routinely measuring testosterone levels in women, because research has not yet proven a link between testosterone levels and symptoms.
If a woman reports any of the symptoms listed above, a doctor will likely check for other, more common, and conditions first.
To diagnose low testosterone in women, a doctor will start with a physical exam and ask about any symptoms. If the doctor suspects low testosterone, they will order a blood test.
If a woman has not yet reached menopause, the doctor will likely advise on the best time to test testosterone levels. This is because they fluctuate throughout the menstrual cycle.