Testosterone in Women

Testosterone isn’t just for men; in women, this hormone has many functions. It is significant for development of lean muscle and strength, as well as bone density. Testosterone helps prevent unwanted body fat, heart disease and cognitive decline. Without it, women have a 50% chance of experiencing a pathological hip or vertebra fracture. Especially frightening is that 20% of hip fracture patients die within a year of their injury. Testosterone also contributes to overall sense of well-being, energy levels, sexual libido and sexual experience. In particular, it’s responsible for the sensitivity of a woman’s nipples and clitoris in addition to improving sexual mood.

In the female, testosterone is produced in the ovaries and adrenal glands. If a woman is thrown into surgical menopause (by having her ovaries removed), she abruptly loses 50% of her natural testosterone—along with 80% of her natural estrogens. Ebbing estradiol and progesterone levels after entering menopause are compounded by falling testosterone and thyroid hormone. A declining hormonal environment is bound to spark bodily changes: a flux in metabolism, altered libido, effects on breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, mental acuity, and energy levels. Women, like men, need adequate testosterone for peak mental acuity, healthy bone density, and muscle tissue.

Incorrect testosterone level measurement is a common pitfall. Clinical indicators of declining testosterone may give a care provider the notion that an individual may be a candidate for testosterone replacement. However, objective measures must be obtained to properly institute and manage therapy as well as rule out and address accompanying medical problems. Both total and free testosterone studies should be measured to adequately evaluate testosterone levels. For females, 15-70 nanograms per deciliter are given as a normal laboratory range.  Free testosterone levels average approximately 2% of the total which are 1-10 picograms per milliliter (pg/ml) for women. Free testosterone is the more valuable of the two, reflecting the amount of hormone available to perform useful work.

Relying on a 50-year age span (from ages 20 to 70) is not useful. A decline of 70% from more youthful levels will produce the previously mentioned clinical problems, yet is declared “within normal range.” A more accurate approach is using the upper end of normal range, adjusted for age—then maintain these levels over time, rather than letting them continually decline. This is the healthy range.


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