What are Normal Testosterone Levels in Women?

Testosterone, one of the key male sex hormones, also plays a significant role in women’s health. While women produce testosterone in a smaller quantity, it is still essential for various functions, including maintenance of libido (sex drive), bone health and muscle mass.

In women, testosterone is mainly produced by the ovaries and adrenal glands after getting signals from the pituitary gland.

Testosterone levels in women are approximately 1/10th to 1/20th of those found in men’s bodies. They fluctuate throughout their lives but typically increase during puberty and pregnancy.

Like men, women can also experience abnormal testosterone levels, leading to health issues like low sex drive and polycystic ovary syndrome (PCOS).

In this article, we will talk about normal female testosterone levels to help you determine whether your testosterone is balanced or needs proper treatment.

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Normal testosterone levels in females by age

Here are the normal total testosterone levels by age in females, according to Mayo Clinic.

Female testosterone levels can vary depending on different factors, including age and menstrual cycle stage. According to Mayo Clinic, normal female testosterone levels are:

Having normal testosterone levels is essential for overall health. Too much or too little testosterone can produce various health effects. It is important to consult with a hormone specialist if you suspect you have a hormonal imbalance.

Normal testosterone levels in females nmol/L

Testosterone levels can be measured in different units based on the clinic and country. In the UK and Europe, they are commonly measured in nanomoles per litre (nmol/L), while in the UK, ng/dL units are more common.

Normal testosterone levels in adult women are <2.7 nmol/L.

If your testosterone levels are above 2.7 nmol/L, it means you have high testosterone, which should be diagnosed and treated on time.

Free testosterone levels in females

Free testosterone is the “active” form of testosterone that is not attached to the sex hormone-binding globulin protein and can easily bind to testosterone receptors. 2% to 3% of total testosterone makes free testosterone.

According to Mayo Clinic, here is the normal range of free testosterone levels in women:

Do testosterone levels fluctuate in women?

Yes, testosterone levels fluctuate in women as they do in men. They are the highest in the morning and then decrease gradually as the day goes on.

Testosterone levels also fluctuate throughout the menstrual cycle. They peak during ovulation and then decline during the luteal phase (the menstrual cycle phase that follows ovulation).

Just like estrogen levels, testosterone levels also decrease with age in women. They reach their lowest point when women enter menopause or postmenopause. Surgical menopause can make testosterone reduction even more significant.

What is low testosterone in women?

Testosterone levels drop in women as they get older, impacting the production of other sex hormones.

However, young adults can experience low T at any time in their lives due to a certain underlying medical condition.

Symptoms of low testosterone in women

Women with low testosterone may experience the following symptoms:

• Low sex drive
• Vaginal dryness
• Irregular menstrual cycle
• Infertility
• Low libido
• Loss of bone density
• Loss of muscle mass
• Depression
• Mood changes
• Lack of energy and motivation
• Poor body fat distribution

Causes of low testosterone in women

You can have a testosterone deficiency due to multiple reasons. Old age is one of the most common low T reasons in both women and men.

As women get older, their ovaries begin to produce less sex hormones like oestrogen, progesterone, and testosterone.

Their bodies prepare to enter menopause, a phase in which the menstrual cycle ends and women no longer produce eggs. Their testosterone levels become half of what they were during their reproductive age or puberty.

Some women have a unique genetic makeup that disturbs their testosterone levels. They produce fewer DHEA and DHEA-S compounds which are testosterone precursors. They may also lack the enzymes required to turn DHEA and DHEA-S into testosterone.

Other low T causes in women are:

• Removal of ovaries
• Chemotherapy
• Radiotherapy
• Brain tumour
• Ovarian failure
• Certain medications, such as corticosteroids, hormonal contraceptives, etc.

What is high testosterone in women?

If you are producing more than the normal levels of testosterone, you may have high testosterone.

High testosterone levels in women can be damaging to their reproductive health and physical appearance. That is why you should talk to your doctor if you think you may have excess testosterone.

Symptoms of high testosterone in women

Women with abnormally high testosterone may experience one or more of these symptoms:

• Irregular menstrual cycle
• Hair loss or thinning
• Facial hair growth or hair development on the chest, back, and abdomen
• Acne or oily skin
• Deepening of voice
• Mood changes
• Increase in muscle mass, leading to a muscular or athletic appearance
• Clitoromegaly (increase in clitoris size)
• Reduction in breast size

Remember that having these symptoms does not necessarily mean you have high testosterone levels. Many other health conditions can also produce similar symptoms.

Causes of high testosterone in women

Common factors that can contribute to too much testosterone in women are:

• Polycystic ovary syndrome (PCOS)
• Congenital adrenal hyperplasia (CAH)
• Adrenal tumors
• Insulin resistance
• Hirsutism
• Congenital conditions
• Certain medications, like hormonal contraceptives

Diagnosis: How to test testosterone levels in women?

Doctors typically review medical history that provides important context about a potential hormonal imbalance.

They conduct a physical examination to look for signs of abnormal levels of testosterone. If they find abnormal symptoms, they suggest a testosterone test to check serum testosterone levels.

The testosterone tests are like a simple blood test. Your blood sample is taken in the morning when testosterone levels are the highest.

Since testosterone levels fluctuate due to the menstrual cycle, the best time to have this test is after 8 to 20 days of menstruation.

At-home testosterone test kits are also available. These are finger-prick tests where you collect and send your blood sample yourself to the laboratory.

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Women often ask: I am a woman with low testosterone levels, what should I do?

You should first consult a hormone specialist, diagnose low T, and then work on eradicating the low T cause.

For instance, if the lack of sleep or poor diet is the cause of your low testosterone, you should make some healthy lifestyle changes.

Some doctors may prescribe Estratest in postmenopausal women as it contains both oestrogen (a female sex hormone) and testosterone. Some may prescribe DHEA supplements to increase your testosterone precursor levels.

Doctors may also suggest hormone replacement therapy (HRT) or testosterone replacement therapy (TRT), expecting this treatment to produce the same effects in women as it does in men.

However, medical researchers are still studying the impact of testosterone administration in women’s bodies.

You should thoroughly discuss hormone therapy with your doctor to find its pros, cons, effects, etc. and then start it if your doctor says so.

There are different testosterone administration methods. You can have testosterone injections, gels, patches, or pellets based on your doctor’s suggestions or your preferences.

What happens if a woman takes testosterone?

Taking synthetic testosterone can help testosterone-deficient women restore their low testosterone levels and alleviate associated symptoms.

Testosterone therapy for women may produce the following effects:

• Improved sex drive
• Improved muscle and bone strength
• High energy levels
• Improved cognitive function

What are the side effects of a woman taking testosterone?

Women taking testosterone can experience some side effects. It is best to have regular TRT monitoring sessions with your doctor to make sure you are getting the best results out of this treatment.

Here are some of the potential side effects that women taking testosterone may have:

• Development of male characteristics, like the deepening of voice
• Facial and body hair development
• Increase in clitoris size
• Acne
• Weight gain

What is the treatment for high testosterone in females?

High testosterone treatment for women is chosen based on the underlying cause of the problem. Lifestyle changes can also help them reduce their testosterone levels or manage symptoms.

Doctors generally prescribe medications like metformin, oral contraceptives, glucocorticosteroids, and progestin to control testosterone production or tackle symptoms.

FAQs about average testosterone levels in females

Do you need to fast for a testosterone test?

You may be asked to fast before your testosterone test because some foods or drinks can disturb your normal testosterone levels. However, it is best to talk to your healthcare provider or medical clinic ahead of time.

Why test testosterone levels in women?

Testosterone is one of the essential reproductive hormones in women. Maintaining periods, libido, bone health, and fertility are some of its key roles.

Its levels are mostly tested in women when they experience hormonal problems like polycystic ovarian syndrome (PCOS).

When you are undergoing testosterone replacement therapy, you may also be asked to test testosterone every now and then to monitor the effectiveness of the treatment.

How to increase testosterone in females naturally?

Simple lifestyle modifications may help some women boost their testosterone levels naturally. Some of the effective natural remedies for low T are:

• Maintaining a healthy body weight
• Getting enough sleep
• Managing stress
• Exercising regularly (e.g., cardiovascular/aerobic exercise, high-intensity interval training, etc.)
• Eating testosterone-boosting foods
• Having a balanced diet regularly

How to treat high testosterone in a woman naturally?

The following tips may help you reduce your testosterone level naturally:

• De-stressing
• Exercising regularly
• Eating foods that have anti-androgenic effects (fatty fish, flaxseed, and spearmint tea)

How to measure testosterone levels in women?

Testosterone levels are measured in women via a simple blood test. It shows total testosterone, free testosterone, and bioavailable testosterone levels in them.

Summing it up

Although testosterone is a key male sex hormone, it is also essential for women’s reproductive, mental and physical health. Normal testosterone levels are comparatively lower in women than in adult men. They rise or fall throughout their lives.

High or low testosterone levels in women produce various health effects. Hence, they must be treated on time.

Consult with a hormone specialist if you doubt you have a hormonal issue. They will conduct a thorough physical examination and run a few tests to diagnose the problem and prescribe a suitable treatment option.

References/scientific studies/Bibliography/Further reading

Donovitz, G.S., 2022. A personal prospective on Testosterone therapy in women—What we know in 2022. Journal of Personalized Medicine, 12(8), p.1194.

Panay, N. and Fenton, A., 2009. The role of testosterone in women. Climacteric, 12(3), pp.185-187.

Islam, R.M., Bell, R.J., Green, S., Page, M.J. and Davis, S.R., 2019. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. The lancet Diabetes & endocrinology, 7(10), pp.754-766.