A woman’s testosterone levels naturally change throughout her life, her menstrual cycle, and even at different times of the day.
Low testosterone in women
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 a male sex hormone, but everyone requires a certain amount. While males have more testosterone than females, female adrenal glands and ovaries produce small amounts of this hormone.
According to the University of Rochester Medical Center, a woman should have a total of 15–70 nanograms per deciliter (ng/dl) of testosterone in her blood. At this time, there are no conclusive guidelines for what should be considered “low” testosterone levels in women.
A woman with low testosterone may feel tired and lethargic. 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.
Because the symptoms linked to low testosterone are so common, a doctor will look for signs of other issues or conditions before making a diagnosis.
The doctor may check for:
- chronic stress;
- thyroid disease;
- transition to menopause.
The two main causes of low testosterone are:
- diminishing levels of the hormone as a normal result of menopause and aging;
- problems with the ovaries or the pituitary or adrenal glands.
Testosterone decreases naturally as a woman ages. Levels of other hormones, such as estrogen, also reduce over time, especially when a woman reaches menopause.
Around the time that menopause begins, a woman may be more likely to have less testosterone because the ovaries are producing fewer hormones.
Medications that combat the side effects of menopause can lower testosterone levels. One such medicine is oral estrogen.
Problems with the ovaries and adrenal glands can also cause lower levels of testosterone. A woman may have reduced levels if her ovaries have been removed, for example, or if she has adrenal insufficiency, which means that the adrenal glands do not work correctly.
High testosterone in women
Too much testosterone can cause symptoms that affect a woman’s physical appearance including:
- excess body hair, specifically facial hair;
- enlarged clitoris;
- decreased breast size;
- deepening of the voice;
- increased muscle mass.
Overly high levels of testosterone in women can also cause:
- irregular menstrual cycles;
- low libido;
- changes in mood.
In more severe cases of testosterone imbalances in women, high testosterone can cause infertility and obesity.
Diagnosing high testosterone
If you notice any of the symptoms listed above, you should talk to a doctor.
A doctor will perform a physical examination based on your symptoms to determine whether or not you need additional tests. During the examination, a doctor will look for these symptoms:
- abnormal facial hair;
- excess body hair.
If your symptoms seem to be abnormal, a doctor will suggest a testosterone test to measure hormone levels in your blood. To perform this test, a doctor will draw some of your blood and have it examined for hormone levels.
The test is typically performed in the morning when testosterone levels are at their highest. Prior to performing this test, a doctor may ask you to stop taking any prescriptions that could affect the test results.
Causes of high testosterone in women
Various diseases or hormonal disorders can cause hormonal changes in women. The most common causes of high testosterone levels in women are hirsutism, polycystic ovary syndrome, and congenital adrenal hyperplasia.
Hirsutism is a hormonal condition in women that causes the growth of unwanted hair, specifically on the back, face, and chest. The amount of body hair 