Testosterone for Women: The Missing Hormone in Female Health

Women's Health | April 15, 2025 | By Jessica Silver, APRN, FNP-C

When we talk about female hormones, estrogen and progesterone typically dominate the conversation. However, there's a critical third hormone that's often overlooked in women's health: testosterone.

Despite being labeled a "male hormone," testosterone plays essential roles in women's physical and emotional wellbeing. In fact, women's bodies produce testosterone in the ovaries and adrenal glands, just in smaller amounts than men (about one-tenth to one-twentieth the level). This smaller quantity doesn't diminish its importance—testosterone is vital for numerous aspects of female health.

For many women experiencing unexplained fatigue, low libido, brain fog, and changes in body composition despite "normal" estrogen and progesterone levels, testosterone may be the missing piece of their hormonal puzzle.

The Essential Roles of Testosterone in Women

Testosterone contributes to female health in ways many women (and their doctors) don't realize:

Energy and Vitality

Testosterone helps maintain energy levels, motivation, and overall sense of vitality. Women with optimal testosterone levels typically report better endurance, less fatigue, and more consistent energy throughout the day.

Cognitive Function

Testosterone supports cognitive functions including memory, focus, and mental clarity. Many women describe the mental fog that comes with low testosterone as feeling like "my brain just isn't working right."

Mood Stability

Optimal testosterone levels help regulate mood and emotional wellbeing. Low levels are associated with increased risk of anxiety and depression, independent of other hormone levels.

Muscle Mass and Strength

Testosterone plays a crucial role in maintaining lean muscle mass and strength. Women with low testosterone often notice decreased muscle tone despite consistent exercise.

Bone Density

Testosterone contributes to bone mineral density and strength, helping protect against osteoporosis and fractures as women age.

Metabolic Health

Healthy testosterone levels support insulin sensitivity and metabolic function, influencing how efficiently the body processes carbohydrates and maintains healthy body composition.

Sexual Health and Libido

Perhaps its best-known role, testosterone is essential for sexual desire, arousal, and satisfaction in women. It also supports vaginal tissue health and sensitivity.

Signs of Low Testosterone in Women

Unlike the dramatic symptoms of estrogen deficiency during menopause, low testosterone symptoms can be subtle and often attributed to other causes. Common signs include:

•  Persistent fatigue despite adequate sleep
•  Decreased sexual desire and responsiveness
•  Difficulty building or maintaining muscle tone
•  Unexplained weight gain, especially around the midsection
•  Brain fog and difficulty concentrating
•  Reduced motivation and drive
•  Mood changes including increased anxiety or depression
•  Thinning hair on the head
•  Dry or thin skin
•  Decreased sense of wellbeing

Why Women's Testosterone Levels Decline

Several factors can contribute to testosterone decline in women:

Age-Related Decline

Women's testosterone levels naturally peak in their 20s and gradually decline with age, with a significant drop during perimenopause and menopause.

Ovarian Issues

Conditions affecting the ovaries, including PCOS, premature ovarian insufficiency, and surgical removal of ovaries, can dramatically alter testosterone production. 

Adrenal Dysfunction

Since the adrenal glands produce about 25% of a woman's testosterone, chronic stress and adrenal fatigue can reduce testosterone output.

Hormonal Birth Control

Many hormonal contraceptives increase sex hormone binding globulin (SHBG), which binds to testosterone and makes less available for use by the body.

Medications

Certain medications, including some antidepressants, blood pressure medications, and corticosteroids, can lower testosterone levels.

Chronic Illness

Inflammatory conditions, autoimmune diseases, and chronic infections can all impact hormone production and balance.

The Conventional Medicine Gap

Most conventional doctors don't routinely test women's testosterone levels, and when they do, they often use standard laboratory ranges that fail to identify optimal levels. Additionally, many labs use testing methods designed for male testosterone ranges that lack the sensitivity to accurately measure the lower levels found in women.

Even when low testosterone is identified, many doctors are hesitant to treat it in women due to limited training in female testosterone optimization and concerns about potential masculinizing effects—concerns that are largely unfounded when proper dosing and monitoring are employed.

The Microdosing Approach to Female Testosterone Optimization

The key to successful testosterone therapy for women lies in precise microdosing—using much smaller doses than those prescribed for men, carefully calibrated to each woman's unique physiology.

When properly administered, female testosterone optimization should provide symptom relief without any masculinizing effects. The goal is to restore levels to the optimal range for women, not to elevate them to male ranges.

Benefits of Properly Managed Testosterone Therapy for Women

Women who receive properly managed testosterone optimization typically report:

•  Increased energy and stamina
•  Improved mental clarity and focus
•  Enhanced mood stability
•  Better muscle tone and strength
•  Easier weight management
•  Increased bone density
•  Restored libido and sexual satisfaction
•  Greater overall sense of wellbeing

Delivery Methods for Women

Several delivery methods can be effective for women:

•  Topical Creams: Precisely dosed creams applied to thin-skinned areas
•  Troches: Small lozenges that dissolve in the vagina
•  Injections: Very low-dose injections (much smaller than male doses)
•  Pellets: Time-released implants placed under the skin

The best method depends on the individual woman's preferences, lifestyle, and how her body metabolizes testosterone.

Comprehensive Monitoring for Safety and Efficacy

Proper testosterone optimization for women requires comprehensive monitoring, including:

•  Total and Free Testosterone levels
•  Sex Hormone Binding Globulin (SHBG)
•  Complete Blood Count
•  Lipid Panel
•  Liver Function Tests
•  Regular symptom assessment

This monitoring ensures the therapy is providing benefits without unwanted effects and allows for precise adjustments to maintain optimal levels.

Is Testosterone Optimization Right for You?

Testosterone optimization may be worth considering if you:

•  Experience symptoms of low testosterone despite healthy lifestyle habits
•  Have had comprehensive testing showing low or suboptimal testosterone levels
•  Are in perimenopause, menopause, or have had your ovaries removed
•  Have tried addressing other hormones but still have persistent symptoms
•  Are working with a healthcare provider experienced in female hormone optimization

Your Path to Hormonal Balance

At ReNu'd You, we specialize in comprehensive female hormone optimization, including the often-overlooked testosterone component. Our approach includes:

1. Thorough Testing: Using sensitive assays specifically calibrated for female hormone ranges
2. Personalized Protocols: Precisely tailored to your unique physiology and symptoms
3. Regular Monitoring: Ensuring optimal levels without unwanted effects
4. Integrated Approach: Addressing testosterone in context with your overall hormone balance

Don't let conventional medicine's oversight of female testosterone impact your quality of life. Schedule a consultation today to discover if testosterone optimization could be the missing piece in your hormonal health puzzle.