Testosterone is the most common androgen produced in both men and women. The majority of testosterone in women and people born with ovaries is made just there – in the ovaries. In terms of volume, we actually make more testosterone than you may think, and for this reason, it shouldn’t be ignored when talking about women’s reproductive, sexual and hormonal health.

Testosterone helps your muscles to develop, your bones to grow, your heart to stay healthy and even impacts the stability of your mood. Most commonly, testosterone is known to help maintain your sex drive and enable or strengthen orgasm. So what’s not to love about testosterone?!

Well, it’s important to have the right amount of testosterone. Too much can cause skin issues, unwanted facial hair, and irregular periods. High levels of this hormone have also been linked to a condition called polycystic ovary syndrome (PCOS). In equal measure, not having enough testosterone may mean you feel fatigued, experience low mood or struggle with sleep. Low testosterone can be due to a genetic or health condition. So in essence, it’s all about balance.

You can have your testosterone levels checked through a simple blood test and there may be treatments a doctor can recommend if you have symptoms of low, or high testosterone. It’s still very early days in terms of research when it comes to the use of testosterone therapy among cisgendered women, and currently you can only receive FDA approved treatment for low libido at this time. Despite this, testosterone is a big one when it comes to feeling well hormonally. So, keep scrolling to learn more about how this helpful hormone may impact you.

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Hormonally

You may be aware that testosterone is important for your sex drive and this is true. Testosterone is known to boost your libido and help with sexual arousal and pleasure in both men and women. But this isn’t the only effect testosterone has.

Testosterone helps:

  • to maintain the bulk in your muscle
  • to make exercise more efficient (helping to build muscle)
  • ensure your bone’s stay healthy and strong
  • to keep your heart and blood vessels healthy
  • to keep your mood and wellbeing stable
  • maintain brain power like concentration, memory and learning.

In women, testosterone levels start to fall in your thirties and then drop sharply at menopause.

Many women who use testosterone therapy during perimenopause or menopause to treat symptoms, report that it helps to improve their energy, motivation and quality of sleep.

Symptoms of low testosterone in women

You may have low testosterone if you experience:

  • Low or no sex drive
  • A lack of energy and fatigue
  • A loss of strength and muscle tone
  • Low mood and anxiety
  • Problems with your sleep
  • Vaginal dryness
  • Thinning hair and dry skin
  • Infertility or irregular periods (no pattern to your menstrual bleeding)

It’s worth mentioning that all of these symptoms are also symptoms of perimenopause and menopause, when testosterone (and other hormone) levels naturally reduce. The symptoms are also fairly general. As such, a symptom on its own (such as tiredness or fatigue) probably isn’t cause for an investigation into your testosterone levels. However, if you are checking a few of these off the list, it may be time to talk to your doctor.

Surgery

If you have had any surgery or treatments that affect your ovaries, your testosterone levels will most likely be affected.

There are conditions that can cause low testosterone aside from menopause.

These include:

  • Turner syndrome (a genetic condition affecting the ovaries)
  • A tumor on your pituitary gland
  • Primary Ovarian Insufficiency (POI) [link]
  • Adrenal Insufficiency (Addison’s disease)
  • Malnutrition
  • Too much prolactin (Hyperprolactinemia)

Some types of birth control and anti-inflammatory medications can also lower your testosterone levels. Antiandrogen medication (such as treatments for PCOS) will also block testosterone.

Sex drive or low libido

Many women find it difficult to tell whether their sex drive is ‘normal’ or healthy. It’s important to remember that when it comes to sex, there is no such thing as ‘normal’. All of us have a different idea of what constitutes good sex; equally how much sex works for you, is a very personal preference. While some couples may have sex every week, others may find it difficult to find time for this level of intimacy. The important thing to check in with yourself about, is how you feel about how often you are having sex and equally, how sex feels when you do have it. For example, if you find yourself dreading sex, or struggling to enjoy the experience, it may be time to talk to someone about what’s going on.

Equally, while testosterone can be a great fix for libido issues that aren’t connected to your relationship, no amount of this hormone is going to make a dent in an unhappy relationship. So, check in with yourself, check in with your partner, and if needed, check in with a healthcare professional if you think your lack of libido may be connected to your hormones.

High levels of testosterone can also cause symptoms in women, many of which relate to our physical appearance.

Symptoms can include:

  • excess body hair, especially on your face
  • some hair loss on your head
  • acne or pimples
  • a decrease in breast size
  • a lower voice
  • greater or increased muscle mass
  • irregular periods, which can sometimes lead to infertility (difficulty getting pregnant)
  • changes in your mood

One of the most common reasons why you may have higher testosterone levels is because of a condition called polycystic ovary syndrome or PCOS. PCOS is caused by having greater amounts of androgen hormones. Testosterone is one of these androgen hormones.  We are also learning that high blood sugar (glucose) and/or insulin resistance is not only a significant feature of PCOS, but it may be more of a cause in developing the condition than we first believed.

Another condition that causes high levels of testosterone is congenital adrenal hyperplasia. This is a condition that affects the adrenal glands, causing the body to overproduce androgens.

You can have a blood test to find out what your testosterone levels are. ‘Normal’ levels depend on your age, as you will have higher testosterone levels in your 20s, than in your 50s.

Treatments are available if you have PCOS but in general, treatments for women with low testosterone levels are still emerging and more research is needed in this area.

There is currently no FDA approved testosterone treatment designed with women’s hormonal makeup in mind, available in the US.

Some healthcare providers use testosterone treatments that are approved for men and prescribe them in smaller amounts for female patients.

These treatments may be given via:

  • injections
  • pellets that are inserted under the skin
  • or creams and gels that are absorbed into the blood through the skin.

A note on pellets

The dosing of testosterone via a pellet is not easy to monitor or control and there are mixed opinions among healthcare professionals when it comes to the use of pellets. If you are thinking about exploring testosterone treatment as a way to improve your menopause symptoms, ensure you speak to a certified menopause practitioner regarding the best treatment for you. They will be able to advise you as to the safest and most effective options that are available to you.

It is becoming more common for healthcare providers and menopause experts to prescribe testosterone as part of hormone therapy (HT) in menopause, as many are recognizing the benefits to women’s mood, sleep, brain fog and libido.

Despite this, there is still a long way to go, to get testosterone recognized as more than a male hormone. Think you can help? If you have a story about your experiences of using testosterone, share it with us on our Hormone Allies page.

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