Low Testosterone in Women

Written by Marijke Vroomen Durning, RN
Medically Reviewed by Zilpah Sheikh, MD on March 19, 2025
7 min read

If your body doesn't get enough of a hormone called testosterone, you may have low levels. Testosterone can contribute to a lower sex drive. But how low testosterone impacts women and people assigned female at birth (AFAB) isn't clear.

Your testosterone normally peaks in your 30s and 40s before it starts to drop. It's unknown why it falls as you get older. But you need it to make another hormone called estrogen. Estrogen is a key hormone to help your bones, heart, reproduction, and more.

“Low testosterone levels can be found in postmenopausal women,” says Joseph E. Barrera, MD, an endocrinologist and associate medical director at Providence Mission Hospital in Mission Viejo, California. “But unlike [estrogen], testosterone levels decline after menopause at a slower rate.” 

In other words, testosterone falls slowly over time. But it's not always your body making less. It's only active if the hormone is free in your bloodstream. That means it's not attached to other proteins like sex-hormone binding globulin (SHBG). 

These proteins can change during pregnancy or hormone therapy. Barrera says that estrogen therapy can bind up testosterone faster. The higher SHBG protein levels can attach quickly to lower your free testosterone levels.

Average testosterone levels in women

You may think testosterone is just for men. But it's not just a “male sex hormone,” helping babies grow sex organs (testicles). 

They just have levels that are about 10 to 15 times higher. Women and people AFAB usually have testosterone levels less than 40 ng/dL.

The most common reason for lower testosterone is getting older. Half of a woman’s testosterone is made in the ovaries and the small glands sitting on top of your kidneys (adrenal glands). 

But it's also made throughout your body, too. It drops as you get older — it's a normal part of aging. In fact, levels drop by half as you reach menopause. Low levels can also happen if you:

  • Go through premature menopause. 
  • Have both ovaries removed.
  • Have chemotherapy, radiation, or other treatments affecting how your ovaries work. 
  • Stopped having a menstrual period for an extended time because of extreme stress, weight loss, or exercise.
  • Have a tumor on your pituitary gland.
  • Have Addison’s disease, which affects your adrenal glands.
  • Make too much prolactin, another hormone (hyperprolactinemia).
  • Have Turner's syndrome, a genetic condition where you don't develop ovaries.

You can also have lower levels if your body doesn't get enough nutrients (anorexia or malnutrition). And it may happen if you take certain medications, like:

  • Hormone contraceptives or oral estrogen
  • Corticosteroids, like prednisone
  • Anti-androgen medications (to treat acne or hirsutism)
  • Opioids 

Sometimes you may have a genetic issue that stops your body from converting certain substances. If so, your body may not turn dehydroepiandrosterone (DHEA) into testosterone. But if your body can't do that, it may lower your levels.

Testosterone may help keep your sex drive healthy. It may also play a role in bone strength, making red blood cells, and more. Most often, low testosterone symptoms aren’t very obvious. You may think something else is causing it.

“[They] can include low libido, fatigue, loss of muscle mass and tone, and weight gain,” Barrera says.  Other symptoms can include:

  • Anxiety
  • Depression
  • Dry skin
  • Hair loss
  • Difficulty sleeping
  • Vaginal dryness
  • Reproductive problems (problems getting pregnant)
  • Irregular periods

If you're in the premenopause stage of life, the best test for your hormone levels is your period (menstrual cycle). 

A normal period each month is a better sign of healthy hormone levels than blood testing. Especially since testosterone tests aren't very precise at lower levels.

But if your period has stopped or you haven't had one, your doctor may order blood tests like:

  • Luteinizing hormone (LH)
  • Follicle stimulating hormone (FSH)
  • Estradiol (estrogen)

And they may give you a progesterone pill for 10 days to see if your period starts. But other doctors just order an ultrasound, instead. Your doctor will talk to you about which test is best for your health.

In some cases, your doctor may check your total testosterone. It looks for all the testosterone in your blood. They may also measure your free testosterone (“active” testosterone). Free testosterone isn’t attached to proteins and is used right away when your body needs it. 

There’s some controversy with testosterone tests. They're made to measure higher hormone levels. So testing for low testosterone levels can be harder.

Testosterone therapy is recommended for hypoactive sexual desire disorder (HSDD) in postmenopausal women. Some doctors may use it off-label for other medical conditions like depression.

But studies are unclear. And most professional societies don't support testosterone use in women except to treat HSDD --- including the North American Menopause Society, the Endocrine Society, and the International Society for Sexual Medicine. 

“Although a variety of testosterone therapies exist for men including topical patches and gels, a nasal gel, implantable pellets and injections, there are no FDA-approved therapies for women,” says Barrera.

"When testosterone replacement is used in women, a fraction of the dose used in men is typically prescribed, but it is still considered an off-label use of the medication,” says Barrera.

These off-label testosterone therapies have been used for decades. Your doctor may suggest using an off-label testosterone patch or cream. Talk to your doctor and decide what's right for you.

Risks of testosterone treatment

There aren't many studies on testosterone treatment in premenopause. Of the ones done, most focus on postmenopausal treatment. And it's usually off-label use to treat your premature menopause symptoms.

“Dosing for women can be tricky, even if a therapeutic level is achieved," says Barrera. Health benefits in women over the long term aren't clear. 

Many experts worry it could affect heart health and possibly raise your breast cancer risk. Testosterone therapy may also cause problems with your:

"Symptoms of testosterone over-replacement can include acne and increased facial and body hair,” says Barrera. Like any medication, testosterone can have side effects. It may cause you:

Can you increase testosterone naturally? 

Some over-the-counter (OTC) products claim to raise your testosterone. These are usually called "testosterone boosters." But they aren’t FDA-approved like medications. 

These food supplements weren't really helpful to raise testosterone in studies, either. Keep in mind they target men, who need much higher levels.

Doctors may start with DHEA supplements, though. These may help your symptoms but can also come with side effects. If you take DHEA, it may cause you:

  • High blood pressure

  • To have a deeper voice

  • Weight gain

  • Facial hair growth

  • Male-pattern baldness

  • Lower "good" HDL cholesterol

Avoid DHEA supplements if you have a family history of hormone-related tumors like breast, ovarian, or adrenal cancer. 

You may also not want to take DHEA if you have depression or bipolar disorder. It may also worsen liver disease and increase insulin resistance, so ask your doctor before taking it.

Testosterone levels naturally begin to drop once it peaks in your 30s. By menopause, your testosterone levels have dropped in half. There aren't any approved testosterone therapies for women. Talk to your doctor about what's best for your health. They may suggest DHEA to start before trying an off-label testosterone treatment.

What happens if testosterone is low in females?

Low testosterone may contribute to a lower sex drive. You may feel fatigued, have difficulty sleeping, or have depression. Testosterone is important for bone health, too.

How can a woman raise her testosterone levels?

Ask your doctor about testosterone. If you already have normal or higher levels, you don't need it. Don't take supplements before talking with your doctor — these were designed for people who need much higher levels.

Can you still lose weight with low testosterone?

Although lower testosterone may make it harder, you can still lose weight if your levels are low. 

But testosterone is a complex hormone, bound by other proteins like SHGB. This complex process affects the levels in your bloodstream and how it acts on your body. 

Talk with your doctor if you have questions about your testosterone levels and reaching your weight goal.

How does testosterone make a woman feel?

Testosterone plays a role in bone health, muscle mass, and more. Low levels may contribute to a lower sexual drive. Raising your levels may help improve sexual desire and pleasure, too.