Your health care provider can measure your testosterone levels by ordering one of three tests. Though often considered a male sex hormone, testosterone is present in females in smaller amounts. A testosterone levels test measures the amount of the hormone testosterone in a sample of your blood.
In regard to therapies for women with low T levels, there is very limited research on the topic. Menopause is often the reason why women experience a change in their sex drive. Menopause, which occurs as a woman ages, can lead to a lower amount of testosterone produced by the ovaries. If a woman has too much testosterone in her body, she may begin to notice changes to her physical appearance.
Additionally, testosterone is crucial for maintaining muscle mass and strength, bone density, and even the distribution of fat in the body. In males, it is responsible for the differentiation of the male fetus during pregnancy, leading to the development of male genitalia. However, testosterone's influence transcends physical attributes; it also impacts mood, energy levels, and cognitive function.
Testosterone imbalance can be attributed to a variety of factors, including natural aging, lifestyle choices, medical conditions, medications, genetic factors, and environmental exposures. These substances can interfere with the body's endocrine system and alter hormonal balance, leading to potential health issues. Klinefelter syndrome, for instance, a condition where a male is born with an extra X chromosome, can lead to lower testosterone production.
However, once you’re in your late 20s, you’ll want a baseline to compare against as you age, says McDevitt. You used to have to go to the doctor’s office, or to a clinic that specializes in hormone evaluation. You want smooth blood flow, so an increase in red blood cells could easily cause stagnation. It’ll cause the red blood cells to overproduce which can, in turn, create a clot in your blood vessels. "If you think about bodybuilders who are doping, they always have injuries and this is why," says McDevitt. "Estrogen is a proliferative hormone, meaning it likes to get cells to grow.
Just like it can be too low, your testosterone can also be too high, and that’s equally problematic (8). Accompanying the weight gain is muscle loss, and the inability to perform workouts to the same levels as before, but also seeing fewer results from the same workouts. "Honestly, a low libido is one of the least heard symptoms," McDevitt says. "What I’ve noticed in my patients," says McDevitt, "is that anyone in the 400s will start to exhibit symptoms of low T." Testosterone levels peak in the earlier phases of life as a teen and young adult (6). The researchers don’t factor in pre-existing conditions or peoples’ lifestyles, which can skew the results, she notes.
The brain is also affected by this sexual differentiation; the enzyme aromatase converts testosterone into estradiol that is responsible for masculinization of the brain in male mice. Some of these effects may decline as testosterone levels might decrease in the later decades of adult life. Pubertal effects begin to occur when androgen has been higher than normal adult female levels for months or years. Among women with congenital adrenal hyperplasia, a male-typical play in childhood correlated with reduced satisfaction with the female gender and reduced heterosexual interest in adulthood. Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. Learn more about how testosterone levels change with age. Low testosterone levels can lead to a variety of symptoms that can vary from person to person.
Testosterone, often celebrated as a key hormone in defining masculinity, has a far-reaching influence that extends well beyond the realm of male physical characteristics. Recognizing the difference between these two forms is essential for accurately diagnosing and managing conditions related to testosterone imbalance. This scenario can occur in cases where there is an increase in SHBG, which binds more testosterone, reducing the amount of free, active hormone. This unbound testosterone is biologically active and can interact with various cells in the body, influencing numerous physiological processes. Testosterone in women is also involved in cognitive function and energy levels, contributing to overall well-being.
No matter your age, making healthy lifestyle choices can help support optimal testosterone levels. Depending on your health goals and concerns, your healthcare provider may recommend testing total testosterone, free testosterone or both. Much of your total testosterone is bound to proteins, like albumin and sex hormone-binding globulin (SHBG). Learning about the difference between total testosterone and free testosterone can help you better understand how this hormone may be impacting certain aspects of your health. Women should remain within the female physiologic testosterone range when therapy is used, not chase male-style replacement levels. In general, guidelines aim for symptom improvement within the normal physiologic male range rather than supraphysiologic levels (Bhasin et al., Journal of Clinical Endocrinology & Metabolism, 2018). Even when a testosterone value looks appealing on paper, treatment is not successful if symptoms have not improved, hematocrit has risen too far, fertility plans were ignored, or side effects are emerging.