Do Women Have Testosterone? Yes, and It Might Be More Important Than You Think

Most women don’t think about testosterone. It’s marketed as a "male hormone" in every health ad and gym supplement commercial out there, so it’s easy to assume it has nothing to do with women’s health. But here’s the truth: women produce testosterone, and it plays a far bigger role in how they feel than most people realize.

In fact, testosterone is the most abundant biologically active sex steroid hormone in a woman’s body throughout her entire life. That’s not a typo. A landmark paper published in The Lancet Diabetes & Endocrinology confirmed that women’s circulating testosterone concentrations are actually higher than their estradiol levels at every stage of life. If that surprises you, you’re not alone. This is one of the most misunderstood facts in women’s health.

So when women start experiencing unexplained fatigue, a vanishing sex drive, brain fog that won’t lift, or muscle loss that doesn’t make sense given their activity level, testosterone is often the missing piece of the puzzle that nobody thinks to check.

Where Does Female Testosterone Come From?

Women produce testosterone from three sources. The ovaries account for roughly 25% of circulating testosterone, and the adrenal glands produce another 25%. The remaining 50% is created through the conversion of precursor hormones like androstenedione and DHEA in peripheral tissues, including fat and muscle.

The amounts are significantly smaller than what men produce. A healthy premenopausal woman typically has total testosterone levels somewhere between 5 and 15% that of men. But "smaller" does not mean "less important." These lower concentrations are precisely calibrated to support a wide range of critical functions in the female body.

What makes this especially relevant is that much of a woman’s estradiol, the primary and most potent form of estrogen, is actually made from testosterone. The ovaries convert testosterone into estradiol through an enzyme called aromatase. So testosterone isn’t just working on its own. It’s also the raw material your body needs to produce the estrogen that regulates your cycle, protects your bones, and supports cardiovascular health.

What Does Testosterone Do in Women?

Testosterone receptors are found throughout a woman’s brain, bones, muscles, heart, and reproductive organs. It’s involved in far more than people typically associate with the word "testosterone."

Energy and Physical Vitality

Testosterone supports the production of red blood cells and plays a role in how efficiently your muscles use oxygen. When levels are adequate, women tend to report steady energy throughout the day, better exercise recovery, and the ability to maintain lean muscle mass. When levels drop, the most common early complaint is a deep, persistent fatigue that sleep doesn’t seem to fix.

Sexual Desire and Function

This is probably the most well-studied benefit of testosterone in women. The 2019 Global Consensus Position Statement, endorsed by 11 international medical societies including The Endocrine Society and the International Menopause Society, confirmed that testosterone therapy effectively improves sexual desire, arousal, orgasm, and satisfaction in postmenopausal women. It’s worth noting that decreased libido related to low testosterone often develops so gradually that women don’t connect the two. They may assume stress, aging, or relationship dynamics are responsible when the root cause is actually hormonal.

Cognitive Function and Mood

Testosterone receptors are densely concentrated in areas of the brain responsible for memory, attention, and executive function. Women with adequate testosterone levels generally report sharper thinking, better focus, and more emotional resilience. The brain fog and difficulty concentrating that many women experience in their 40s and 50s can sometimes be traced back to declining testosterone, not just changes in estrogen or progesterone.

Bone and Cardiovascular Health

Testosterone contributes to bone mineral density, which becomes increasingly important as women approach and pass through menopause. Research in The Lancet Diabetes & Endocrinology has also highlighted favorable cardiovascular effects of testosterone in women, noting no adverse cardiovascular outcomes in studies of transdermal testosterone therapy.

How Testosterone Changes Over a Woman’s Life

Understanding when and how testosterone shifts can help explain symptoms that might otherwise be chalked up to "getting older."

In her 20s, a woman’s testosterone production is at its peak. This is when energy, libido, and muscle tone are typically at their strongest. Starting around age 30, testosterone begins a slow, steady decline. By the time a woman reaches her 40s, her testosterone levels may already be half of what they were before.

Menopause doesn’t cause the same dramatic drop in testosterone that it causes in estrogen. However, the postmenopausal ovary continues to produce some testosterone. A review in Fertility & Sterility confirmed that the postmenopausal ovary is still an androgen-secreting organ and that testosterone levels are not directly or dramatically altered by the menopausal transition itself. That said, the cumulative effect of decades of gradual decline means that by the time a woman is in her 50s or 60s, testosterone levels can be significantly lower than what’s needed for optimal function.

Certain events can accelerate this decline. Surgical removal of the ovaries (oophorectomy) causes an immediate and substantial drop in testosterone production. Oral contraceptives can increase sex hormone-binding globulin (SHBG), a protein that binds to testosterone and makes it less available to tissues. Adrenal conditions, chronic illness, and long-term corticosteroid use can also lower testosterone output.

Signs of Low Testosterone in Women

Low testosterone in women is not always obvious. Unlike hot flashes or irregular periods, which are clearly linked to hormonal change, the symptoms of Testosterone Deficiency tend to be subtler and are often misattributed to stress, depression, or simply aging.

Common signs include persistent fatigue that doesn’t improve with sleep, reduced or absent sexual desire, difficulty with arousal or orgasm, brain fog and poor concentration, loss of motivation or a general sense of apathy, decreased muscle mass or strength despite regular exercise, joint discomfort or stiffness, and thinning hair.

One of the challenges with recognizing low testosterone is that many of these symptoms overlap with other conditions. A woman experiencing fatigue and low mood might be prescribed an antidepressant when what she actually needs is a comprehensive hormone panel. This is why testing matters, and why testing beyond just estrogen and progesterone matters.

How Is Testosterone Tested in Women?

Testing for testosterone in women involves a simple blood draw, ideally done in the morning when levels are highest. The key markers to evaluate include total testosterone, free testosterone (the portion not bound to proteins and available for your body to use), and SHBG.

The 2019 Global Consensus Position Statement specifically recommends measuring total testosterone as the primary biomarker, noting that evidence supporting "free" testosterone as the biologically active fraction is still limited. However, in practice, many clinicians look at both total and free testosterone for a more complete picture, especially in women taking oral estrogen, which can elevate SHBG and reduce free testosterone levels.

It’s also important to understand that there are no universally agreed-upon "deficiency" cutoffs for testosterone in women. The consensus statement emphasizes that a blood testosterone level alone should not be used to diagnose a condition like hypoactive sexual desire disorder. Instead, symptoms and lab results need to be evaluated together.

What Can Be Done About Low Testosterone in Women?

For women experiencing symptoms consistent with low testosterone, the first step is a thorough evaluation. That means comprehensive lab work that looks at the full hormonal picture, not just estrogen, along with a detailed discussion of symptoms, medical history, and goals.

Lifestyle factors can make a meaningful difference. Resistance training is one of the most effective natural ways to support healthy testosterone levels. A diet rich in adequate protein and healthy fats provides the building blocks for hormone production. Quality sleep and effective stress management also play important roles, since chronic stress diverts hormonal resources toward cortisol production at the expense of sex hormones like testosterone.

When lifestyle changes aren’t enough, or when levels have dropped to a point where they’re significantly impacting quality of life, bioidentical Hormone Replacement Therapy (HRT) that includes testosterone may be appropriate. This is where working with a provider experienced in women’s hormone optimization becomes critical.

Testosterone for women is typically administered as a compounded bioidentical cream applied to areas with thin skin, or as a low-dose subcutaneous injection. The doses are carefully calibrated to restore levels within the normal premenopausal range, nowhere near the levels used in male testosterone therapy.

What Comprehensive Hormone Therapy Looks Like

Testosterone doesn’t exist in isolation. In women, it works in concert with estradiol, progesterone, and other hormones to maintain balance. That’s why the most effective approach to addressing low testosterone is comprehensive hormone therapy that looks at the entire hormonal ecosystem, not just one number on a lab report.

At Affinity Whole Health, Hormone Replacement Therapy for women starts with a comprehensive lab panel that evaluates testosterone, estradiol, progesterone, and other related hormones. From there, an Affinity Medical Provider develops a personalized treatment plan that may include bioidentical estradiol, progesterone, and testosterone based on your individual needs and symptoms.

Is Testosterone Therapy Safe for Women?

Safety is understandably a top concern, and it’s an area where misinformation is common. The 2019 Global Consensus Position Statement reviewed the available evidence and concluded that testosterone therapy for postmenopausal women, when dosed to maintain levels within the normal premenopausal range, is not associated with serious adverse events, such as increased breast cancer risk, heart disease, or blood clots. 

The most commonly reported side effects at appropriate doses are mild and manageable: occasional acne or oily skin, and a slight increase in hair growth. These effects are typically temporary and often resolve with dosage adjustment. Virilizing effects like voice deepening or significant hair growth are extremely rare when testosterone is dosed correctly within female physiological ranges.

It’s worth emphasizing that the safety profile depends heavily on proper dosing and monitoring. This is not a situation where more is better. Regular lab work and follow-up appointments are essential to ensure levels stay within the appropriate range and that the therapy is producing the desired results without unwanted side effects.

Why Ongoing Support Matters

Hormone optimization isn’t a one-and-done process. Finding the right balance takes time, monitoring, and sometimes multiple adjustments. This is where having a dedicated support system makes a real difference.

At Affinity Whole Health, every patient is paired with a dedicated Patient Care Coordinator (PCC) who serves as their personal point of contact throughout the entire treatment journey.  PCCs work directly with medical providers in the clinic, so you get fast, informed answers without waiting days for an email response or navigating an automated phone tree.

This kind of personalized support is especially valuable during the first few months of treatment, when doses are being fine-tuned and you’re learning what your body responds to. Most women experience initial improvements in energy and libido within 2 to 4 weeks, with body composition and muscle tone changes becoming noticeable after 2 to 3 months. Full optimization often takes 5 to 6 months of consistent therapy.

Frequently Asked Questions

Is testosterone really the most abundant sex hormone in women?

Yes. While it’s produced in much smaller quantities than in men, testosterone circulates at higher concentrations than estradiol in women at every life stage. This is well established in the medical literature and was highlighted in a major review published in The Lancet Diabetes & Endocrinology.

Will testosterone therapy make me look masculine?

No, not at appropriate doses. Testosterone therapy for women uses doses that are roughly 1/10th to 1/20th of what’s prescribed for men. The goal is to restore levels to within the normal premenopausal range. At these doses, virilizing side effects like voice changes or facial hair growth are extremely rare.

Do I need testosterone if I’m already on estrogen and progesterone?

Not necessarily. But if you’re on HRT and still experiencing persistent fatigue, low libido, brain fog, or difficulty maintaining muscle, it’s worth having your testosterone levels checked. Many women find that adding testosterone to their existing regimen addresses symptoms that estrogen and progesterone alone couldn’t resolve.

At what age should I start worrying about testosterone levels?

Testosterone begins declining around age 30, so symptoms can start appearing in the late 30s or early 40s. However, conditions like premature ovarian insufficiency or surgical menopause can cause significant drops earlier. If you’re experiencing symptoms of low testosterone at any age, it’s worth discussing with a healthcare provider.

How long does it take to feel the effects of testosterone therapy?

Most women notice improvements in energy and libido within the first 2 to 4 weeks. Body composition changes and muscle tone improvements typically become apparent after 8 to 12 weeks. The full benefits of a well-optimized hormone program often aren’t fully realized until 5 to 6 months.

The Bottom Line

Yes, women absolutely have testosterone, and it’s doing far more important work in your body than most people give it credit for. From energy and brain function to sexual health and bone density, this hormone quietly supports some of the most fundamental aspects of how you feel every day.

If you’ve been dealing with symptoms like persistent fatigue, vanishing libido, difficulty concentrating, or unexplained body composition changes, testosterone could be part of the answer. The first step is understanding your complete hormonal picture through comprehensive lab work and a consultation with a provider who takes the time to connect your symptoms with your biology.

At Affinity Whole Health, we’ve been helping women optimize their hormones since 2012. Our medical team, led by Dr. Michael Koehler, MD, takes a comprehensive approach to hormone replacement therapy that includes evaluating testosterone alongside estradiol, progesterone, and other key hormones. Dr. Koehler recently completed the renowned "Hormone Therapy for Early Adopters" course led by Dr. Rachel Rubin – a board-certified urologist, fellowship-trained sexual medicine specialist, and one of the nation's leading experts in women's menopause and sexual health utilizing testosterone.  Every patient works with a dedicated Patient Care Coordinator for personalized support, and initial lab work is just $99. If you’re ready to find out what’s really going on with your hormones, schedule a consultation today.