Testosterone is one of the clearest cases where a hormone's public reputation gets in the way of understanding your own body. It is filed under "male", and so it goes unexamined in women — including when it is exactly what is out of balance.
An underestimated role in women
Testosterone is produced naturally in women, in far smaller quantities than in men — roughly a quarter by the ovaries, a quarter by the adrenal glands, the rest converted elsewhere in the body. Its best-established role is in sexual desire. It is a normal and necessary hormone in the female body, not an anomaly to be found.
When the level is too low
Levels decline gradually from the mid-thirties, and fall abruptly after removal of the ovaries. What that means in practice is narrower than it is often presented. Libido is where the evidence is solid. It is much thinner elsewhere: trials of testosterone therapy in women have found no effect on general wellbeing, none on depressed mood, and none on lean mass or muscle strength at twelve months. There is no recognised female androgen-deficiency syndrome, and no blood level that defines one.
When the level is too high
An excess of testosterone — hyperandrogenism — typically shows up as acne, increased hair growth on the face or body, and sometimes irregular cycles. PMOS (previously PCOS) is the most frequent cause of androgen excess in women, but other rarer causes exist and must be excluded by a professional before concluding.
- Do not write testosterone off as a male hormone unrelated to your own balance — it has a real role in women.
- If acne, increased hair growth and an irregular cycle occur together, say so — that combination points towards hyperandrogenism.
- Unexplained loss of libido after 45 to 50 may have a hormonal component worth exploring, not only stress or tiredness.
- Never supplement hormones without medical supervision, including products presented as natural.
Reviewed by the OVEA medical committee