Low Testosterone in Women: Symptoms, Causes, Diagnosis, Treatment, and Prevention
Low testosterone in women may cause low libido, a lack of energy, and irregular menstrual cycles. Your doctor can measure your testosterone levels with a blood test and, if necessary, treat it with testosterone supplements. But in most cases, low T diagnosis and treatment isn’t recommended in women.
What Is Low Testosterone in Women?
Low testosterone (or “low T”) in women is the production of too little testosterone, a type of sex hormone. In women, testosterone is produced primarily in the ovaries and adrenal glands.
Men make more testosterone than women, but the hormone is still very important for females: In women, testosterone helps maintain energy levels, libido, and bone and muscle health.
The symptoms of low testosterone in women can overlap with those of other conditions, including depression, thyroid problems, or anemia (low iron). Some common ones include:
Low libido or sex drive (hypogonadism)
Fatigue
Loss of strength and muscle tone
Irregular menstrual cycle
Infertility or trouble conceiving
Vaginal dryness
Depression or anxiety
Thinning hair
Dry or brittle skin
Sleep problems
The main cause of low testosterone in women is aging, particularly after menopause, when the body decreases the production of reproductive hormones like testosterone and estradiol (the primary sex hormone in women). Additionally, certain surgeries, health conditions, and medications can all cause a drop in testosterone levels, such as:
Menopause (when the ovaries produce fewer hormones, including testosterone)
Premature menopause
Ovarian insufficiency
Ovary removal surgery (oophorectomy)
Amenorrhea (loss of menstrual period from stress, weight loss, or exercise)
Turner syndrome (a genetic condition where the ovaries don’t develop normally)
Addison’s disease (adrenal insufficiency)
Hyperprolactinemia (too much of the hormone prolactin)
Pituitary gland tumor
Chemotherapy
Radiation
Malnutrition or anorexia
Certain medications may also contribute to low testosterone in women, including:
Hormonal birth control
Corticosteroids
Antiandrogen medication (testosterone is a type of androgen hormone)
Oral estrogen therapy
Opioids
Some of these medications are actually used to treat conditions of high testosterone in women, such as polycystic ovarian syndrome (PCOS).
Doctors are advised against diagnosing low testosterone in women.
It’s not exactly clear whether low T is the direct cause of symptoms such as low libido. Moreover, other conditions can cause similar symptoms in women, including depression, diabetes, or heart disease.
And even though testosterone levels can be measured with a blood test, hormone levels can vary throughout the day. In people who menstruate, testosterone can also be higher on some days than others. There’s also no “normal” amount of testosterone for women, including for premenopausal women; and T levels naturally decline with age.
Currently, no treatments have been approved by the U.S. Food and Drug Administration (FDA) to treat low testosterone in women, in part because these therapies haven’t been well-studied in women. Still, in certain situations, some doctors may prescribe testosterone replacement therapy off-label, which can come in various forms, such as:
Injections
Pellets
Creams
Patches
Gels
Pills or capsules
But doctors may avoid prescribing testosterone replacement therapy in women, as the benefits are unclear, and it can come with risks. According to the Endocrine Society, any woman who does take testosterone replacement therapy should be monitored for signs and symptoms of androgen excess, or signs of elevated testosterone.
Over-the-counter DHEA supplements are another option; DHEA is a precursor to testosterone, and can prompt the body to make more of the hormone.
Instead of testosterone replacement therapy, your doctor may recommend treatment to address symptoms such as low libido, vaginal dryness, anxiety, depression, or sleep issues.
It’s not known whether it’s possible to prevent low testosterone that stems from, for example, genetics. But by taking steps to avoid malnutrition, extreme exercise, stress, or weight loss that can cause amenorrhea in premenopausal women, you can help keep testosterone levels from dropping even further.
Testosterone levels in women naturally decline with age, but testosterone replacement therapy can bring those levels up. While long-term safety information about the use of testosterone therapy in women is inconclusive, some research suggests it’s safe to take in the short term.
Low testosterone in women has been linked with low libido, although the relationship isn’t clear-cut. Other health issues can also play a role in low sex drive, including vaginal dryness, emotional distance from a partner, stress, and mood problems.
The FDA has approved two medications to help improve sexual desire in premenopausal women: flibanserin (Addyi) and bremelanotide (Vyleesi). But the effectiveness of these medications is unclear.
Low testosterone in women is the deficiency of testosterone, a type of sex hormone in the body. Testosterone production naturally declines with age, and some research has linked low T to low libido, fatigue, vaginal dryness, and more. No FDA-approved treatments exist for low testosterone in women, but hormone replacement therapy can be prescribed off label in forms such as creams, injections, and patches to boost testosterone levels and improve symptoms.
