• Menopause
• Vaginal Changes
• Hormone Replacement Therapy

Low Testosterone in Women: Causes, Symptoms, and Treatment

Medically reviewed and edited by Lauren Cramer, PA- C

Published: October 24, 2023
Updated: November 13, 2025
5 mins

Testosterone is commonly recognized as a male hormone. However, women also have testosterone — albeit in smaller quantities compared to their male counterparts — and it plays a number of vital roles in the female body.

When women don’t have enough testosterone, it can lead to several symptoms. 

While low testosterone doesn’t typically cause physical pain on its own, it can contribute to fatigue, weakness, and reduced muscle tone that may indirectly increase discomfort or decrease physical resilience.A deficiency of this hormone can also have psychological and emotional effects on women — potentially impacting their quality of life.

In this article, we will explore the causes of low testosterone in women, the symptoms associated with this deficiency, and the available treatments.

What is Testosterone?

Testosterone belongs to a class of hormones called androgens that are responsible for the development of secondary sexual characteristics in men such as facial and pubic hair, deepening of the voice, and increased muscle mass.

In men, testosterone is primarily produced in the testes. In women it is produced in the ovaries and adrenal glands.

While women have significantly lower testosterone levels than men, this hormone has a vital role in a woman’s body, including regulating:

• Libido

• Blood cell production

• Muscle mass

• Bone strength and health

• Energy levels

• Mood

• Hair and skin growth

• Metabolism

• Cholesterol levels

For this reason, too little or too much testosterone can have a great impact on a woman’s overall health.

What Causes Low Testosterone in Women?

Testosterone deficiency in women, also called hypoandrogenism, can result from primary or secondary causes.

Primary (physiologic and natural) causes 

• Aging and menopause: Ovarian androgen production gradually declines from the mid-30s onward; by menopause, total and free testosterone are often 50-70% lower than in early adulthood.

• Natural decline in adrenal output: DHEA and DHEA-S (precursors to testosterone) fall with age, further reducing available substrate.

• Oophorectomy (ovary removal): Women who have had their ovaries surgically removed may experience significantly lower testosterone levels.

• Aging: As women age, their ovarian function declines, which can lead to lower levels of testosterone being produced. Postmenopausal women, in particular, have an increased risk of experiencing low testosterone levels.

• Adrenal insufficiency: Also known as Addison's disease, this condition is related to the adrenal glands, where testosterone is produced in women. While this disease primarily involves the adrenal glands, it can also affect hormonal balance.

Secondary causes

Secondary causes result from external factors or conditions that disrupt hormone regulation:

• Hormonal imbalances: Conditions like a malfunctioning pituitary gland (hypopituitarism) can disrupt the hormones that stimulate the ovaries to produce testosterone. Chronic stress can also disrupt the release of hormones.

• Certain medications: Some birth control pills, as well as glucocorticoids, opioids, antidepressants and anti-androgenic (spironolactone) can lower testosterone levels. Glucocorticoids are steroid medications like prednisone.

• Chronic illnesses: Conditions such as type 2 diabetes and chronic kidney disease (CKD) can cause hormonal disturbances associated with low testosterone in women. Ongoing inflammation in the body from illness can also affect hormone production.

• Lifestyle factors: Excessive physical exertion, very low or high body weight, a sedentary lifestyle, poor sleep, high stress (elevated cortisol), and nutrient deficiencies can all contribute to hormonal imbalances.

• Alcohol and substance abuse: These behaviors may disrupt endocrine function, potentially leading to low testosterone levels.

What are the Symptoms of Low Testosterone in Women?

As mentioned above, testosterone plays an important role in many functions in the body. So, a deficiency of this hormone would naturally cause unpleasant symptoms and health problems.

While researchers have explored the effects of excess testosterone in women, there is little scientific research into low testosterone symptoms.

It’s important to note that not all these symptoms may appear together and every woman will experience them differently. Some may have mild symptoms while others may have more pronounced effects.

Low libido

In both men and women, testosterone is associated with sexual desire. Without testosterone, there is a reduced activation of the part of the brain known as the hypothalamus, which is involved in sexual arousal.

Low sexual desire in women can lead to less sexual intimacy, which can put a strain on the relationships they have with their partners.

Fatigue and low energy levels

Testosterone helps to regulate energy levels because it influences muscle mass and metabolism – two factors that impact our energy.

Lower levels of testosterone can lead to feelings of fatigue and low energy. This can make it challenging to stay alert and complete daily tasks.

Mood changes

Our moods are somewhat impacted by the amount of testosterone in the body. It also affects the brain’s neurotransmitter systems. 

For this reason, low testosterone levels can lead to mood swings, irritability, and an increased risk of mood disorders such as depression.

Changes in muscle mass and strength

As an anabolic hormone that promotes muscle protein synthesis, a lack of testosterone can result in muscle loss and decreased physical strength.

Weight gain

Low testosterone in women can contribute to increased body fat – particularly around the abdomen – and loss of lean muscle mass. Testosterone plays a key role in regulating muscle protein synthesis and fat metabolism, so when levels drop, the body tends to store more fat and burn fewer calories at rest, leading to a shift in overall body composition.

Hot flashes

The hypothalamus helps regulate body temperature, and hormonal changes – particularly declining estrogen levels – can make it more sensitive to temperature shifts, leading to hot flashes.

While low testosterone alone isn’t a primary cause, it may contribute indirectly since some testosterone is converted to estrogen in the brain. 

Sleep disturbances

Hormonal imbalances, including low testosterone, can interrupt the sleep-wake cycle. This can disrupt an individual’s natural sleeping patterns, potentially making it difficult to fall or stay asleep.

Changes in the skin and hair

Testosterone plays an important role in skin integrity, collagen production, and hair growth in women. Low levels can lead to dry, thinner skin and reduced hair density or texture changes, while excess testosterone can have the opposite effect – causing oily skin, acne, or unwanted hair growth (hirsutism). Maintaining balanced levels helps support healthy skin and hair.Vaginal dryness and discomfort

Another important role that testosterone plays in women’s bodies is the health of the vaginal tissues and lubrication.

Reduced testosterone levels in women can contribute to lower sexual desire and arousal, which may indirectly reduce vaginal lubrication. However, estrogen deficiency is the primary cause of vaginal dryness and discomfort during intercourse. Both hormones work together to support sexual function and vaginal tissue health.

Menstrual pattern changes

While androgens have supportive roles in the ovary, menstrual-cycle regulation depends mainly on FSH/LH and estrogen-progesterone balance. Low testosterone alone is unlikely to disrupt cycles; other endocrine or ovulatory causes are far more common. 

Cognitive problems 

While research on this is limited, there is some evidence to suggest that low testosterone levels may impact cognitive functions – such as memory and mental clarity – in women. This is potentially due to how hormones influence brain function.

Bone health problems

Testosterone promotes bone density in women. Low levels of this hormone can increase a woman’s risk of osteoporosis and bone fractures, especially in postmenopausal women.

Treating Low Testosterone in Women

Women who experience low levels of testosterone can explore a variety of treatment options, such as:

• Hormone replacement therapy (HRT): This testosterone therapy is prescribed by healthcare providers and comes in the form of topical gels, creams, patches, or injections.

• Dehydroepiandrosterone (DHEA) supplements: DHEA (dehydroepiandrosterone) is a hormone made by the adrenal glands that serves as a building block for both androgens, like testosterone, and estrogens. Supplementing with DHEA can increase androgen levels, but its effects depend on dose, age, and baseline hormone levels. Because high androgen levels can lead to side effects such as acne, unwanted hair growth, or mood changes, DHEA should only be used under the guidance of a qualified healthcare provider and may not be suitable for every woman.

• Lifestyle changes: Adopting a balanced diet, increasing physical activity (resistance training), improving sleep, and using stress management techniques are natural ways to increase your testosterone levels.

• Management of underlying conditions: If low testosterone is the result of a medical condition, such as adrenal disorders, the focus should be on addressing these, which may lead to improved testosterone levels.

• Medication adjustments: If low testosterone is being caused by certain medications, your doctor may adjust your dose or suggest alternatives.

How Do Healthcare Providers Diagnose Low Testosterone in Women?

Most healthcare providers will be able to diagnose low testosterone levels by using a blood test. However, it’s important to note that hormone levels fluctuate during the menstrual cycle, meaning your blood test results may vary.

There are four types of blood tests your doctor can run to determine if you have low testosterone levels:

• Total testosterone level: This test measures the overall level of testosterone in the bloodstream.

• Free testosterone level: Free testosterone is the biologically active form of the hormone that isn’t bound to proteins in the blood. This is usually a more accurate indicator of testosterone levels.

• Sex hormone-binding globulin (SHBG): This is a protein that binds to testosterone and can affect how much of this hormone the body can use.

• Dehydroepiandrosterone sulfate (DHEA-S): As mentioned above, DHEA is a precursor to testosterone and can provide your doctor with information about androgen production in your body.

• Other hormone levels: Additional tests may be used to measure other hormones in your body. 

When Should I Seek Medical Help for Low Testosterone Levels?

If you are experiencing any of the symptoms outlined above – especially if they’re affecting your overall quality of life – it’s important that you speak to a healthcare provider. 

Low testosterone levels in women could also be an indication of an underlying health condition such as Addison’s disease, which may require specific treatment.

Where Can I Learn More About Low Testosterone in Women?

It’s normal for hormones levels to change at various points in your life. However, LifeMD can help you get ahead of menopause before it progresses. With LifeMD, a licensed healthcare professional can help you understand more about your hormonal health and how to treat menopausal symptoms early.

The LifeMD Women’s Health Program offers compassionate, personalized care tailored to your unique needs. Whether you’re entering menopause or managing other common women’s health concerns, a healthcare provider will work with you to create a treatment plan that’s right for you.

Make an appointment to see if you qualify.

Lauren Cramer, PA- C

Lauren is a passionate and dedicated board-certified physician assistant. She received her Bachelor’s degree in Kinesiology and Exercise Science from SUNY Cortland — graduating magna cum laude while competing as a three-sport collegiate athlete in indoor and outdoor track and cross country. She went on to complete her Master’s degree in Biological Sciences and earn her Physician Assistant degree from Daemen College in Buffalo, New York. Lauren has years of focused experience in perimenopause, menopause, and postmenopause care, specializing in hormone replacement therapy (HRT), bone health optimization, and a functional medicine approach to women’s wellness. She integrates evidence-based hormone therapy with lifestyle, nutrition, and metabolic strategies to support long-term vitality, cognitive health, and bone density. In addition to her women’s health expertise, Lauren has a well-rounded background in allergy, asthma, otology, laryngology, and rhinology. Functional medicine has always been a passion of hers, and she continues to pursue advanced certification to deepen her ability to deliver personalized, root-cause care to her patients.

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