• Menopause
• Vaginal Changes
• Hormone Replacement Therapy

Low Testosterone in Women: Causes, Symptoms, and Treatment

Medically reviewed and edited by Rhonda Honeycutt, FNP

Testosterone is commonly recognized as a male hormone. However, women also have testosterone — albeit in smaller quantities — 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.

Many symptoms of low testosterone cause pain and discomfort. 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.

Although 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

• Reproductive function

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?

Also known as hypoandrogenism, a testosterone deficiency in women has both primary and secondary causes.

Primary causes

The primary causes of testosterone insufficiency are:

• Polycystic ovary syndrome (PCOS): A hormonal disorder where women experience imbalanced levels of androgens, which disrupt normal ovarian function. As testosterone is produced in the ovaries, PCOS can interfere with the production of this hormone.

• Women who have had their ovaries removed: Women who've had their ovaries surgically removed — through a procedure known as an oophorectomy — may experience low levels of this hormone.

• 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 some testosterone is produced in women. While this disease primarily involves the adrenal glands, it can also affect hormonal balance.

• Congenital conditions: Genetic disorders such as congenital adrenal hyperplasia (CAH) can lead to disruptions in the production of androgens by the adrenal glands.

Secondary causes

Low testosterone levels in women can also be caused by these factors:

• 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, 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, a significantly low body weight, and obesity can lead 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 can lead to unwanted body fat, especially around the abdomen.

This is because testosterone helps regulate how the body metabolizes fat, and a deficiency can lead to an imbalance between muscle and fat.

Hot flashes

The hypothalamus is largely responsible for body temperature. Lower levels of testosterone in women can impact this brain structure and result in hot flashes.

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 has a direct impact on skin health and hair growth. A deficiency in this hormone can result in thinning hair and dry skin.

It can also cause changes in the quality of the hair and skin.

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 can lead to less lubrication, causing potential dryness and pain during sexual intercourse.

Menstrual pattern changes

A significant part of the regulation of the menstrual cycle relies on testosterone. So, low levels of this hormone can disrupt menstrual cycles, possibly resulting in irregular periods or changes in menstrual flow.

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 is a hormone that stimulates testosterone and other androgens in the body. This testosterone treatment should only be used under the supervision of a healthcare provider as it may have potential side effects and might not be suitable for all women.

• Clomiphene citrate: A medication that stimulates the ovaries to produce more testosterone. This treatment is often prescribed to women with PCOS.

• Lifestyle changes: Adopting a balanced diet, increasing physical activity, 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 PCOS or 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.

• Vaginal hormone therapy: Topical hormone therapies can be used by women who experience vaginal dryness and discomfort due to low testosterone levels.

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?

If you’re concerned about low testosterone and the symptoms that come with it, LifeMD is here to help.

A doctor or nurse practitioner can meet with you online and provide more information on any concerns you may have about low testosterone in women.

Make an appointment with LifeMD to get started today.

Rhonda Honeycutt, FNP

Rhonda has been a Family Nurse Practitioner since 2013. She loves working with patients and seeing improvements in their health through collaboration in care plan decisions. Rhonda is licensed in 50 states and is bilingual. Her hobbies and interests include reading, exploring new languages, and spending time outdoors with her son, spouse, and 10 dogs.

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