Frequently asked questions about testosterone therapy for women

Testosterone plays an important role for women in maintaining energy, libido and muscle mass, yet it is often overlooked in conversations about health and hormones. Women produce testosterone in smaller amounts than men, and the right balance contributes to wellbeing, mood and physical performance. If you experience symptoms such as fatigue, a loss of sexual desire or changes in muscle strength, hormone balance may be a contributing factor, which is why testosterone deserves attention as part of a holistic approach to women’s health.

In this reader-friendly guide, you’ll find clear explanations of what testosterone does, which symptoms may indicate a deficiency or excess, and what steps you can take if you suspect your hormones are out of balance. The focus is on practical information, helping you to ask informed questions when speaking with your GP or specialist. You’ll also find links to reliable sources such as the RIVM, along with relevant internal pages about hormones and… gezondheid om je verder te informeren over testosteron voor vrouwen en aanverwante zorgopties.

What is the impact of testosterone on women and why is this important?

Testosterone contributes to various physical and mental processes in women, influencing libido, energy and muscle maintenance. The hormone helps build and preserve muscle mass, supports bone density and plays a role in mood and cognition. It also affects sexual motivation and, together with oestrogen, can positively influence overall sexual health. Maintaining the right testosterone balance is important, as abnormal levels can lead to symptoms such as reduced energy, changes in body composition and mood fluctuations, making testosterone a key factor in both preventive and restorative women’s healthcare.

The effect of testosterone in women is subtle yet significant, and it interacts closely with other hormones such as oestrogen and progesterone, making hormonal balance complex but manageable. Testosterone also supports recovery after physical activity and can influence fat distribution in the body, which is particularly relevant when making lifestyle changes or following a fitness programme. Since hormone levels naturally fluctuate with age and life stage, it’s important to assess symptoms and overall wellbeing in relation to hormonal changes rather than focusing solely on lab values. In this context, testosterone in women is best understood as part of a broader hormonal picture.

Do women naturally have testosterone?

Women do produce testosterone, albeit in much smaller amounts than men, with production taking place in the ovaries and adrenal glands. Normal blood levels in women vary depending on the testing method and laboratory, but total testosterone levels in adult women generally range between about 0.5 and 2.4 nanograms per millilitre, or between 15 and 70 nanograms per decilitre in certain measurement systems. These values fluctuate with age, contraceptive use and other hormonal conditions, so results should always be interpreted by your GP or an endocrinologist before drawing any conclusions about testosterone in women.

Age and life stage influence how much testosterone women naturally produce. Levels typically decline after menopause and can fluctuate throughout the reproductive years. It’s useful to know that free testosterone levels are sometimes more meaningful than total levels, especially when symptoms don’t align with standard laboratory reference ranges. When assessing testosterone in women, doctors consider not only the absolute values but also clinical symptoms and related hormones such as SHBG and oestradiol to determine an accurate diagnosis and appropriate treatment plan.

What are the symptoms of low testosterone in women?

A testosterone deficiency in women can affect several areas of daily life and often presents as a reduced libido or loss of sexual interest — a symptom that many women find significant and distressing. You may also experience persistent fatigue, decreased muscle strength and a lower exercise capacity, which can impact both physical performance and everyday activities. Symptoms often develop gradually and may occur alongside mood changes such as irritability or a persistent sense of apathy, which means the deficiency is sometimes mistaken for stress or burnout.

Furthermore, low testosterone levels in women can, over time, lead to anatomical changes such as loss of muscle mass and an increased risk of bone loss — especially around menopause, when other hormones are also shifting. Because the symptoms are often vague and non-specific, it’s important to discuss your full medical history and have laboratory tests done by your GP or a specialist. Reliable information about testing options can be found on health portals and through your GP, and internal links such as our pages on hormones and testosterone can provide additional context.

What are the symptoms of having too much or high testosterone in women?

Excess or elevated testosterone levels in women often present with noticeable physical changes, including increased facial hair or body hair in a more male pattern, and acne that can be difficult to treat. You may also experience changes in your voice or scalp hair growth; in some cases, the voice may become slightly deeper, or hair density may decrease. These changes tend to develop gradually but can have a significant impact on self-image and psychosocial wellbeing, making early discussion with your GP or specialist important to identify the underlying cause.

In addition, high testosterone levels in women can be associated with menstrual irregularities such as irregular cycles or amenorrhea, as well as fertility problems due to hormonal imbalance. Some women with elevated testosterone may also notice an increase in muscle mass and a reduction in fat storage, but this does not necessarily indicate better overall health. If you recognise several of these symptoms, it’s advisable to seek medical advice and consider endocrine testing. Reliable information can also be found through trusted sources such as the RIVM.

What causes high testosterone levels in women?

An elevated testosterone level in women can have several causes, ranging from hormonal disorders to medication use and tumours. A common cause is polycystic ovary syndrome (PCOS), in which the ovaries produce more androgens, leading to symptoms such as irregular menstruation and excess hair growth. Other possible causes include adrenal disorders such as congenital adrenal hyperplasia or adrenal adenomas, as well as rare androgen-producing tumours, which can cause rapid and pronounced symptoms and require prompt medical evaluation.

In addition, certain medications, supplements, or anabolic steroids can artificially raise testosterone levels, causing symptoms that resemble high testosterone. Genetic factors and hormonal imbalances can also play a role, and in some cases, no clear cause can be identified without thorough investigation. An integrated approach involving blood tests, imaging, and a detailed medical history helps doctors determine the underlying cause of elevated testosterone levels and provide targeted treatment or referral.

How is high or low testosterone diagnosed in women?

Diagnosis of high or low testosterone begins with a detailed medical history and physical examination, followed by laboratory tests to measure total and free testosterone levels, as well as SHBG, oestradiol, and other relevant hormones. Doctors often take blood samples in the morning, when testosterone levels are most stable, and may repeat tests to rule out natural variation. If specific causes such as PCOS or adrenal disorders are suspected, additional examinations, such as ultrasound imaging of the ovaries or scans of the adrenal glands, may be required to obtain a clear picture of the organs involved.

In addition to blood tests and imaging, a referral to an endocrinologist may be necessary for a more in-depth evaluation and interpretation of the results, especially in cases of abnormal values or complex symptoms. It’s important to discuss any medications, supplements, and contraceptive use before blood is drawn, as these factors can affect the results. For practical information and guidance, you can consult your GP and specialised medical guidelines. Additional resources on this topic can also be found through our internal links and trusted external sites such as the RIVM.

Can women use testosterone (testosterone therapy), and is it safe?

Testosterone therapy for women is sometimes considered for those with demonstrably low testosterone levels and persistent symptoms despite other treatments, but its use requires careful weighing of risks and benefits. In some countries, approved formulations specifically for women are available, while in others, doctors may prescribe off-label; for this reason, close monitoring is essential to minimise side effects such as changes in fat distribution, acne, or alterations in LDL cholesterol. Safe use includes regular monitoring of hormone levels, lipids, and liver function, as well as discussion of reproductive plans, since treatment can affect fertility.

Whether testosterone therapy is appropriate and safe depends on your individual health situation and goals, and it should therefore only be considered under medical supervision. Treatment focuses on effectiveness and minimising side effects, and it is often reserved for younger women with specific indications or postmenopausal women under strict follow-up.

Do testosterone supplements work for women, and when are they recommended?

Testosterone pills for women are used less frequently than transdermal gels or patches because of variable absorption and a potentially greater impact on liver function and lipid profiles. For this reason, doctors generally prefer topical or injectable forms. The most suitable form of administration depends on personal preference, side effects, and medical history; while pills can be effective, they should be prescribed with caution and under strict medical supervision. Side effects can vary depending on the medication, so doctors carefully weigh the risks against the potential benefits before recommending oral testosterone.

When testosterone pills are considered, this usually follows thorough diagnostic evaluation and is reserved for situations where other treatment options are unsuitable or have proven insufficient. The indication may include women with confirmed low testosterone and persistent symptoms that significantly affect their quality of life. Always discuss possible alternatives, such as topical gels, patches, or lifestyle interventions with your doctor, and consult reliable guidelines and specialised healthcare providers for a safe and effective approach to hormonal concerns.

How can women naturally increase their testosterone levels?

You can naturally support healthy testosterone levels through targeted lifestyle adjustments that promote hormonal balance, including getting enough sleep, doing strength training, and following a protein-rich diet that aids muscle recovery. Reducing stress and avoiding chronically elevated cortisol levels also contribute to better hormonal balance, while maintaining a healthy body weight is important since excess weight can disrupt hormone levels. Eating foods rich in healthy fats and micronutrients such as zinc and vitamin D supports hormone production, but supplements should always be discussed with a doctor to avoid unnecessary risks.

Regular strength training has a proven effect on muscle mass and can indirectly increase free available androgens in physically active women, while excessive cardio without adequate nutrition can be counterproductive. Small adjustments, such as optimising protein intake after exercise, improving sleep quality, and avoiding extreme diets, all contribute to a more stable hormonal balance. For personalised guidance, you can consult a dietitian or exercise specialist and refer to our pages on lifestyle and hormones.

How can women lower their testosterone levels, and which treatments can help?

Lowering elevated testosterone levels in women starts with addressing the underlying cause, such as PCOS or adrenal disorders, and may involve lifestyle adjustments, medication, or, in some cases, surgical intervention, depending on the situation. For PCOS, weight loss, dietary improvements, and contraceptives containing oestrogens and progestogens often help to reduce androgen levels and promote more regular menstrual cycles. In addition, anti-androgen medications and certain oral contraceptives can be effective in reducing excess hair growth and acne, though these treatments require regular monitoring and careful consideration of side effects and contraindications.

In cases with a clear organic cause, such as an androgen-producing tumour, targeted surgical treatment is usually the solution, while adrenal disorders may require collaboration with an endocrinologist. Lifestyle adjustments, including a healthy diet and tailored physical activity, remain supportive and can enhance the effectiveness of medical treatments. For practical steps and medical guidance, it’s important to work with your treating physician to create a treatment plan that takes your personal goals and overall health into account.

Conclusion

Testosterone is an essential part of hormonal balance in women and affects both physical functioning and emotional wellbeing — which is why paying attention to symptoms and proper diagnostics matters. Whether the issue is deficiency or excess, a good approach starts with a careful medical history, targeted blood tests, and consultation with your doctor or a specialist, with your personal factors and life stage front and centre. Internal links to our pages on hormones and testosterone can help you prepare for that conversation and find reliable information about possible treatments and lifestyle adjustments.

If you suspect your symptoms may be hormone-related, schedule an appointment to discuss diagnostic and treatment options, including natural approaches and medication where appropriate, as effective treatment is always personalised and safe when guided by a medical professional. Testosterone in women deserves serious attention within regular healthcare, and with the right support, many symptoms can be reduced and quality of life improved. Don’t hesitate to ask questions and consult reliable sources such as the RIVM for additional information.