Although Testosterone is generally viewed as a male-only hormone, women’s ovaries also make small amounts of testosterone. It helps many organs and body processes in women.
The pituitary gland in the brain controls the amount of testosterone the body makes.
Most of the testosterone in the blood attaches to 2 proteins: albumin and sex hormone binding globulin (SHBG).
Some testosterone is called free if it is not attached to proteins.
Free testosterone and albumin-bound testosterone are also referred to as bioavailable testosterone. This is the testosterone that is easily used by your body.
Reference ranges for females:
| Age: | T Level (ng/dL): |
| 0-5 mo. | 20-80 |
| 6 mos.-9 yrs. | < 7-20 |
| 10-11 yrs. | < 7-44 |
| 12-16 yrs. | < 7-75 |
| 17-18 yrs. | 20-75 |
| 19+ yrs. | 20-75 |
| Avg. adult female | 15-70 |
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Elevated levels of the marker Free Testosterone, Direct (Female) in the blood signify that a woman has more of the active form of testosterone circulating in her body than is typical.
Testosterone is a hormone associated with male traits and reproduction, but it's also present in females in smaller amounts and plays a crucial role in muscle strength, bone density, and libido.
When levels are higher than normal, it can lead to conditions such as polycystic ovary syndrome (PCOS), which is one of the most common reasons for elevated testosterone in women.
Other causes might include adrenal gland disorders or certain types of tumors.
Symptoms of elevated testosterone in females can vary but often include hirsutism (excessive hair growth in areas where men typically grow hair), acne, irregular or absent menstrual periods, and sometimes a deeper voice or increased muscle mass.
Treating elevated free testosterone levels in women involves a comprehensive approach that starts with a thorough evaluation to confirm the diagnosis. Treatment strategies may include lifestyle modifications, such as adopting a healthy diet and regular exercise, and medications like hormone therapy, anti-androgens, or insulin-sensitizing drugs, depending on individual symptoms and underlying causes. Additionally, managing any diagnosed underlying conditions is critical to effectively addressing the hormonal imbalance. Regular monitoring of hormone levels and symptoms helps in adjusting the treatment plan as necessary. For some, alternative therapies might offer symptom relief, though these should be approached cautiously and discussed with a healthcare provider. This personalized, multi-faceted approach aims to balance hormone levels, alleviate symptoms, and improve overall health in post-menopausal women with elevated free testosterone.
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Low testosterone can cause one or more of the following symptoms in women:
- sluggishness
- muscle weakness
- fatigue
- sleep disturbances
- reduced sex drive
- decreased sexual satisfaction
- weight gain
- fertility issues
- irregular menstrual cycles
- vaginal dryness
- loss of bone density
It is important to note that research in this area is still limited.
Because the symptoms linked to low testosterone are so common, a doctor will look for signs of other issues or conditions before making a diagnosis.
The two main causes of low testosterone are:
- diminishing levels of the hormone as a normal result of menopause and aging
- problems with the ovaries or the pituitary or adrenal glands.
Testosterone decreases naturally as a woman ages. Levels of other hormones, such as estrogen, also reduce over time, especially when a woman reaches menopause.
Around the time that menopause begins, a woman may be more likely to have less testosterone because the ovaries are producing fewer hormones.
Also, medications that combat the side effects of menopause can lower testosterone levels. One such medicine is oral estrogen.
Problems with the ovaries and adrenal glands can also cause lower levels of testosterone. A woman may have reduced levels if her ovaries have been removed, for example, or if she has adrenal insufficiency, which means that the adrenal glands do not work correctly.
There is currently a lack of research into the treatment of low testosterone in women. Many doctors are much more concerned about testosterone levels that are too high.
If a woman reports any of the symptoms listed above, a doctor will likely check for other, more common, conditions first.
If a woman has not yet reached menopause, the doctor will likely advise on the best time to test the testosterone levels. This is because they fluctuate throughout the menstrual cycle.
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1,5-Anhydroglucitol (1,5-AG), Intermediate Glycemic Control, 5-Methyltetrahydrofolate, Adiponectin, Adiponectin (Boston Heart), Albumin/Creatinine Ratio, Random Urine, Anti-Thyroglobulin ab. (0-39), Anti-Thyroglobulin Antibody (Boston Heart), C-Peptide, LC/MS/MS, C-Peptide, Serum, C-Peptide, Ultrasensitive (Endocrine Sciences), Ceruloplasmin, CoQ10, Creatinine, Random Urine, Cyclic AMP, Plasma, Dihydrotestosterone (female), Dihydrotestosterone (male), Estimated Average Glucose (eAG), Free Androgen Index, Free testosterone, Free Testosterone (Male) in pmol/L, Free Testosterone (Male/Serum) in ng/ml, Free Testosterone, Direct (Female), Free Testosterone, Direct (Male), Free Testosterone, Percent (Female), Fructosamine, Glutamic Acid Decarboxylase, Glycated Serum Protein (GSP), Hemoglobin A1c (HbA1c), HOMA-B, HOMA-IR, HOMA-S, Homocysteine, Insulin (Fasting), Insulin Antibody, Insulin Resistance Score, Insulin, Free (Bioactive), Insulin, Intact, LC/MS/MS, Insulin-Like Growth Factor I (IGF-1), Iodine, Serum/Plasma, Nonesterified Fatty Acids (Free Fatty Acids), Pregnenolone, Proinsulin, Sex Hormone-Binding Globulin (SHBG), T7 Index, Testost., % Free+Weakly Bound, Testost., % Free+Weakly Bound (female), Testost., F+W Bound (female), Testost., Free, Calc (Female), Testosterone, Testosterone (Female/Child), Testosterone, bioavailable, Testosterone, bioavailable (male), Testosterone, Serum (Female), Thyroglobulin, Thyroglobulin Antibodies (0 - 1 IU/L), Thyrotropin Receptor Ab, Serum, Thyroxine-binding globulin, TBG, TMAO (Trimethylamine N-oxide), Triiodothyronine, Serum, TSH Receptor Antibody (TBII), Zinc Transporter 8 (ZnT8) Antibody
