Low Testosterone in Women: Causes, Symptoms, and Natural Remedies

Even in small amounts, testosterone supports various important functions in a woman’s body, including:

• Stimulating the production of red blood cells
• Maintaining sex drive (libido)
• Supporting reproductive hormones
• Strengthening bones
• Enhancing mental focus
• Sustaining energy levels
• Maintaining ovarian health

By the age of 40, a woman’s androgen (including testosterone) levels naturally decline by about 50%. Although research is ongoing, medical professionals are beginning to better understand the symptoms and potential treatments for low testosterone in women.

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Even mild testosterone deficiency can cause noticeable effects. Common symptoms include:

• Low sexual desire (libido)
• Reduced sexual satisfaction
• Mood swings or feelings of despair
• Muscle weakness
• Mental health issues like anxiety, depression, irritability, or chronic fatigue
• Dry skin
• Lack of energy or motivation
• Thinning hair
• Sleep disturbances (insomnia)

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Testosterone is produced in multiple parts of the female body, including:

• Ovaries
• Adrenal glands
• Peripheral tissues

The ovaries are the primary source of testosterone in women. As women approach menopause, the function of the ovaries declines, resulting in decreased hormone production. This is why women in perimenopause or post-menopause often experience low testosterone levels. Other contributing factors include:

• Adrenal insufficiency – when adrenal glands underperform
• Oophorectomy – surgical removal of the ovaries
• Hypopituitarism – a disorder affecting pituitary gland hormone production
• Estrogen therapy – oral estrogen can suppress testosterone levels
• Premature menopause
• Genetic causes – some women may have enzyme deficiencies that prevent conversion of DHEA/DHEA-S into testosterone

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Low testosterone is often underdiagnosed in women, as its symptoms can mimic stress, depression, menopause, or thyroid problems. Conditions that may be confused with low testosterone include:

• Iron deficiency anemia
• Hypothyroidism
• Perimenopause
• Mental health disorders

To confirm a diagnosis, doctors typically perform a blood test. According to Boston University School of Medicine (2002):

• A testosterone level below 25 ng/dL is considered low for women under 50
• A level below 20 ng/dL is low for women aged 50 and above

Since hormone levels fluctuate daily, timing the test is important. For menstruating women, testing is usually recommended between days 8 and 20 of the menstrual cycle.

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What treatments can be used to treat low testosterone in women? This has not been studied extensively. Doctors know what causes high testosterone in women, but not much about what causes low testosterone. However, doctors may prescribe a medication called Estratest to postmenopausal women. This medication contains testosterone along with estrogen. However, it is a synthetic form of testosterone and is not as effective in treating low testosterone. Having too much testosterone in your body can also cause side effects. Side effects of excessive testosterone use in women include:

• Acne
• Facial hair
• Masculine physical characteristics, including male pattern baldness and a deeper voice

Doctors may also prescribe testosterone injections. Some women also use testosterone gels from compounding pharmacies. However, these gels are traditionally used for men who have much higher average testosterone levels than women. An over-the-counter option is to take DHEA supplements. Since DHEA makes testosterone, taking DHEA may increase the amount of testosterone in one's body. So talk to your doctor before starting DHEA supplements to treat low testosterone.

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Women who are pregnant or planning to become pregnant should not take androgens. Women who are breastfeeding should also not take testosterone medications. You should always talk to your doctor before starting testosterone or any other medications and supplements.