More Than Just a Male Hormone: The Truth About Testosterone in Women

You've probably heard of testosterone as the hormone that makes men, well, men: the hormone that defines masculinity. Tied to images of aggression or performance-enhancing drugs, even the controversial topic of its use in gender transition, testosterone's importance in women often gets sidelined. 

Women produce testosterone, oestrogen, and progesterone, and this hormonal balance impacts their overall health. So, let’s break some myths and understand how testosterone levels in women affect their well-being.

Fact: Testosterone is often mislabelled as a ‘male hormone,’ but the truth is far more nuanced. While it's true that testosterone levels are significantly higher in men, both men and women produce testosterone.

In women’s bodies, testosterone is produced by the ovaries and adrenal glands.

Fact: Contrary to popular belief, testosterone levels aren't static; they fluctuate throughout life. In women, the normal range typically falls between 15 and 70 ng/dL.

Normal testosterone levels in women across their lifespan:

• Adolescence: Testosterone levels rise during puberty, contributing to physical development and the onset of menstruation. In younger girls (10-11 years), female testosterone levels typically range from 7 to 44 ng/dL, while in teenagers (12-18 years), levels can fluctuate between 7 and 75 ng/dL.
• Reproductive years: Levels generally stabilise during this period, which is crucial for sexual function. In adult women (19 years and older), testosterone in women falls typically within the range of 8 to 60 ng/dL.
• Menopause: Testosterone levels gradually decline as oestrogen production decreases. This can lead to various symptoms associated with menopause.

When it comes to measuring testosterone levels in women, a simple blood draw provides accurate information about your hormone levels. If you're experiencing symptoms related to potential testosterone imbalance, your healthcare provider may recommend a blood test to measure your hormone levels. This test is often done in the morning as testosterone levels tend to be higher at that time.

Too much or too little testosterone can lead to a range of issues. Striking a balance is essential to enjoying the hormone's benefits without experiencing adverse side effects.

Fact: Testosterone is vital for everybody’s overall health and wellness.

a. Bone health

• Testosterone directly influences the activity of osteoblasts, the cells responsible for building bone tissue. By stimulating osteoblast function, testosterone promotes bone formation and density.
• It helps regulate calcium levels, a mineral essential for bone health. Maintaining optimal calcium levels is vital for bone strength and preventing osteoporosis.
• Adequate levels of testosterone also help to slow down bone breakdown, a function primarily performed by osteoclasts. By reducing bone resorption, testosterone preserves bone mass.

b. Muscle strength

• Testosterone stimulates protein synthesis, the process by which muscle cells build and repair themselves — resulting in an increase in muscle mass and strength.
• It promotes the development of muscle fibres, particularly fast-twitch fibres responsible for power and strength.
• It creates an anabolic environment that favours muscle growth over muscle breakdown and generates red blood cells, critical for transporting oxygen to all parts of the body, providing energy and vitality.

c. Mood and emotional health

• Testosterone influences mood, contributing to feelings of well-being, confidence, and motivation.
• Recent studies indicate there may be a connection between testosterone levels and brain functions such as memory and concentration.
• Testosterone is a key player in regulating sexual desire and arousal in women. It contributes to a fulfilling sex life.

Testosterone acts as a catalyst for a woman’s libido. It doesn’t merely influence desire; it ignites it. Here’s how:

• Neurotransmitter influence: Testosterone interacts with neurotransmitters in the brain, specifically those involved in pleasure and reward. This enhances the brain’s response to sexual stimuli, amplifying desire.
• Blood flow and sensitivity: Testosterone increases blood flow to the genital area, enhancing sensitivity and arousal. 
• Hormonal balance: Testosterone works with other hormones like oestrogen to create a hormonal environment conducive to desire.

As women approach menopause, their testosterone levels gradually decrease. This hormonal shift can contribute to various symptoms of low testosterone in women, including:

• Decreased libido
• Fatigue and low energy
• Mood changes

Fact: Contrary to popular belief, high testosterone levels aren't uncommon in women.

Causes of testosterone imbalance in women include conditions like Polycystic Ovary Syndrome (PCOS) and Congenital Adrenal Hyperplasia (CAH). Elevated levels of testosterone in women can result in a number of noticeable physical changes.

“PCOS felt like a constant battle. The excess hair, the irregular periods, the weight gain — it was a relentless assault on my self-esteem. I felt like a stranger in my own body,” says Sana, a PCOS patient.

The symptoms of high testosterone levels in women may include:

• Acne
• Excessive facial and body hair
• Irregular or absent periods
• Thinning hair
• Enlarged clitoris
• Deepened voice
• Increased muscle mass 
• Weight distribution around the upper body 
• In severe cases, high testosterone can even cause infertility.

“For diagnosing high testosterone levels in women, a blend of physical examinations, blood work, and occasionally ultrasounds are employed to uncover the root causes. Managing testosterone imbalances involves lifestyle adjustments like diet and exercise. In some cases, medications and hormone replacement therapy suffice. In more severe situations, it might be recommended to pursue surgical options,” says Dr Miloni Gadoya, a gynaecologist based in Mumbai. It is critical that you speak to your doctor to investigate troubling symptoms and arrive at a diagnosis.

Fact: While testosterone therapy is more commonly associated with men, women can also benefit from it under specific circumstances like reduced libido. While research on the safety and effectiveness of testosterone therapy in women is still ongoing, it’s a topic gaining increasing attention.

Testosterone, often relegated to the sidelines of women’s health conversations, is a powerful player in female well-being. From influencing libido to contributing to bone health, its impact is far-reaching. By dispelling myths and fostering open dialogue about testosterone, we encourage women to control their health and pursue suitable treatment when necessary.