Understanding Testosterone in Women : Role, Symptoms, and Treatment Options

1. Introduction

   1. Definition of Testosterone and its Role in Female Health

      Testosterone is a hormone that belongs to a class of androgens, which are male sex hormones. These are also present in women, in lower amounts as compared to men. Research indicates that 15-70 nanograms per deciliter of testosterone should be present in a female’s blood.⁽¹⁾ However, how much should be considered as low testosterone levels is still not clear.⁽²⁾

      Testosterone is produced by ovaries and adrenal glands in females. Its role in women’s health is as follows: 

      • Testosterone has a crucial role in the female reproductive system, particularly in the early stages of embryonic development. It plays a role in the formation of ovaries and helps in the development of ovarian follicles.
      • It regulates sexual desire in women. Adequate levels of testosterone contribute to a healthy sex drive and sexual function.
      • It maintains bone density and strength in women. Testosterone plays a role in bone remodeling.
      • It influences muscle development and helps in maintaining muscle mass and strength in women. It plays a role in protein synthesis and growth in muscle tissues.
      • Testosterone influences metabolism including fat metabolism. It may affect the fat distribution in the body and may contribute to increased abdominal fat.
      • Studies show that testosterone has a protective effect on cardiovascular health and helps in maintaining healthy blood vessel functioning.⁽³⁾

      Testosterone levels may fluctuate throughout the menstrual cycle and decrease with age. It is essential for women’s health. A too-high or too-low level may lead to various health issues. If a female experience symptom of low testosterone or hormonal imbalance, a healthcare provider should be consulted for proper evaluation, diagnosis, and potential treatment options.

   2. Importance of Maintaining Proper Testosterone Levels

      Maintaining proper testosterone levels is essential for both men and women and plays a crucial role in overall health and well-being.

      Testosterone declines naturally with age in both males and females. Certain medical conditions or lifestyle factors can also lead to an imbalance in testosterone.

      Seeking medical advice and evaluation is essential for identifying and addressing any underlying issue. Hormone replacement therapy under the guidance of a healthcare professional can help restore hormone balance and improve overall health and quality of life.

2. Overview of Testosterone Production in Females

   Testosterone production primarily occurs in ovaries and in adrenal glands to a lesser extent.

   This hormone is mainly associated with males, but it plays an essential role in a female’s health as well. The production of hormones in females involves a complex interplay of hormones within the endocrine system. 

   • Ovarian Production: Testosterone production in females occurs in theca cells in the ovarian follicles (small sacs in the ovaries containing immature eggs).
   • Hormonal Regulation: There are hormonal signals that regulate the production of testosterone. The pituitary gland, located in the brain, releases luteinizing hormones in response to signals from the hypothalamus. Luteinizing hormones stimulate theca cells in the ovary to produce testosterone.
   • Conversion of Androgens: This is another significant source of testosterone in females. Androgens are a group of hormones produced in adrenal glands and include testosterone. Androstenedione is an androgen that can be converted into testosterone in various tissues including fat cells and skin.
   • Menstrual Cycle and Hormone Fluctuation: The levels of testosterone may vary in females throughout the menstrual cycle. During the early part of the cycle as the ovaries prepare an egg for release there is a gradual increase in testosterone production. The levels of testosterone peak during ovulation and falls during the luteal phase. Testosterone level further declines if fertilization does not occur. If pregnancy occurs the placenta contributes to the production of testosterone to support fetal development.
   • Pregnancy and Menopause: The placenta produces an increased amount of testosterone to support the developing baby’s growth. After menopause, as the menstrual cycle ceases, the ovaries produce significantly lesser testosterone and the production relies on the peripheral conversion of androgens.

   Testosterone levels are considerably lower in females than males but play a vital role in women’s health. Any significant deviation in testosterone levels whether it is too high or too low can lead to health issues and should be evaluated or managed under the guidance of a healthcare professional.

3. Symptoms of Low Testosterone in Females

   1. Physical Symptoms

      There are a variety of physical symptoms that occur due to low testosterone levels in females. 

      • Fatigue and decreased energy may lead to reduced stamina and the feeling of being constantly tired.
      • Increase in body fat especially around the abdomen leading to an apple-shaped body. There may also be a decrease in muscle size and strength.
      • The bone density reduces, which may increase the risk of osteoporosis and fractures.
      • The regularity and predictability of the menstrual cycle are affected.
      • Thinning of hair on the scalp.
      • Dryness of skin and changes in skin texture.
      • Low testosterone levels may decrease breast fullness and firmness.
      • Some females may also experience increased sensitivity to cold.

   2. Sexual Symptoms

      The level of testosterone may impact sexual desire, arousal, and satisfaction in females. Even if testosterone is not the sole hormone responsible for female sexual function, it does play a crucial role in supporting healthy libido and sexual well-being. The sexual symptoms of low testosterone levels in females include: 

      • Reduced sensitivity in the genital region which decreases interest or motivation for sexual activity and lack of interest in sexual activity.
      • Decreased vaginal lubrication which leads to vaginal dryness and discomfort during intercourse.
      • Trouble in achieving orgasm or having a less intense orgasm.
      • A decline in sexual thoughts, fantasies, and daydreams about sex.

      Sexual desires and fantasies can be influenced by physical, psychological, and emotional factors. Testosterone may interact with other neurotransmitters and hormones to influence sexual well-being.

   3. Emotional and Psychological Symptoms

      Testosterone plays a role in the emotional and cognitive aspects of the health of females. Low levels of testosterone may lead to the following emotional and psychological symptoms: 

      • Mood swings lead to sudden changes in emotions such as irritability, sadness, or anger.
      • Increased irritability or decrease in the ability to tolerate stress and frustrating situations.
      • A feeling of depression or sadness.
      • Decrease in self-esteem and reduced self-assurance.
      • Difficulty in initiating or sustaining activities that were once enjoyable.
      • Increased anxiety in some females.
      • Some females may experience difficulties in memory, attention, and spatial abilities.
      • A feeling of being mentally unclear or foggy.
      • Sense of emotional fatigue or emotional exhaustion.

      Females experiencing emotional or psychological symptoms should seek guidance from a healthcare professional.

4. Potential Causes of Low Testosterone in Women

   There are various factors that can cause low testosterone in females: 

   • Aging: The ovarian function decreases with age and this can lower testosterone production.⁽⁵⁾
   • Ovarian Dysfunction: Any condition affecting the function of ovaries such as ovarian tumors, surgical removal of ovaries, or damage to the ovaries can decrease testosterone production.⁽⁶⁾
   • Hypopituitarism: In this disorder, the pituitary gland does not produce sufficient hormones including luteinizing hormone and follicle-stimulating hormone. Luteinizing hormone is necessary for the production of testosterone in ovaries, its low levels may lead to low testosterone levels.⁽⁷⁾
   • Adrenal Disorders: Disorders of adrenal glands such as adrenal insufficiency can lead to low testosterone levels ⁽⁸⁾
   • Chronic Stress: The body’s hormone balance is affected by stress. This may reduce the testosterone production.⁽⁹⁾
   • Medications: Certain medications including hormone contraceptives may interfere with the production of testosterone.
   • Chronic Illness: Kidney diseases, liver diseases, and certain inflammatory conditions may affect the production of testosterone levels.
   • Excessive Exercise or Dieting: Exercising excessively or dieting can negatively impact hormone production and disrupt the endocrine system, leading to low testosterone levels.⁽¹⁰⁾

5. Treatment Options for Low testosterone in Females

   The treatment option for low testosterone levels depends on the underlying cause and symptom severity. The healthcare professional may recommend one or more of the following treatment options: 

   • Hormone Replacement Therapy: This involves the administration of exogenous testosterone and can be given in the form of cream and gels, testosterone pellets, and testosterone injection.
   • Lifestyle changes: Regular exercise, eating a balanced diet, and adopting stress management techniques can help keep a check on hormone levels.
   • Addressing Underlying Conditions: If a low testosterone level is due to any chronic medical condition, addressing it can help in improving the hormone level.
   • Medication Adjustment: If any medication is a cause, adjusting the medication or discontinuing it can improve testosterone levels.
   • Psychological Support: Seeking counseling or therapy can help with emotional well-being and prove to be beneficial in improving the testosterone level.

   It is important for a female to closely work with a healthcare professional such as a gynecologist or endocrinologist to determine the most appropriate approach for the situation.

Testosterone is not just a male hormone; its influence on women’s health is profound and multifaceted. This pivotal hormone touches upon numerous dimensions of a woman’s life, from physical attributes like muscle mass and bone density to the intangible realms of mood, cognition, and overall emotional wellness. Ensuring that testosterone levels remain within the optimal range is indispensable for the integrity of the female reproductive system, vitality, sexual health, and overall well-being. Should women suspect an imbalance in their testosterone levels, it’s crucial to consult with a healthcare expert. Such proactive measures pave the way for timely assessments, precise diagnoses, and tailored therapeutic interventions.

Also Read:

• Testosterone Deficiency : Causes, Symptoms, Treatment, Side Effects of Testosterone Replacement Therapy
• What Is The Best Testosterone Treatment?
• How Can I Boost My Testosterone Deficiency?
• Is Low Testosterone Hereditary?
• Why Would A Man’s Testosterone Be Low?
• Does Being Sexually Active Increase Testosterone?
• Why Do Men Take Testosterone?