Testosterone plays a surprisingly wide role in women’s bodies, influencing everything from bone strength and muscle mass to sex drive, mood, and skin. Women produce far less testosterone than men, but the hormone is essential for normal physical and mental function throughout life. About a third of it comes directly from the ovaries, while the rest is produced indirectly by both the ovaries and adrenal glands, then converted into its active form in tissues throughout the body.
How Much Testosterone Women Normally Have
Women under 50 typically have a total testosterone level above 25 ng/dL, while women over 50 tend to run above 20 ng/dL. For comparison, men’s levels range from roughly 300 to 1,000 ng/dL, so women operate on a fraction of that amount. But even at these lower concentrations, testosterone is biologically active and important.
Levels aren’t static. Testosterone begins a gradual decline starting around age 40, dropping about 25% between the early 40s and late 50s. Interestingly, this decline is driven by age itself rather than menopause. A 2024 study in eBioMedicine found that testosterone concentrations were unaffected by menopausal status when researchers compared premenopausal and postmenopausal women of the same age. The hormone reaches its lowest point around ages 58 to 59, then modestly rises again.
Bone and Muscle Strength
Testosterone helps keep bones dense and strong through several pathways. It slows down the cells that break bone tissue apart while supporting the cells that build it. It also suppresses certain immune cells that can act as bone-destroying precursors. Some of testosterone’s bone-protective effect comes from its conversion into estrogen within the body, which further reinforces bone density and helps buffer against osteoporosis.
Higher free testosterone levels are also associated with greater lean body mass in women. This matters practically: maintaining muscle supports metabolism, joint stability, and physical independence as you age. When testosterone drops, women often notice reduced physical stamina and a harder time maintaining muscle tone, even with consistent exercise.
Sex Drive and Sexual Response
Testosterone is one of several hormones that shape sexual desire in women, though the relationship is more complex than a simple “more hormone equals more drive.” The hormone influences how the brain processes and responds to sexual cues, modulating neurotransmitters and peptides involved in arousal and motivation. Large epidemiological studies have found that blood testosterone levels don’t reliably correlate with sexual function across women as a whole, which means two women with identical testosterone levels can have very different levels of desire.
That said, when testosterone drops very low, many women notice a clear decrease in sexual interest, responsiveness, and pleasure. Postmenopausal women given low-dose transdermal testosterone in clinical trials reported more frequent satisfying sexual encounters and stronger sexual desire. Locally applied hormonal precursors have also been shown to restore genital sensitivity and improve orgasm intensity, likely by reversing tissue changes rather than boosting desire in the brain. The takeaway is that testosterone contributes to sexual function through both central (brain) and local (tissue) pathways.
Skin, Hair, and Sebum Production
Testosterone and its more potent form, DHT, are the primary drivers of terminal hair growth, the thicker, darker hair that replaces fine body hair. During puberty, rising androgen levels trigger this conversion in the pubic and underarm regions. In adult women, testosterone continues to influence hair follicles in sex-specific areas including the face, chest, and abdomen.
The catch is that androgens have the opposite effect on the scalp, where they can inhibit hair follicles and contribute to thinning. This is why women with elevated testosterone sometimes experience both unwanted facial or body hair (hirsutism) and hair loss on the head at the same time. Testosterone also drives sebum production through oil glands in the skin. When levels are higher than normal, the result is often oilier skin and acne, particularly along the jawline and chin.
Mood, Energy, and Thinking
Low testosterone in women is linked to persistent fatigue, low mood, and a general feeling of diminished well-being that doesn’t have another obvious explanation. A pilot study of over 500 peri- and postmenopausal women found that four months of transdermal testosterone therapy significantly improved both mood and cognitive symptoms. Among women with mood-related complaints like irritability, tension, and depressed feelings, 47% reported improvement. For cognitive symptoms like difficulty concentrating and memory problems, 39% improved.
Mood responded more robustly than cognition overall. Mean mood symptom scores dropped by 34%, compared to a 22% decrease in cognitive scores. Fatigue was the most common complaint at the start (92% of participants reported it), and it showed meaningful improvement. Memory problems were the hardest to budge, with only 34% of women reporting a change, though the improvement was still statistically significant.
What Happens When Levels Are Too High
Excess testosterone in women most commonly shows up as a cluster of visible and reproductive symptoms. The hallmark signs include hirsutism (coarse hair growth on the face, chest, or back), persistent acne, oily skin, and thinning hair on the scalp. Ovulation can become irregular or stop, leading to missed periods and difficulty conceiving. Polycystic ovary syndrome (PCOS) is the most common cause of chronically elevated androgens in women of reproductive age.
Sudden or severe hirsutism, especially during pregnancy, can occasionally signal a more serious condition involving the ovaries or adrenal glands and warrants prompt medical evaluation.
What Happens When Levels Are Too Low
Female androgen deficiency is characterized by a diminished sense of well-being, persistent unexplained fatigue, and decreased sexual desire, receptivity, and pleasure in a woman whose estrogen levels are otherwise adequate. The diagnosis is supported by finding low free testosterone on blood testing. Because there’s no universally agreed-upon cutoff for “low,” and because testosterone levels don’t always match symptoms, identifying women who would benefit from treatment remains a clinical challenge.
There are currently no FDA-approved testosterone products for women in the United States. When prescribed, testosterone therapy for women is off-label, typically using a transdermal cream or gel at roughly one-tenth the dose used for men. Starting doses are generally around 5 mg daily, sometimes increasing to 10 mg. Injectable, pellet, and oral forms are not recommended for women because they can push levels above the normal range, increasing the risk of side effects like acne, hair changes, and voice deepening. In Australia, a testosterone product is approved specifically for women, but it remains the only country with such an approval.
Testosterone therapy is generally considered only for postmenopausal women with low desire, as the evidence in premenopausal women is insufficient to support routine use.