Testosterone plays a far bigger role in women’s health than most people realize. Though often labeled a “male hormone,” women produce testosterone throughout their lives, and it influences everything from bone strength and muscle tone to sexual desire, mood, and cognitive sharpness. Women’s bodies make much less of it than men’s, with normal adult levels ranging from about 8 to 60 ng/dL compared to several hundred in men, but that smaller amount is essential for daily functioning.
Where Testosterone Comes From in Women
Women produce testosterone from two main sources: the ovaries and the adrenal glands (small glands that sit on top of the kidneys). About one-third of circulating testosterone comes directly from the ovaries. The remaining two-thirds take an indirect route. Both the ovaries and adrenal glands produce a precursor hormone called androstenedione, which gets converted into testosterone in other tissues throughout the body, including fat and skin.
This distributed production matters because it means testosterone levels aren’t controlled by a single organ. If your ovaries are removed surgically, you lose a significant source, but not all of it. And because conversion happens in peripheral tissues, factors like body composition can influence how much active testosterone is available.
Bone Strength and Muscle Mass
Testosterone helps maintain bone mineral density in women by acting directly on androgen receptors in bone tissue. It also works indirectly: fat and other tissues convert some testosterone into estrogen, which provides additional bone protection. Research on women over 65 has found a significant association between testosterone levels and bone density at the hip, suggesting that lower testosterone increases the risk of osteoporosis in older women. Notably, studies on postmenopausal women show that combining testosterone with estrogen therapy increases bone density more effectively than estrogen alone.
Testosterone also supports muscle protein synthesis and helps maintain lean body mass. Women with low testosterone often notice a gradual loss of strength and muscle tone that feels disproportionate to changes in their activity level. This isn’t just a cosmetic concern. Maintaining muscle mass is one of the strongest predictors of mobility, fall prevention, and metabolic health as you age.
Sexual Desire and Arousal
Of all testosterone’s roles in women, its connection to sexual desire gets the most attention. Testosterone interacts with multiple brain chemicals involved in how you perceive and respond to sexual cues. Your brain actually produces its own testosterone from cholesterol, and this local production appears to be widespread throughout the central nervous system. The relationship between blood testosterone levels and desire isn’t perfectly straightforward, though. Women with similar blood levels can have very different levels of sexual interest, partly because individual differences in androgen receptor sensitivity affect how strongly the hormone’s signal is received.
When sexual desire drops significantly and causes distress, it may be diagnosed as hypoactive sexual desire disorder (HSDD), defined as a persistent lack of sexual fantasies and desire for sexual activity. Testosterone therapy has been shown to improve sexual desire, satisfaction, arousal, and orgasmic response in both naturally and surgically menopausal women. These benefits appear to hold even when women aren’t taking estrogen therapy alongside it, and they’ve also been observed in women whose libido decreased as a side effect of antidepressants.
Memory, Learning, and Mood
Testosterone’s effects on the brain go well beyond sexuality. In premenopausal women, higher natural testosterone levels have been linked to stronger performance on spatial and mathematical tasks. In older women, higher levels correlate with better verbal fluency and verbal memory.
A pilot study in healthy postmenopausal women found that 26 weeks of testosterone therapy led to significant improvements in both verbal and visual learning and memory. Women in the treatment group scored meaningfully higher on tasks like recalling word lists and navigating spatial memory challenges compared to women who received no treatment. These results held even after adjusting for age and baseline ability, suggesting testosterone was the driver rather than some other factor.
Low testosterone is also associated with mood changes. Women with low levels commonly report depression, anxiety, persistent fatigue, and difficulty sleeping. These symptoms overlap heavily with other conditions like thyroid disorders and iron deficiency anemia, which is one reason low testosterone in women often goes unrecognized.
How Levels Change With Age
Testosterone levels in women peak during the late teens and twenties, then decline gradually. According to Mayo Clinic Laboratories reference ranges, free testosterone (the portion available for your body to use) tops out around 1.06 ng/dL for women in their early twenties and drops to about 0.64 ng/dL by age 95. That’s a roughly 40% decline over a lifetime, but it happens slowly, losing a small fraction each decade rather than falling off a cliff.
This pattern is quite different from estrogen, which plummets relatively quickly during menopause. Testosterone’s decline is more gradual and begins earlier, starting in the thirties and continuing steadily. Women who have their ovaries removed experience a more sudden drop, losing that one-third of production that comes directly from ovarian tissue. The adrenal glands and peripheral conversion continue to supply the rest, but the overall level is significantly reduced.
Signs of Low Testosterone
Common symptoms of low testosterone in women include low sex drive, persistent fatigue, loss of muscle tone and strength, vaginal dryness, thinning hair, dry or brittle skin, difficulty concentrating, and mood disturbances like depression or anxiety. Some women also experience irregular menstrual cycles or trouble conceiving.
Diagnosing low testosterone in women is genuinely difficult. There’s no universally agreed-upon threshold for what counts as “low” in women, and hormone levels fluctuate throughout the menstrual cycle and even between morning and evening. If you’re still menstruating, there’s a specific window in your cycle that gives the most accurate reading. Many healthcare providers hesitate to make the diagnosis because the symptoms overlap so closely with depression, thyroid dysfunction, and anemia. A blood test is the only way to measure testosterone directly, but interpreting the result requires context about your symptoms, age, and overall health rather than simply checking whether a number falls inside a reference range.
Testosterone Therapy for Women
Testosterone therapy in women is most established for treating low libido. When dosed appropriately for female physiology, it generally carries a low risk of masculinizing side effects like voice deepening or excess hair growth. The key is using formulations designed for women’s much lower physiological needs rather than scaling down products made for men.
Intravaginal testosterone is also being studied for genitourinary symptoms of menopause like vaginal dryness and painful intercourse. The vaginal and urinary tract tissues contain androgen receptors along with enzymes that activate testosterone locally. Clinical studies have found that intravaginal testosterone, used alone or alongside vaginal estrogen three times per week, significantly improves pain during sex, lubrication, libido, and overall sexual satisfaction compared to placebo.
One important limitation: no testosterone products are formally approved for women in many countries. Prescriptions typically involve off-label use of low-dose formulations, which means access and guidance vary widely depending on where you live and who you see. Testosterone therapy has shown effectiveness for increasing muscle mass as well, but at higher doses the risks of masculinizing effects and cardiovascular events increase, so careful dosing matters.