The Role of Testosterone in Women's Health: An Often Overlooked Hormone

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Dr. Khoshaba

December 16, 2023

Testosterone, predominantly recognized as the quintessential male hormone, has a lesser-known but equally vital role in the female body. While its presence in women is often overshadowed by hormones like estrogen and progesterone, testosterone's influence spans a range of physiological functions, from bone health to emotional well-being. 

This article embarks on a journey to explore the multifaceted role of testosterone in women's health , challenging preconceived notions and unveiling its profound impact on female health and well-being. Let’s start!

Production and Regulation of Testosterone in Women

Testosterone, while commonly associated with males, is vital for females too. In women, it's primarily produced in the ovaries, adrenal glands, and peripheral tissues. 

The production is regulated by hormones like Gonadotropin-Releasing Hormone (GnRH), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH), which originate from the hypothalamus and pituitary gland. 

These hormones work in a feedback mechanism to maintain testosterone levels. Throughout a woman's life, testosterone levels vary, rising during puberty, fluctuating during menstrual cycles, increasing during pregnancy, and decreasing during menopause. 

Despite its lower concentration in women compared to men, testosterone plays a crucial role in various physiological processes in the female body.

Physiological Roles of Testosterone in Women

Although present in lower concentrations in women than in men, testosterone plays several vital roles in the female body. Here's a breakdown of its primary physiological functions:

role of testosterone in women's health

Bone Health

Testosterone contributes to bone density maintenance. It aids in preventing osteoporosis and bone fractures, especially in postmenopausal women. A deficiency in testosterone can lead to decreased bone density and an increased risk of fractures.

Muscle Mass and Strength

Testosterone is essential for muscle development and function in women. It helps maintain muscle tissue, contributes to muscle strength, and can influence overall muscle function.


Testosterone is a significant contributor to women's sexual health. It plays a role in sexual desire and arousal. Many women with decreased libido have been found to have low testosterone levels.

Mood and Well-being

Testosterone can influence mood, cognitive functions, and overall well-being. Some studies suggest that women with low testosterone levels might experience mood swings, depression, and fatigue.

Fat Distribution

Testosterone affects how women store fat. It promotes a more even distribution of fat and can help prevent the accumulation of visceral fat, which is linked to various health issues, including cardiovascular diseases.

Skin and Hair

Testosterone can influence skin health, contributing to the skin's thickness and oiliness. It also plays a role in hair growth, which is why an imbalance can lead to conditions like hirsutism (excessive hair growth) or hair thinning.

Brain Function

Some research suggests that testosterone might play a role in cognitive functions, including memory and attention. It might also influence the risk of developing neurodegenerative diseases.

Red Blood Cell Production

Testosterone stimulates the production of red blood cells, which can influence energy levels and overall vitality.

In summary, while testosterone is often primarily associated with male physiology, it has diverse and essential roles in women's health, ranging from bone health to mood regulation. Recognizing its multifaceted functions can lead to a better understanding of various health issues women might face due to hormonal imbalances.

Conditions Related to Testosterone Imbalance in Women

Testosterone imbalances in women can lead to a variety of health issues. Both excess and deficiency can have significant physiological and psychological impacts. Here are some conditions related to testosterone imbalance in women:

role of testosterone in women's health
  1. Polycystic Ovary Syndrome (PCOS)

PCOS is one of the most common endocrine disorders in women of reproductive age. Women with PCOS often have elevated testosterone levels, which can lead to symptoms such as irregular menstrual cycles, infertility, acne, and hirsutism (excessive hair growth).

  1. Hypoactive Sexual Desire Disorder (HSDD)

This condition is characterized by a persistent or recurrent lack of interest in sex. Low testosterone levels can be a contributing factor to HSDD, affecting libido and overall sexual satisfaction.

  1. Osteoporosis

Low testosterone levels can lead to decreased bone density, making bones more fragile and increasing the risk of fractures. This is especially concerning for postmenopausal women, who naturally experience a decline in testosterone and other hormones.

  1. Muscle Weakness and Wasting

Testosterone plays a role in maintaining muscle mass and strength. A deficiency can lead to muscle weakness, fatigue, and reduced physical performance.

  1. Depression and Mood Disorders

Testosterone imbalances, especially deficiencies, have been linked to mood disturbances, including depression, mood swings, and irritability.

  1. Cardiovascular Risks

Some studies suggest that low testosterone levels in women might be associated with an increased risk of cardiovascular diseases, including heart attacks and strokes.

  1. Menopausal Symptoms

As women approach menopause, the levels of all hormones, including testosterone, fluctuate. This can exacerbate various symptoms like hot flashes, mood swings, and sleep disturbances. Some women opt for testosterone therapy to alleviate some of these symptoms.

  1. Adrenal Disorders

The adrenal glands produce a precursor to testosterone called androstenedione. Disorders of the adrenal gland, such as adrenal tumors or congenital adrenal hyperplasia, can lead to abnormal testosterone levels.

  1. Hair and Skin Issues

Elevated testosterone levels can lead to conditions like acne and oily skin. On the other hand, low levels might contribute to dry skin and hair thinning.

  1. Insulin Resistance and Metabolic Syndrome

Elevated testosterone levels, especially in conditions like PCOS, can lead to insulin resistance, increasing the risk of type 2 diabetes and other metabolic issues.

In conclusion, testosterone plays a vital role in various physiological processes in women, and imbalances can lead to various health issues. Recognizing the signs and symptoms of testosterone imbalance can help in early diagnosis and management, ensuring better health outcomes for women.

Testosterone Therapy in Women

Traditionally associated with men, testosterone therapy has gained attention in recent years for its potential benefits in women, especially those with specific health conditions or menopause. 

Here’s a breakdown of how this therapy can help:

  • Improved Sexual Desire: One of the most documented benefits of testosterone therapy in women is increased libido.
  • Mood and Well-being: Some women report improved mood, reduced depression, and better well-being after starting testosterone therapy.
  • Increased Muscle Strength: Testosterone can enhance muscle strength and physical performance.
  • Bone Health: Testosterone therapy can help increase bone density, reducing the risk of fractures in postmenopausal women.

However, like all hormone therapies, testosterone replacement in women comes with potential risks, including:

  • Potential cardiovascular risks.
  • Hirsutism (excessive hair growth) and acne.
  • Liver toxicity with oral formulations.
  • Possible deepening of the voice.
  • Altered cholesterol levels.
  • Breast changes or discomfort.

Ultimately, while testosterone therapy offers potential benefits for women with specific health conditions, weighing these against potential risks is vital. A healthcare professional's guidance is crucial before starting therapy.

Key Takeaways

Testosterone, often labeled the "male hormone," plays a pivotal yet underappreciated role in women's health. Its impact on female physiology is profound, from safeguarding bone density and influencing libido to regulating mood and muscle mass. 

As our understanding of testosterone's multifaceted role in women deepens, it underscores the importance of maintaining hormonal balance and the potential implications of its imbalance. Recognizing and respecting the significance of testosterone in women's health can pave the way for better diagnostic, therapeutic, and preventive strategies in the future.

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

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