Women’s Testosterone: What It Does and Why It Matters

Testosterone Is Not Just a Male Hormone

Testosterone is produced in the ovaries and adrenal glands in women — in smaller amounts than in men, but with physiological importance that’s disproportionate to the quantity. The idea that testosterone is exclusively a male hormone has contributed to decades of underdiagnosis in women who have clinically significant testosterone deficiency.

What Testosterone Does in Women

Testosterone serves several distinct functions in female physiology:

• Libido and sexual function — testosterone is the primary hormonal driver of sexual desire in both sexes. Low testosterone is the most common hormonal cause of low libido in women, more than estrogen decline in many cases.
• Energy and stamina — testosterone supports mitochondrial function and oxygen-carrying capacity. Women with low testosterone typically experience fatigue that persists despite adequate sleep.
• Muscle maintenance — testosterone is anabolic in women as in men; it supports lean muscle mass and influences body composition. As testosterone falls, body fat tends to increase and lean mass decreases even with consistent exercise.
• Bone density — testosterone contributes to bone remodeling alongside estrogen. Both hormones are needed for optimal bone protection.
• Cognitive function — testosterone receptors are present throughout the brain. Low testosterone in women correlates with cognitive fog, word retrieval difficulty, and reduced mental sharpness.
• Mood and motivation — testosterone supports dopaminergic pathways. Low levels are associated with flat mood, low motivation, and anhedonia — sometimes mistaken for depression.

When Does Testosterone Decline in Women?

Testosterone production begins declining in women in their late 20s to early 30s — earlier than estrogen decline. By the mid-40s, most women have testosterone levels roughly half of their early-adult peak. This decline accelerates with surgical menopause (oophorectomy) or premature ovarian insufficiency, but occurs naturally in all women across time.

How Is Low Testosterone Diagnosed in Women?

Standard annual physicals almost never include testosterone measurement for women. Even when ordered, total testosterone alone is an inadequate measure — because testosterone’s availability depends on SHBG (sex hormone binding globulin). High SHBG (common in women taking oral estrogen or oral contraceptives) binds testosterone and reduces its activity, even when total testosterone appears normal.

MultiGen Wellness measures free testosterone (the active, unbound fraction) alongside total testosterone and SHBG for every female patient. This distinction frequently changes the clinical picture.

Testosterone Therapy for Women

Testosterone therapy for women uses doses far below the male therapeutic range. Low-dose topical testosterone is the most common approach — applied to inner thigh or arm. Subcutaneous pellets are also used. Properly dosed female TRT does not produce masculinizing effects; monitoring free testosterone at every follow-up ensures levels stay within the physiological female range.

MultiGen Wellness prescribes testosterone for women as part of a comprehensive hormone evaluation — not as a standalone treatment — and monitors the full panel at regular intervals throughout the program.