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Is Testosterone Good for Menopause and Aging Women?

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When you think of testosterone, you probably think of it as the male sex hormone with a reputation for muscle-building and vitality. But testosterone is actually a very important hormone in women too. It’s not often until middle age – therefore menopause – that women notice the effects of dropping testosterone levels.

What Does Testosterone Do for Women?

Testosterone in women contributes to a good deal whole slew of health benefits we want1:

  • High levels of energy and vitality
  • An overall feeling of well-being
  • A healthy sex drive (and improved sexual desire and sensitivity)
  • Increased muscular strength and endurance
  • A better overall mood

In addition to those coveted commodities, testosterone is possibly essential to the development of eggs in the ovaries, probably during follicular development, though it’s not entirely clear. Testosterone in the ovaries may also make your follicles more sensitive to follicle-stimulating hormone (FSH), which helps mature oocytes (young eggs) into ovulated eggs.

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In other words, testosterone in women is pretty important.

What Does Low Testosterone Do to a Woman?

Low testosterone, on the other hand, can make women feel pretty lousy. Symptoms of testosterone deficiency include:

  • Diminished sexual pleasure and decreased sexual sensitivity
  • A low – or nonexistent – libido
  • Low energy
  • Depression and/or mood swings
  • Decreased physical strength and endurance
  • Loss of muscle mass

Low testosterone also impacts a woman’s ability to focus and concentrate, which is a damper to productivity.

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Does Testosterone Decrease During Menopause?

Yes: Decreased testosterone levels are a normal result of menopause, and your levels will decrease naturally with age. In fact, testosterone levels reach their peak around age 18 or 19 before declining throughout the remainder of adulthood.

Your testosterone levels will slowly decrease as you approach menopause, and they will continue to drop throughout menopause. Testosterone isn’t the only hormone that dwindles, though: Your estrogen and progesterone levels will also drop.

This decrease in hormones is what causes the infamous vasomotor symptoms women experience during menopause – hot flashes, night sweats, palpitations and flushing. Losing these important chemical messengers also leads to unfavorable – and quite frankly, annoying – symptoms like vaginal dryness, painful sex, mood swings, fatigue, bloating, headaches, sleep disturbances and weight fluctuations.

What Is the Average Testosterone Level by Age?

The “normal” or healthy level of testosterone in the bloodstream varies widely, depending on thyroid function, protein status and other factors.

For women ages 19 and up, normal testosterone levels range from 8-60 ng/dL (nanograms per deciliter). This chart shows the normal testosterone levels throughout a woman’s lifetime. Because the range of normal levels is so large, there’s no real metric by which doctors can determine whether your levels are “low.”

recommended testosterone levels for women infographic

What Are the Side Effects of Testosterone Replacement Therapy in Women?

While some research shows that testosterone replacement therapy can improve many of the symptoms of testosterone loss – especially the vasomotor symptoms like hot flashes and night sweats – the side effects of treatment outweigh the benefits for some women.

Many women report unfavorable side effects such as hoarseness or deepness in their voices, increased body and facial hair, decreased breast size, balding and acne.

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How Do Women Know if They’re Going Through Menopause?

Menopause is defined as the lack of a menstrual cycle for 12 consecutive months, but most women start to notice menopause-like symptoms in their early 40s. This is about when perimenopause, the phase leading up to your last menstrual cycle, begins.

During perimenopause, sex hormone levels begin to wane due to a decrease in ovary functioning. The first symptom is often a change in the length of a woman’s menstrual cycle. For example, you may notice that your period is only four days instead of six. If you tend to have regular cycles, you’ll notice this change relatively quickly. If your periods are already irregular, it may take several months to notice a difference.

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For some women, vaginal symptoms are the first sign of menopause. Dryness, itchiness and discomfort are indicators that hormone levels are thrown off. Painful intercourse and frequent urinary tract infections are also signs of impending menopause. Even without these symptoms, many women notice a lack of interest in sex leading up to menopause.

Do Women Need to Get Testosterone Treatments?

If you’ve experienced any androgen-deficiency symptoms for an extended period of time, and your symptoms cause you personal distress, you should talk to your gynecologist or primary care doctor. They’ll be able to discuss options with you, and, if they themselves can’t help, they may be able to refer you to another medical practitioner who specializes in female sexual health.

Testosterone replacement therapy, however – available in oral, implanted, injectable and topical forms – may not be the answer. And the fact of the matter is that there isn’t an agreed-upon metric by which doctors can measure to determine whether or not your levels of the hormone are low.

This is compounded by the fact that many of the reported deficiency symptoms are very subjective, such as low sex drive and mood swings. Your “low energy” probably feels different than someone else’s version of the same symptom.

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Short-term testosterone replacement therapy may be a good way to revive your energy and mood and boost your libido. But long-term therapy isn’t usually advised because of the mixed reviews about its effects on the heart2.

Because doctors and researchers don’t fully understand low testosterone levels in women or how to best treat a deficiency, it’s important to consider both the potential risks and benefits before committing to treatment.

If you do think you might benefit from testosterone treatment, first take a blood test to determine how much of the hormone you have. In the end, it’s your job to decide whether the benefits of testosterone – or any hormone – replacement therapy outweigh the reported side effects.

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Natural ways for women to balance testosterone

  1. Avoid an extremely low-fat diet. A restrictive diet may not be good for overall health or your hormone levels. Dietary fat, especially from healthy sources, is strongly linked to testosterone levels3.
  2. Exercise. Exercising, especially strength training, boosts testosterone production naturally.
  3. Manage stress. High and constant stress increases cortisol production which may impact testosterone production in women (just as it does in men).
  4. Stop taking oral contraceptives. These suppress testosterone4 and other hormones.

Citations and Sources

1.
Bain J. The many faces of testosterone. Clin Interv Aging. 2007;2(4):567-576. [PMC]
2.
Anawalt B, Yeap B. Conclusions about testosterone therapy and cardiovascular risk. Asian J Androl. 2018;20(2):152-153. [PMC]
3.
Dorgan J, Judd J, Longcope C, et al. Effects of dietary fat and fiber on plasma and urine androgens and estrogens in men: a controlled feeding study. Am J Clin Nutr. 1996;64(6):850-855. [PubMed]
4.
Zimmerman Y, Eijkemans M, Coelingh B, Blankenstein M, Fauser B. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis. Hum Reprod Update. 2013;20(1):76-105. [PMC]
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Amanda Capritto

Amanda Capritto writes about health, fitness, nutrition and medicine. She's a certified personal trainer and integrative nutrition health coach, and spends her free time CrossFit-ing, hiking, and trying a new extreme activities every so often (skydiving, anyone?).
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