- Low testosterone in women directly causes weight loss resistance, decreased energy, mood changes, hair loss, and reduced sex drive. Check your levels if you haven't, as most doctors miss this connection.
- Testosterone isn't just for men. Replacing low testosterone safely in women leads to modest weight loss of 5-15 pounds, improved mood, stronger muscles, increased energy, and a healthier immune system.
- Vaginal application of testosterone cream provides the most benefit for libido compared to other delivery methods, giving you that extra boost many women need.
- Avoid hormone pellets for testosterone replacement because you can't adjust the dose if needed, and the surgical insertion creates unnecessary risk. Transdermal creams are safer and more flexible.
- Testosterone replacement rarely causes serious side effects when dosed properly at physiologic levels. Only about 1 in 20 women experience mild issues like acne or irritability.
Weight gain, low sex drive, hair loss, decreased energy, and depression.
What do these things all have in common?
They can all be caused by low testosterone in women.
If you were under the impression that testosterone was a male hormone, think again:
Testosterone is a very important hormone for women as well as men.
And unfortunately, it’s one of those hormones that is often ignored by doctors.
Or worse, your symptoms may be misdiagnosed as depression or as a “normal” consequence of aging.
And that’s too bad…
Why?
Because you can replace testosterone safely and effectively with the right knowledge to help you get back to feeling “normal”.
Let’s dive in…
Signs and Symptoms You Have Low Testosterone
Are you in your ’40s to ’50s?
Have you had menopause?
Have you noticed a change in your mood or just overall the way that you feel?
If you are like many women out there you might not be feeling like yourself, leading to look into hormone replacement.
And because each hormone can cause different symptoms you are probably wondering WHICH hormone is causing your problem(s).
Well, let’s figure it out.
Low testosterone in Women usually presents with one or more of the following:
- Decreased sex drive or decreased libido (including lack of interest in sex or difficulty in getting aroused)
- Inability to build muscle mass, inability to maintain muscle mass, or “sagging”, especially in the upper arms
- Depressed mood or increased irritability
- Inability to lose weight or increased weight gain (especially without a change to your diet)
- Decreased energy levels or fatigue
- Hair loss or thinning of the hair
Now what can be confusing is that some other hormone imbalances can cause similar issues, so it’s worth taking a look at those as well…
Low testosterone should be differentiated from low thyroid (hypothyroidism) which presents with one or more of the following:
- Fatigue and exhaustion especially after a good night’s sleep
- Increased hair loss
- Changes in mood including depression or anxiety
- Weight gain or weight loss resistance
- Changes in skin, hair, and nails
- Cold hands or feet and inability to tolerate cold temperatures
- Difficulty with sleep including insomnia or REM sleep disorders
Low testosterone should also be differentiated from menopausal symptoms (low estrogen and low progesterone) which usually presents with one or more of the following:
- Hot flashes or changes in body temperature throughout the day
- Increased fluid retention or swelling
- Changes in mood including depression, anxiety, or irritability
- Not feeling like “yourself”
- Weight gain (usually 10-15 pounds)
- Insomnia or waking up feeling flushed or hot
- Inability to tolerate hot temperatures
- Changes in sex drive or libido or pain with intercourse
Hopefully, you can see the overlap in these symptoms which is why it is so critical to CHECK your labs and use them in conjunction with your symptoms to really determine what your issue is.
Now in truth, you should realize that most women are going to be low in SEVERAL of these hormones which is why they will likely experience major overlap in their symptoms.
A good place to start is with the most worrisome of your symptoms and the most worrisome of your lab results.
This way you can systematically determine what the main issue is for you and treat that.
But what causes these low hormone levels in women anyway?
Are all women doomed to develop low testosterone? (The answer might surprise you)…
What Causes Low Testosterone in Women?
Let me get this out of the way early:
Yes, most women WILL experience a decline in their testosterone levels.
Just like men go through andropause, women go through menopause + an equivalent to andropause.
If you didn’t already know:
Andropause = age-related decline in testosterone
Menopause = age-related decline in estrogen/progesterone
Somatopause = age-related decline in growth hormone
So, even if you lived a VERY healthy and relaxing life – your testosterone levels WILL eventually go down.
But other issues can premature lowering of testosterone levels.
And these other issues help to explain why some women are experiencing lower-than-normal testosterone levels younger and younger.
What issues am I talking about?
Hormone imbalances.
Specifically insulin resistance.
You can see several studies showing that insulin resistance can cause BOTH elevated levels of testosterone (1) and decreased levels of testosterone (2).
I’ve found that women who tend to have INCREASED levels of testosterone due to insulin resistance often fall on the PCOS spectrum.
And women who tend to present with LOW levels of testosterone with insulin resistance tend to present with weight loss resistance, decreased libido, and mood changes.
But just realize that insulin resistance can cause either LOW or HIGH levels of testosterone depending on your body.
This is also very important when you consider that about 50% of the population has insulin resistance to some degree (3).
That means that statistically speaking, you have a 50% chance of having insulin resistance and issues with your testosterone levels.
If you don’t have insulin resistance your testosterone will eventually decline with age (4).
But don’t let this freak you out.
Why?
Because it’s very possible to replace those low testosterone levels safely and effectively to help you start feeling better.
But first, what kind of benefits do you stand to gain?
Benefits of Replacing Testosterone in Women
Each woman will have different benefits when replacing testosterone.
It really depends on the symptoms that they PRESENTED with.
So, for instance:
If low testosterone is causing issues with libido or weight gain, then replacing your levels may help with these 2 issues.
Make sense?
Below I’ve included a list of the changes that you might expect to see (based on my clinical experience in replacing testosterone in women).
Benefits of replacing testosterone in women:
#1. Improved Weight Loss
Many of the studies that exist out there for testosterone replacement are primarily directed at men.
There is a clear correlation between weight loss and testosterone replacement (5).
While there are fewer studies showing that testosterone therapy helps weight loss in women, there is a clear correlation that is seen clinically.
In my experience, women experience MANY of the same benefits that men do when replacing testosterone.
While the weight loss when replacing testosterone is not as profound in men as it is in women, it can still help.
This is likely due to the fact that testosterone helps boost metabolism by helping women build muscle mass (6).
The combination of increased energy and increased muscle mass is probably responsible for the extra weight loss that many women experience while taking testosterone.
Realize that testosterone is certainly not a magical weight loss pill, however.
Increasing testosterone will likely result in modest weight loss (on the order of 5-15 pounds) unless it is used in conjunction with other hormone replacement, dietary changes, etc.
#2. Improved Mood
The correlation between mood and testosterone is well established (7).
Low levels of testosterone are associated with higher rates of depression in women.
The combination of menopause + low testosterone sets women up for depression.
If you see your PCP you will most likely be prescribed an anti-depressant when in reality the change in your mood is likely related to your hormones!
Don’t fall for this trap.
Do you remember the saying “grumpy old men”?
They get grumpy because their testosterone levels fall, if you replace them they become much happier, more relaxed, and less irritable.
The same thing is true with women who supplement with testosterone.
Adding testosterone to your regimen (as a woman) can help boost mood (decrease depression-like symptoms), reduce irritability, and improve quality of life.
#3. More Muscle Mass (and therefore a better metabolism)
Do you feel like it’s difficult to gain or hold onto muscle mass despite exercising like crazy?
Low testosterone may be playing a role.
In fact, it just might be the combination of low progesterone plus low testosterone leading to many of the issues that women face regarding muscle mass.
I’m sure you have seen the effects of decreased muscle mass in elderly women with flabby skin (especially in the arms) and thin extremities.
Studies show that testosterone and progesterone (8) BOTH have an impact on muscle mass and muscle growth.
We’ve already established that after menopause women have low levels of BOTH so many are set up for a double whammy.
The decrease in testosterone causes atrophy of the muscles in the body.
Often, space, where the muscle should have been, is replaced with fatty tissue which causes sagging of the skin and flabby skin that some women experience.
Adding testosterone can help build muscle mass (which in turn boosts metabolism).
#4. Higher Sex Drive and Libido
Even if you have no interest in improving your mood, losing extra weight, or building muscle mass – maybe increased sex drive and libido will catch your eye.
Testosterone as a hormone is clearly associated with sex drive in women (of course it’s not the only thing involved but it is very important).
One very interesting fact about women is that (unlike men) their sexual lives tend to last as long as they have a willing partner (9).
And since sexual activity is associated with numerous health benefits (10), this becomes very important!
Testosterone can help libido and sex drive in a couple of different ways:
1) Increased desire to have sexual intercourse – If your desire is lower than normal, or you have noticed that it has decreased over the last several years then testosterone may be of benefit.
2) Improved sexual pleasure – The intensity and pleasure of intercourse are ALSO improved (in addition to increased desire) in some women who supplement with additional testosterone (11).
It will NOT help if you are having painful intercourse which can happen with menopause.
The decline in estrogen levels can cause changes in the vaginal wall which can lead to vaginal atrophy (12) and pain during intercourse.
Pain with intercourse can lead to a decreased desire for sex, but this should be differentiated from the scenarios above.
To recap:
Supplementing with testosterone can boost desire (AKA increased sex drive and libido) as well as pleasure and intensity during sex.
To get the most benefit and biggest “bang for your buck” applying testosterone vaginally seems to boost these effects even further.
Many women who apply testosterone transdermally (on their skin elsewhere) don’t always get the added benefit of increased libido until they apply it vaginally.
#5. More Energy
Many women do experience increased energy while supplementing with testosterone, but this is more of a subjective response to the treatment.
I suspect that increased energy likely comes from improved muscle mass, increased metabolism, and changes in mood.
But no matter the reason, it’s still true that testosterone can BOOST energy levels in many women.
If you are experiencing decreased energy levels make sure you ALSO check your other sex hormones (estrogen and progesterone) in addition to thyroid hormone.
Usually, low energy levels are associated with one or more hormone imbalances.
Treatment for Low Testosterone in Women
If you’ve been reading this post so far and you’re interested in learning more about supplementing with testosterone then read on…
I don’t recommend that women just take extra testosterone for the sake of it.
Instead, they should be evaluated based on their symptoms and lab results.
So it becomes really important to understand what “normal” testosterone levels are because most doctors aren’t familiar with ordering and managing hormone levels.
It’s also important to realize that when supplementing with testosterone as a woman we are talking about doses MUCH smaller than what a male would get.
How to check your Testosterone Levels
Like thyroid function, there is a difference between “normal” and “optimal” levels of testosterone.
First off:
To accurately test testosterone levels you need to check for BOTH Total and Free testosterone levels in the serum.
Below I’ve included some test results from a patient of mine with sub-optimal testosterone levels:
You can see from this example her total testosterone was 23 with a reference range that spans 14 to 76.
Her value of 23 technically put her in the “normal” range but certainly not the optimal range.
Likewise, you can see her free testosterone at 0.27 with a reference range of 0.10 to 0.85 – again putting her in the low range of normal.
This is a perfect example of a patient who might benefit dramatically from testosterone replacement and supplementation.
Generally, I like to see testosterone levels in the upper 50% of the reference range.
Treating testosterone is completely different, but if you are NOT taking testosterone then an “optimal range” to shoot for would be that upper 50%.
I’ve also included an example of insulin levels and blood sugar that commonly accompany low testosterone levels:
Because of the association with insulin resistance and low testosterone, I always recommend that each patient gets ALL of their hormones checked at the same time.
This helps to create a “story” of what is happening in the body.
Testosterone and Autoimmune disease
I also want to take a second and mention the link between low testosterone levels and autoimmune disease – which can be another huge reason to consider adding testosterone to your regimen.
There is a reason that most autoimmune diseases are found in women and one of those reasons is felt to be testosterone levels.
Testosterone has an impact on the immune system (13), specifically that it can help balance the system that helps your immune system differentiate between self and foreign.
It does this by altering T-cell immunity and helping to boost the TH1 response (14).
In my practice, I’ve found a strong correlation between low normal testosterone levels (or even non-existent testosterone levels) and autoimmune disease, especially in women.
Boosting testosterone levels can help boost your immune response and with other changes to lifestyle and diet, I’ve seen it also help reduce antibody levels in some cases.
This would be yet another reason to consider adding testosterone therapy to your regimen if you are a woman.
How to take Testosterone
There are many ways to actually take Testosterone, but the most important part is this:
The testosterone should be given either by intramuscular/subcutaneous injection or via transdermal application.
Basically, you should NOT be taking testosterone as an oral supplement.
Because of this testosterone comes in many preparations:
- Hormone Pellet – This is a device filled with a pre-set amount of hormones that can be surgically inserted into the body to allow a release of hormones over a period of time.
- Testosterone creams/gels/liquids/patches – In these preparations testosterone is bound to a carrier that diffuses through the skin for absorption. Gels are generally used for men while creams are generally used for females. Some formulations don’t allow for vaginal application, which can be a downside.
- Testosterone injections (Subcutaneous or intramuscular) – Injections can be as frequent as every week and usually contain a large boost of testosterone that slowly fades over time (usually days). This application doesn’t allow for vaginal placement.
- Testosterone liquid in an organic base – This is my preferred route which I will discuss below.
When supplementing with any hormone I find that it’s always best to try and mimic or emulate what a woman’s body would have done normally when she was younger.
That means mimicking the release of testosterone during a woman’s cycle:
You can see the testosterone levels are relatively stable with a boost around ovulation (which helps explain the increased sex drive around that time of the month for many women).
My preferred route is through topical/transdermal applications that allow for vaginal placement to get that extra boost of libido.
I also will switch to smaller doses of subcutaneous or transdermal testosterone shots in some women with autoimmune diseases to get a “boost” that slowly declines over the next several days.
Generally, I don’t recommend pellets for the following reasons:
- The dose is hard to adjust and each person needs a unique dose – That means if you overestimate or underestimate the dose you have to wait several months for the pellet to “expire”.
- No vaginal placement.
- Surgical incisions needlessly increase the risk of complications like infection or postoperative bleeding.
- Hormone levels with pellets generally provide a MASSIVE boost to hormone levels that then tapers off over time to “baseline” which does not mimic the testosterone levels of a healthy young woman.
For these reasons, I tend to stay away from pellets as a way to replace hormone levels.
Negative Side Effects of Testosterone?
Maybe you are thinking right now:
What’s the catch?
And I wouldn’t blame you, but I’m here to tell you that generally testosterone is tolerated VERY well in most women.
Why?
Because when I (and other hormone doctors) replace hormone levels our goal is to only replace what your body NEEDS.
So, as long as you just provide what the body needs and not more than what it is used to there shouldn’t be any negative side effects.
This isn’t always true, because some people are very sensitive to hormones/fillers/binders/etc. but it is true for the majority of patients.
When testosterone isn’t well tolerated the side effects tend to be mild:
- Irritability or change in mood (especially anger)
- Acne or increased propensity to develop pimples
- Oily skin or changes in complexion
- Mild fluid retention or swelling
These side effects are quite rare but they do occur on occasion.
In my experience, only 1 out of 20 women will experience one of the side effects above in the doses that I recommend.
Wrapping it up
To recap:
Testosterone is a very important hormone in women and low levels can lead to serious symptoms that can be mistakenly diagnosed by providers who aren’t knowledgeable about hormone replacement.
Supplementing with testosterone (in healthy amounts) can lead to increased weight loss, improved mood, increased libido/sex drive, increased energy, and increased muscle mass.
When supplementing with testosterone, I recommend using the transdermal application method and, if libido is an issue, then the vaginal application method seems to work the best.
When possible, I recommend avoiding pellet forms of hormones due to risks from the surgical application of the pellet and the inability to titrate hormone dosing.
If you follow these guidelines replacing testosterone can be very helpful and rewarding.
Now it’s your turn:
Are you currently using testosterone?
Has it helped you with any of your symptoms? Why or why not?
Scientific References
#1. http://www.ncbi.nlm.nih.gov/pubmed/18615851
#2. http://www.ncbi.nlm.nih.gov/pubmed/18319314
#3. http://www.ncbi.nlm.nih.gov/pubmed/17967708
#4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293806/
#5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154787/
#6. http://www.ncbi.nlm.nih.gov/pubmed/24203065
#7. http://www.ncbi.nlm.nih.gov/pubmed/11955793
#8. http://www.ncbi.nlm.nih.gov/pubmed/24203065
#9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474615/
#10. http://www.ncbi.nlm.nih.gov/pubmed/19817979
#11. http://www.ncbi.nlm.nih.gov/pubmed/7616872
#12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971714/
#13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614669/
#14. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103356/
Hi Dr. Child’s,
I somehow came across this thread and have read each and every post/answer. I have recently been getting blood work done trying to figure out my hormones.
I am 27 yrs old and I am always tired except when I lay down at night I can’t fall asleep, I have hot flashes daily, hair growth on chin, stomach and nipples (embarassing), no libido, and I have been off birth control for 2 1/2 not preventing pregnancy and have not gotten pregnant. I have been told by my dr I am just a mystery and may need to just go to an endocrinologist.
I am showing free testosterone at 1.5 and total testosterone at 14.
Progesterone is .8
DHEA S is 835
Estrogen is 110
I was using testosterone cream on the backs of my knees every night for 6 months and results went down from 2.5 to 1.5 and 35 to 14 I had no mood or libido changes. Dr wants me on higher dose vaginal cream and back on birth control pills (lo loestrin)
I could go on with test results but my concern is my dr doesn’t understand why I have such low testosterone and such high DHEA S if she doesn’t know I don’t know who would!
I know this is a long shot but any advice is appreciated I am starting to think I could have premature ovarian failure. (But my cycles are regular off birth control)
Look into PCOS. It might give you an idea what is going on with you, possibly.
Hi Dr. Child’s,
Can you tell if you apply the testosterone cream every day or more like the progesterone cream(days 14-28)?
Hi Mary,
Generally testosterone is applied each day.
Hi Dr. Childs,
Thank you so much for writing this, because it is so hard to find comprehensive information about testosterone for women online! I just got lab results back from my doctor showing my testosterone was nearly half the minimum amount. I’m going to start taking supplements, as recommended by my doctor. How soon/often do you recommend rechecking testosterone levels after a patient begins supplementation? I want to be sure I am getting the right dose, but I’m not sure how soon these take peak effect.
Thanks!
Hi Meredith,
You should be fine checking in 8 weeks or so but it can be sooner/later depending on how you respond to the hormone.
Hi,
If Total T is bottom range 378 (200-800) and Free T is 13 (1,9-15). Shbg is low 20 (41-79).
Do I have low or high testosterone then?
I also have low thyroid. Feel very fatigued and many problems.
Hi Conni,
You need to use the combination of your symptoms plus lab results to help determine. You should also evaluate testosterone in the setting of current thyroid status.
I recently had my sex hormones tested. I am a postmenopausal 51 year old female and my main concern is weight I need to lose around 50 lbs and it’s been very tough. This is what my profile says
Estradiol 0.6
Progesterone 24
Pg/e2 40
DHEAS 8.6
Cortisol 4.6
I made an appt with a new Dr but it’s over a month away. I was also looking into your meal plans, got the 3 day today. Any general advice for me?
Hi,
I am a 45 year old female, not in menopause yet.
I suffer from hair loss, decrease libido, swinging mood. My Free Testosterone is 2.6 normal range (1.1 – 5.8) and my Total Testosterone is 7.11 normal range is (0-90).
My SHBG is 15 normal range ( 9-55).
Does low Testosterone level is the reason for my hair Loss. And if I want to take organic base liquid Testosterone how many drops should I take?
Thank you so much for all your help.
I was just informed I have 0 testosterone my dr is afraid to give me anything as I am a breast cancer survivor! I’ve been dealing with exhaustion, brain fog as well as no interest in sex and not much interest in anything else since chemo over 5 yrs ago!
I only have Medicaid in the state of Arizona can you tell me how I might get some help with this?
I am 61 and ready to exit this planet as living on Adderall and pain meds isn’t getting to the root. My BC was from estrogen dominance and positive for her2 as well. I’m tired of being sick and tired and have suspected testosterone deficiency for a while now….really need to figure out a way to replace it! Many blessings
Thank you so very much,
Do you think one can find balance with just bio-identical testosterone if she has had a total hysterectomy and oophorectomy?
Hi Jennifer,
That seems unlikely considering that you will have greatly reduced levels of both progesterone and estrogen in addition to testosterone.
Hi Dr. Childs,
Thanks for the article. It was very helpful. I recently noticed changes in my sleep patterns and can relate to some other symptoms listed for low testosterone. After explaining this to my OBGYN and failing to find a solution with typical FSH and thyroid level checks, I switched doctors to see if another point of view could help. The next doctor got a full history, asked a lot of the questions your article asks about symptoms and tested for testosterone levels. Sure enough, my serum testosterone is <3 with ref range 8-48ng/dL. (All other CBC, chemistry, and lipid panels WNL). Since I just found this out, we have yet to have a consultation about it, so I'm not seeking your medical advice. I am curious about your mention of Testosterone liquid in an organic base as your preferred method. I could not find any further information for that. Do you mind elaborating? Thanks!
Melanie
So, I am 57 and just had my testosterone levels tested and they are so low that they could not measure them. I have been on estrogen (fearing) and progesterone for about a year. I have been exhausted, low to no sex drive, etc. Had my doc check the T levels and she called to say they were so low they could not measure. WTH? She suggested the Estrogen and T pellet. I have been previously competing in bike racing, but the T will make me have to quit that due to T being on the banned list. Is it really going to make things that much better?
Hiya Doc,
Female in my late 40’s. Nervous about starting testosterone supplementation but I trust my doctor implicitly. My lab work came back and everything looked good but the testosterone level was 15. I have been having hair loss and a sluggish metabolism despite eating well and getting exercise. My Dr gave me a testosterone injection today and I am a bit nervous. I did not think to ask how much as I trust her judgment. After coming home and reading on the internet, I now worry If I could have some of these side effects like acne and enlarged body parts (good grief) Will one injection wreak havoc if it wasn’t the right route to take? Thanks so much!
Hi Dr. Childs,
I just got my bloodwork done and I will be going back to Dr. next week, My Dr. sells pellets she advertises for them and I’m sure she is going to want me to do the pellets. first of all, I don’t have 400.00 every 3 months for pellets which are not covered by insurance. Second, I am scared to get them. I’m with you, what about overdoing the hormone, then I’m stuck with it for 3 months until it wears off? what a waste. How can I get the liquid organic formula if she won’t give it to me?
Hi Sherry,
Your physician may be willing to try other therapies, so I would just let her know that you would prefer a cream/gel/liquid over a pellet. If that doesn’t work then you may need to seek a second opinion.
I love your hormone articles. Very informative!
I am 42 and have gained 15 lbs out of nowhere, hair clogging the drain, dry skin, brain fog, toss and turn sleep, fatigue. The thyroid is great as I’m on 300 mgs of armour. T3 and T4 at top of ranges, TSH at zero. I don’t snack between meals anymore and that dropped leptin from 32 to 5. I’m on metformin and a very light dose of Victoza. Didn’t know IR went along with low T and I also have (5) AI diseases. Reading this article, it makes sense. Despite GF, DF eating, working out 3-4 days a week, optimizing thyroid, leptin, and insulin, I cannot lose weight and my hair loss is terrifying. I just looked at my labs from 3 months ago, total and free testosterone are scraping the bottom of the ranges and SHBG is 300! Ding ding ding. Calling my doc in the morning!
I’m a 50-year-old gym owner, personal trainer and figure competitor. I had a full hysterectomy in 2011 and it was a complete success. In 2015, my body, my mood, and my energy level took a complete 180 and I found myself not being myself nor did I look anything like myself. I’ve gained about 20 lbs over the course of these last 3 years and it has been absolutely impossible to lose. I’ve no energy and I have no desire to workout although I thoroughly love working out in our gym.
I can’t use any creams or estrogen as cancer runs in my family. I think this is going to be a fantastic alternative for me. I’m doing injections and just started.
Two questions – how long before I see the effects of a .25 mg dose and can women get a prescription.
Thank you in advance for any answers I may receive and THANK YOU for sharing this information. It’s a great read with a plethora of information.
Dr Childs
Can you take progesterone 0.5% and testosterone 1% once a day as a bioidentical cream in the evenings? I have estrogen dominance and am treating insulin resistance with berberine and alpha lipoic acid as per your website. I have both creams and wondered if their application would be best. I am transitioning into menopause but I really want my ovaries to keep active and not schrivel up!
Thanks so much!
Hi Luana,
There really is no “set time” that hormones can or should be taken. I will often times change up how patients take their meds depending on several factors so it’s more about the individual.
Is it safe for a DES Daughter, 65 years old, to take testosterone? I have never taken any hormones or birth control pills. I have a multi nodule goiter but do not show out of range thyroid on any of the thyroid tests. I do take 10 mg lexapro which has alleviated anxiety/depression. I take no other medications.
Hi Ellen,
I’m not actually sure if DES would result in a contraindication to testosterone therapy, I can’t think of a reason why it would but it’s worth looking into further to make sure.
I am 49, female, have hypothyroidism that is well controlled by medication. Over the past few years, I have developed depression, insomnia, hair loss, fatigue. I recently had a total hysterectomy with bilateral salpingo-oophorectomy and Burch procedure. My libidio came to a screeching halt and I became intolerant of any activity. I slept 17 hours after sitting 4 hours listening to a band play.
My doctor has me on oral estrogen and at my request started me on testosterone injections. I felt like my old self within a few hours. I don’t have my libido back but hopefully, amounts can be adjusted. I’m overweight and despite trying to eat right and have a moderately active lifestyle,I gain weight easily. I believe I may be starting to have insulin resistance too. My A1C has been around 5. The thought of losing even 10 to 15 lbs is encouraging. I’m 5’9 and weigh 215 lbs. I have no appetite since the surgery. Eating 1200 Kcal has been easy. If I could break this cycle I may lose weight and decrease my insulin resistance. Thank you for explaining this so well!
holmeseryn@gmail.com
Hello Dr. Childs,
I am a 27 year old woman and I recently had bloodwork done and the results found that my testosterone is low. After reading your description of the symptoms of low testosterone, it all makes sense.
I have had issues the past few years gaining muscle and losing weight (I’m currently 15-20 lbs overweight). Despite the fact that I am exteremely active and health conscious. For years, I’ve worked out 5-6 days per week doing a combination of lifting and HIIT workouts in addition to training for triathalons. I also am eating healtheir than ever. I eat a whole foods diet and avoid processed sugars and carbs, gluten, and I eat minimal dairy. Yet, it seems that I cannot even lose a pound and I have poor muscle tone. In addition, I suffer from psoriasis.
I would very much like treatment, but I’m not sure where to go. My PCP is a very holistic doctor and when I inquired with her about testing my hormones she said it wouldn’t be of help…. Therefore, I turned to a physical medicine office offering “free” assessments. They are the ones who did the bloodwork that determind my testosterone to be low. However, they seem to be a bit gimmicky and I don’t trust them. They essentially have a salesman who is not a doctor talk to you about your results and their treatment is $200/month and not covered by insurance. Do you have a recommendation for doctors located near Columbus, OH? I am desperate!
Thanks,
Eryn
Hi Eryn,
Sorry but I do not know anyone in that area to recommend or I would!
I just got a full blood work up and received a diagnosis of “depleted” testosterone. I’m 48 years old and have some of the symptoms. My testosterone level was <12. I DO NOT want to do hormone pellet therapy for this. Also libido is not an issue for me as I am not sexually active. I’m hoping to lose weight (as I have become resistant to losing weight) and be able to sleep as I have wicked insomnia. Any recommendations on dosage for using a cream and where to apply? Thanks!
Hi Leah,
I can’t really give dosing specifics because that really depends on the person, but in terms of application, you can use it pretty much anywhere that won’t come into contact with others throughout the day. Inner thigh works well.
Hi, I am 35 year old female. My doctor just informed me my testosterone levels came back very low. She tested all other very extensive labs and all very normal. So she’s recommending potentially testosterone replacement to help with my symptoms.
Is this common in young very healthy females? I have two young children (1&3). Would it be safe to do treatment?
Thanks for any help!
Hi Kris,
I wouldn’t say it’s common but it certainly does happen. My patient sampling is somewhat biased, though, because I tend to only see people who have hormone issues.
Started testosterone gel, seven weeks, lots of hair falling out any suggestions?
Hi Donna,
You may be converting the testosterone to DHT which may be accelerating the hair loss.
Hi, thank you for your article. I am wondering about when in my cycle would be best to test for testosterone? Should I test around ovulation to see the peak? Or will that “peak” potentially put me in the “normal range” because normal range covers high and low levels in a cycle? In other words does the “normal range” change based on where you are in your cycle? (No one has ever taken my lab results and asked me what day of my cycle I’m on to help correctly interpret where the normal range should be.) Hope that makes sense!
Thanks for you input!
Hi Genica,
I usually test for it around the mid-luteal phase but only because that’s when I also test progesterone and estradiol. Otherwise, I don’t think it matters that much.
Hi there, I am 47 years old femal and my menopause panel came back with a testosterone level of 3, which my doctor said is low and should be between 7 and 48. She didn’t recommend I do anything about it because there might be unwanted side effects such as facial hair and balding. However, I have not been feeling well – very tired and moody. Does being on or off birth control pills affect the number. I was off my birth control pill (lo loestrin) for 2 weeks and 1 day when the test was run. Thank you for any help!
Hi Julie,
Most physicians are clueless when it comes to hormone replacement therapy so you will most likely need to see a specialist. There’s virtually no risk of the side effects you listed if therapy is done correctly.
Dr. Childs,
My total testosterone was 18 and free was 0.2. I am 30 year old female, and I am slightly nervous to start hormone replacement therapy. My doctor states they would start me on low dose cream, but I am unsure of the long term effects of me starting so young on therapy. I also have Hashimoto’s thyroiditis and my levels seem to be okay for now, but they continue to spiral every 6 weeks.
Do you think starting testosterone at my age will cause long term effects? I have tried supplementing with 10mg DHEA, but no change in levels when rechecked.
Thanks!
Hi Johnna,
Testosterone, if used correctly, doesn’t cause any negative long-term effects.
I am a 41-year-old woman who recently had all my hormones and labs drawn due to fatigue, weight gain, low libido, and acne. I’ve always eaten a healthy balanced diet of 1400-1600 calories and day and exercise 4-6 days a week (boot camp and one day dedicated to my long run of 7-10 miles). My labs showed the following (day 16 of my cycle): Testosterone 20.91, SHBG 48, Estradiol 89, Progesterone 12, DHEAS 289, Free Testosterone 0.293, vit D 42.5, HGA1c 5%, Insulin 7.8, TSH 0.69, Free t4 0.89, free t3 2.8, reverse t3 16, B12 473, ferritin 49. I was started on 0.75 gm of testosterone cream and retested in 6 weeks had had a saliva level of testosterone of 60. I also started taking 1000mg B12, 5000IU D3, Ashwagandha, and a Multi-vitamin. I also take Effexor XR 75mg/day for migraine prophylaxis. The provider increased my testosterone to 1gm/day. I am still having some fatigue and this cycle since my bump I had an acne breakout and night sweats. Also since my weight hasn’t budged I began a LCHF diet (healthy fats like olives, avocados, lots of veggies and nuts). I want to make sure I am not missing anything…any advice would be great!
Hi
I have taken hormone replacement for 4 years. One out of many symptoms I had when started, was hairloss. and that is the only symptom I have left. Total I lost 3/4 of my hair 🙁
I started up with testosterone gel (Testim), Estradiol, Progesteron, Pregnenolone, DHEA, Thyroid, Fludrocortisone and Medrol. Unfortunately I misunderstood the doctor, so instead of taking 0,2 ml, I took 2 ml for a period of 2 month!
I was advises to skip the testosterone for a while but every time I start up with a tiny amount, my hairloss seams worse. Then I skip again.
I still take the rest of the hormones including a bunch of vitamins and minerals, B-complex, B-12, C, D, E, Omega 3+7, selenium, zink and magnesium.
To prevent the hair, or trying to, I also take Finestaride.
All the blood tests looks good, except for the low testosterone.
The doctor honestly does not know what to do…..
Do you have any suggestions what I can do to ?
Best regards
Birgit
Thank you so much. I am 29 yr/old Female with Testosterone showing only 8. This is the only informative article for women I have found thus far in my research, and it wsa very clearly stated and well written.
Dr. Westin Childs,
Could you please recommend a doctor in the NYC Tri-State area who already ascribes to your theories and methods? It would be so much easier to go directly to someone who understands and agrees with you than to try to find a doctor and then try to convince/convert him or her to your way of thinking!
Thank you,
Dee
Rye, NY
Hi,
My Dr just prescribed me bio-identical HRT with Testosterone. They are sublingual tabs. I see you say that transdermal is best. Will the sublingual still work?
Thank you!!!
I have found it difficult to find information on women and testosterone so this article was very informative! Thank you! I had lab work done recently and my free testosterone and free testosterone weekly bound were both well below the normal range, my SHBG was close to the top and my total testosterone was at the very low end of normal. It sounds like I might benefit from treatment and it’s something I’m definitely going to look into! Thanks again for the great info!
Hi Dr. Childs,
About two weeks ago I started a compounded hormone cream that contained testosterone (50mg/ml stock solution 0.01ml. I am finding myself ANGRY…just seething in a person who is normally easy going. This does not seem like a large amount of testosterone (taken to GIVE me a libido) but is it a large amount? If I am not tolerating it, is there a lower dose or another way that might work better. Or am I just out of luck. What else for libido? 200mg progesterone (stopped the cream all together) and estradiol patch 0.025.
Hi Donna,
I would check out this post for more information about low libido: https://www.restartmed.com/low-sex-drive-women/
First I would like to thank you for writing these great articles on hormones!
As my blood tests revealed very low total testosterone, free testosterone not calculable and SHBG very high my physician prescribed me transdermal Testogel/ Androgel ( for men) 0,5 mg a day. She suggested I use it on my upper arms and shoulders like men do. But I’ve read that many women use it on inner thighs or lower belly. Supposedly to have more benefits for libido? My main goal would be to have more energy and more focus, libido would just be a nice bonus.
I’m interested in your thoughts…
Hi Lemand,
Women typically get a boost in libido if they apply their testosterone vaginally, but the prescription must be formulated to allow for that.
I’m pretty sure that’s exactly what I need testosterone level is low, my primary doctor doesn’t seem to care. Which makes me uncomfortable so I stopped seeing Dr. I currently have no Dr or gbyn. How can you help me?
I had lichen sclerosis in the vagina and towards the rectum and had surgery in July 2018 and it was removed. I couldn’t have sex because it was so painful also tender to touch.
My doctor has me on testosterone gel that I apply on my arm daily and I also use Intrarosa which is a vaginal insert and valisone cream. It seems these 3 combinations work together to keep it from coming back. I feel great with no side effects. Sex is great again. I feel good and everyone tells me I’m glowing. Can I stay on testosterone forever? It is a very low dose.
Thank so much for your Article.
I recently felt something was wrong with my hormones. I am a 38 year old female. Found out that my testosterone was not detectable.
My doctor said it’s just not something he treats and if I want I can talk to an endocrinologist. Neither him or my general doctor seem to think anything should be done. I just don’t understand the casual behavior from md’s. They clearly know nothing about this and make me feel like I am insane.
It’s nice to see that it’s not something that all doctor’s are afraid of touching.
Hi Debbie,
Yes, most people just assume doctors know everything about health but they couldn’t be more wrong when it comes to hormones. Doctors basically receive zero training in this field and yet patients tend to believe them when they make recommendations about hormone management. It’s the entire reason my blog and website exist!
Hello,
Two years ago I was loosing my hair. I’ve got some blood test that showed low testosterone levels, after taking birth control pill for 2 months the symptoms disappeared. Now two years later I’m experiencing the same symptoms again. I’m a 53 year old female with no period for 1 year. What do you recommend?
Hi Wilda,
Birth control pills only ever mask issues by shutting down the HPO axis. You need to start with a full hormone panel (off the birth control) to figure out which hormones may be contributing to your hair loss. You can also help get an idea as to what the issue is by looking at the pattern of hair loss you are experiencing.
I gain weight on testosterone pellets therapy. I do love all the other benefits but I hate the weight gain no matter what I do.
My Testosterone is (3. My PCP gave me today Birth control pill. what is your thought?
where do I get cream? Is there any risk of cancer on the cream?
I have been reading about pine pollen for low-t, your thoughts
Is there a way to boost testosterone production without using hrt? Once you’re on it as a woman in your late 30’s, do you use it forever?
Hi Maureen,
There are ways to naturally increase testosterone production for sure but they vary in effectiveness from person to person. In addition, pretty much no matter what, testosterone and other hormone production will fall as you age.
Dear Dr Child’s
I am 59 and over the past few years I have made several attempts at wearing an E patch and using a T gel. I had a hysterectomy at 55, still have ovaries. I use cytomel for my thyroid. Well each time I used the patch about a month then added in the T gel. I start out feeling great and then after a few weeks start having bad chest pain and weakness. After alot of googling my symptoms seem inline with a carditis type illness. After I stop, everything resolves in a few weeks. Before I started everything I had extensive heart tests showing no problems. Basically all my hormones are flatlined and I know I need them. Oh I have also had issues with mold but have been treating it and it’s fairly resolved. Do you have any idea what going on? Thank you Annie
Excellent reading. I have gone over lab work from 2021 and the weight I’ve gained is 20lbs since. There was no initial bad reading despite all these symptoms appearing – and the doctor was Integrative Medicine Practioner. I am just now going over my labs and finding out why I feel like Sh*t.
Hi Samantha,
Hormonal issues can be particularly difficult to diagnose because each person is so different.
dr i have all the symptoms, fatigue , hair falling, insomnia, low energy i cant loose this weight. i also have an itch without rash all over my body that no doctor knows what it is for 5 years now that i am still with the itch taking 1100 mg of gabapentin more or less daily. i take it every 8 hours and the gabapentin gets me sleepy and i can not even drive becausse i am scared of falling asleep to go see my grandkids but i had my uterus removed when i was 28 years old, i do have my ovaries. would that be a reason for all this? thanks
Hi Lourdes,
You’d want to get a comprehensive set of lab tests including hormones to see if you can find the cause. It should become apparent with the right tests.
I have been prescribed an oral compounded dissolving pill they are sending in the mail.
You said you do not recommend an oral testosterone treatment? I didn’t want to do the pellets.
My testosterone is 16 my biggest complaint is achy joints specifically in my feet and then my knees but not as bad. I am 52 active and do find it difficult to maintain muscle. Not diabetic 5’6 14lbs.
Would love your opinion here.
I only want to know one thing. How do I make you my doctor? lol
Hi Carrie,
I’m not seeing patients but if that ever changes I will send out an email to my mailing list!
I love all of your information and I definitely have low testosterone. I was wondering what vaginal testosterone you would recommend?
Hello!
55y/o female, total hysterectomy, total thyroidectomy. On estradiol patch .05, armour 3 grains. NP added 5mg testosterone gel (due to low lab values). Been using several weeks. No noticeable difference related to testosterone but I’m having high heart rate, anxious, can’t sleep thru night and wondering if the testosterone if affecting my thyroid levels. I’m researching but can’t find a connection. What are your thoughts?