Introduction
When most people think of testosterone, they associate it with men. However, testosterone imbalance in women is a common yet often overlooked issue that can significantly impact energy, metabolism, muscle strength, brain function, mood, and libido. Unlike estrogen and progesterone, which drop significantly at menopause, testosterone declines more gradually with age, making it an important hormone to monitor for long-term health.
Some women experience low testosterone, leading to fatigue, weight gain, loss of muscle mass, and reduced libido. Others struggle with high testosterone, which is commonly linked to polycystic ovary syndrome (PCOS) and symptoms such as acne, excess facial hair, and irregular menstrual cycles. Both high and low testosterone levels can disrupt a woman’s overall well-being and may contribute to other hormonal imbalances, metabolic issues, and even cardiovascular risks.
This article explores testosterone imbalance in women, examining the role of testosterone, the effects of both high and low levels, and natural ways to restore balance through diet, exercise, and lifestyle changes. For women experiencing significant symptoms of low testosterone, medical options such as testosterone replacement therapy (TRT) may also be considered.
What Does Testosterone Do in Women?
Testosterone is produced in the ovaries and adrenal glands and is also converted from DHEA (another androgen). Though it is often thought of as a “male hormone,” women need it for:
- Muscle strength and bone density – Supports lean muscle mass and helps prevent osteoporosis.
- Fat metabolism and weight management – Affects how the body stores fat and builds lean muscle.
- Energy and motivation – Plays a role in overall drive, productivity, and endurance.
- Cognitive function – Supports focus, memory, and mental clarity.
- Libido and sexual health – Essential for arousal, sexual response, and overall sexual well-being.
Testosterone, Libido, and Cholesterol: What Research Says
- Low testosterone is linked to reduced libido. Research published in The New England Journal of Medicine found that women with low testosterone experienced decreased sexual desire and lower sexual responsiveness (Davis et al., 2002). Another study in Menopause (2018) confirmed that testosterone therapy improved sexual function in postmenopausal women with hypoactive sexual desire disorder (HSDD) (Reed et al., 2018).
- Low testosterone may contribute to higher cholesterol levels. A study in The Journal of Clinical Endocrinology & Metabolism (2011) found that postmenopausal women with lower testosterone levels had higher total cholesterol and LDL (“bad”) cholesterol, increasing their risk of cardiovascular disease (El Khoudary et al., 2011).
These findings highlight why women experiencing low libido, fatigue, or rising cholesterol levels should consider testing their testosterone levels.
What Happens When Testosterone is Too Low?
Common Causes of Low Testosterone in Women
- Aging – Testosterone naturally declines with age, though not directly due to menopause.
- Chronic stress – Elevated cortisol can suppress testosterone production.
- Poor diet – Low intake of healthy fats and protein may reduce hormone production.
- Overtraining or lack of exercise – Too much endurance training can lower testosterone, while strength training supports it.
- Toxins and endocrine disruptors – Plastics (BPA), pesticides, and household chemicals can interfere with hormone balance. See our Free Toxin Free Guide [HERE]
- Insulin resistance – Blood sugar imbalances can contribute to hormone dysregulation.
Symptoms of Low Testosterone in Women
- Fatigue and low energy
- Reduced libido and difficulty with arousal
- Loss of muscle mass and strength
- Increased body fat, especially around the midsection
- Brain fog and trouble concentrating
- Mood swings, anxiety, or depression
- Thinning hair or brittle nails
- Poor sleep quality
- Increased cholesterol levels
How to Naturally Support Low Testosterone
- Strength training – Lifting weights stimulates testosterone production. Compound movements like squats and deadlifts are especially beneficial.
- Increase healthy fats – Testosterone is made from cholesterol. Consuming avocados, nuts, eggs, olive oil, and fatty fish supports hormone production.
- Optimize nutrient intake – Zinc, magnesium, and vitamin D are essential for testosterone production.
- Reduce stress – Chronic stress raises cortisol, which suppresses testosterone. Meditation, breathwork, and yoga can help.
- Eliminate toxins – Reduce exposure to BPA, processed foods, and synthetic chemicals found in beauty and cleaning products.
Medical Options: Should You Consider Testosterone Replacement?
For some women, lifestyle changes alone may not be enough. Testosterone replacement therapy (TRT) is available as a prescription and may help with severe symptoms. Options include:
- Topical creams or gels
- Pellets (implanted under the skin)
- Injections
Women considering TRT should work with a doctor who specializes in hormone balance to determine whether it’s appropriate.
What Happens When Testosterone is Too High?
Common Causes of High Testosterone in Women
- Polycystic Ovary Syndrome (PCOS) – The most common cause, often linked to insulin resistance. See our free guide [HERE]
- Insulin resistance and high blood sugar – Excess insulin stimulates the ovaries to produce more testosterone.
- Adrenal dysfunction – Chronic stress can lead to excess DHEA and testosterone.
- Obesity and metabolic syndrome – Excess fat tissue can disrupt hormone balance.
- Excessive testosterone supplementation – Overuse of testosterone therapy or certain supplements.
Symptoms of High Testosterone in Women
- Excess facial and body hair growth (hirsutism)
- Acne and oily skin
- Irregular or absent menstrual cycles
- Hair thinning or male-pattern baldness
- Deepened voice (in extreme cases)
- Increased muscle mass, especially in the upper body
- Mood swings, irritability, or aggression
- Weight gain, especially in the abdominal area
How to Naturally Lower High Testosterone
- Balance blood sugar – A low-carb, whole-food diet can help manage insulin resistance.
- Prioritize strength training over excessive cardio – Strength training improves insulin sensitivity.
- Drink spearmint tea – Studies show that spearmint tea can help lower excess androgens.
- Support liver detoxification – Eating cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts supports hormone metabolism.
- Reduce inflammation and improve gut health – A probiotic-rich diet with fiber can help restore hormonal balance.
Final Thoughts
Testosterone is essential for women’s health, influencing energy, metabolism, muscle strength, sexual function, and heart health. While lifestyle adjustments—including diet, exercise, and stress management—can be effective, some women may need to discuss testosterone replacement therapy with their doctor.
The key to hormone balance is understanding your body and making sustainable, long-term changes to support optimal health.
Want to check in on your other hormones – take our free quiz
Scientific References
Scientific References
- Low Testosterone and Libido
- Davis, S. R., et al. (2008). Testosterone for low libido in postmenopausal women not taking systemic estrogen therapy. New England Journal of Medicine, 359(19), 2005-2017. https://doi.org/10.1056/NEJMoa0707302
- Parish, S. J., & Simon, J. A. (2018). Sexual function in older women: Assessment and treatment. Menopause, 25(5), 513-527. https://doi.org/10.1097/GME.0000000000001079
- Testosterone and Cholesterol/Heart Health
- Laughlin, G. A., Barrett-Connor, E., & Kritz-Silverstein, D. (2000). Postmenopausal estrogen and androgen levels are related to cardiovascular risk factors and disease in women. The Journal of Clinical Endocrinology & Metabolism, 85(12), 4501-4507. https://doi.org/10.1210/jcem.85.12.7016
- Zhao, D., Guallar, E., Ouyang, P., et al. (2018). Endogenous sex hormones and incident cardiovascular disease in postmenopausal women. Journal of the American College of Cardiology, 71(22), 2555-2566. https://doi.org/10.1016/j.jacc.2018.02.077
- Testosterone and PCOS/Insulin Resistance
- Escobar-Morreale, H. F. (2018). Polycystic ovary syndrome: Definition, aetiology, diagnosis, and treatment. Nature Reviews Endocrinology, 14(5), 270-284. https://doi.org/10.1038/nrendo.2018.24
- Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774-800. https://doi.org/10.1210/edrv.18.6.0318
- Testosterone and Strength Training
- West, D. W., & Phillips, S. M. (2012). Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training. European Journal of Applied Physiology, 112(7), 2693-2702. https://doi.org/10.1007/s00421-011-2246-z
- Spearmint Tea and Reducing High Testosterone in Women
- Grant, P. (2010). Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. Phytotherapy Research, 24(2), 186-188. https://doi.org/10.1002/ptr.2900