Testosterone Testing for Women: Should You Consider It?

Written by: Amy Harris, MS, RN, CNM

Testosterone (T) is often thought of as a male hormone, but it plays a crucial role in women's health too. Both people with testes and with ovaries produce testosterone, a type of chemical messenger. Women have lower testosterone levels than men, and women's testosterone levels fall even lower at the time of menopause (when women stop having periods). Researchers believe that testosterone may play a role in women's energy, muscle strength, mood, libido, and bone density.^{1, 2}

In this article, we'll explore testosterone testing for women, including:

 
• How testosterone contributes to women's health and well-being
 
• How and when to test your testosterone
 
• Signs and symptoms of low and high testosterone in women
 
• The possible causes of either high or low testosterone in women
 
• Whether or not to test your testosterone levels

You can take control of your own well-being and sexual health once you better understand testosterone testing options and when it might be good to get tested.

How Does Testosterone Play a Role in Women's Health and Well-Being?

Testosterone contributes to women's health, even though women produce much smaller amounts of testosterone compared to men. Your ovaries produce about half of your body's testosterone. Although estrogen is the dominant female hormone, testosterone also contributes to:^1,2,3,4

 
• Muscle mass and strength – Prevents muscle loss and supports metabolism
 
• Menstrual cycles and female fertility
 
• Energy and strength – Helps maintain stamina and reduce fatigue
 
• Libido and sexual function – Boosts sex drive, ability to orgasm, and sexual satisfaction
 
• Mood and mental clarity – Reduces depression and brain fog
 
• Bone health – Helps prevent osteoporosis (a disease causing thin and weak bones)

Testosterone may be especially important as women age by:

 
• Helping their bones stay strong and less likely to break (measured as bone density)
 
• Allowing them to continue a healthy and satisfying sex life
 
• Enjoying an improved mood and sense of well-being

Testosterone levels that are outside of the normal range for a person's age (either too low or too high) can sometimes cause unpleasant symptoms or health problems. Testosterone testing for women can help you rule out any serious medical conditions causing abnormally high or low testosterone levels.

Did You Know That There Are Two Types of Testosterone?

You can test your testosterone levels with a blood test, either a finger-prick or drawn from a vein. These tests can be done at a healthcare provider's office, at a laboratory or clinic, or with an at-home testosterone test.

When considering testosterone testing for women, it helps to know that you have two types of testosterone in your body and that there are different tests for each. The first test measures your total testosterone (TT):⁵

 
• Includes all testosterone in your body
 
• Measures testosterone that is bound to proteins such as sex hormone-binding globulin (SHBG) and albumin and free testosterone

When comparing total testosterone vs. free testosterone, free testosterone plays a bigger role in how you actually feel.

Free testosterone (FT) is:⁶

 
• Unbound and available for your body to use
 
• The "active" testosterone that influences muscles, libido, sexual function, and energy
 
• Makes up only a tiny fraction of total testosterone in your body (1-2%)

If you are not in menopause (meaning you no longer have periods), do not have primary ovarian insufficiency (when your ovaries stop working the way they should before the age of 40), or have not had your ovaries surgically removed, your testosterone levels can fall within the broad range of 15-70 nanograms per deciliter (ng/dL).⁷

Choosing the Right T Tests for Women

Unfortunately, the tests for measuring testosterone are not perfect, and your healthcare provider might order several types of tests. The type of test may depend upon:

 
• The symptoms you are experiencing and how they are impacting your quality of life
 
• Your age and menopausal status
 
• What other medications you are taking
 
• What other medical conditions you have

Some of the tests commonly ordered for evaluating a woman's testosterone status include:^5,6

 
• Total Testosterone Test – Measures the overall amount of testosterone in your blood
 
• Free Testosterone Test – Measures the active, unbound testosterone that your body can use
 
• Sex Hormone-Binding Globulin (SHBG) Test – Determines how much testosterone is bound and unavailable

When Is the Best Time to Test for the Most Accurate T Levels?

The changes in your testosterone levels can complicate the testing, depending on the time of day and where you are in your menstrual cycle (if you still have them). For the most accurate results, follow these tips:^7,8,9,10

 
• For premenopausal women (people still having monthly periods) and/or those being tested to determine fertility or other medical conditions such as polycystic ovarian syndrome (PCOS): Test on days 3-5 of your menstrual cycle, between 7-10 in the morning when testosterone hormone levels are highest. Other hormones related to fertility such as follicle stimulating hormone (FSH) and estradiol vary over the course of your menstrual cycle and are typically tested in the first 3-5 days after your last normal menstrual period.
 
• For postmenopausal women or those no longer having periods: Test any day of the month, but still between 7-10 in the morning.
 
• Wait at least 3 months after stopping hormonal contraception of any type (including progestin-coated IUDs such as Mirena®) or menopause hormone therapy (MHT) for the most accurate results. The added hormones from your birth control or hormone therapy can suppress your body's own production of testosterone, making tests inaccurate.

What Symptoms Can Low Testosterone Cause In Women?

Not everyone with low testosterone symptoms will experience the same symptoms, and some people don't have any symptoms at all, even if their test results show that they have low testosterone levels. Most health care providers do not diagnose low testosterone because research has not been able to identify a clear link between actual testosterone levels and specific symptoms.¹

It can also be hard to diagnose a testosterone deficiency because other conditions, such as thyroid issues, depression, or nutrient imbalances, can cause many of the same symptoms.¹

Nevertheless, some common symptoms of low testosterone women report are:^1,10

 
• Fatigue (feeling tired all of the time) and low energy
 
• Low libido, difficulty with orgasms, lack of sexual satisfaction
 
• Vaginal dryness and/or pain with intercourse
 
• Muscle weakness and loss of muscle tone
 
• Depression or anxiety
 
• Infertility or trouble conceiving
 
• Irregular menstrual cycle
 
• Thinning hair
 
• Dry, brittle skin
 
• Trouble sleeping

After reading this list, you may notice that many of these symptoms can be interrelated. If you have trouble sleeping for months on end, you are at greater risk for depression and anxiety, and might not be all that excited about having sex. It is also true that you may have some or all of these symptoms, but your testosterone (T, FT, SHBG) levels could still fall within normal ranges.

This is why it is important to review your symptoms with a healthcare provider and then discuss what your testosterone test results mean for you, before trying to boost testosterone naturally or testosterone replacement therapy. You can consult with a healthcare provider in person at a health center or clinic or at home online through a Women's Health Virtual Visit, like Everlywell offers.

What Can Cause Low Testosterone Levels in Women?

From the long list below, you can see that there are many possible diagnoses for why your testosterone levels could be low, such as:¹

 
• Aging, perimenopause, and menopause
 
• Polycystic Ovarian Syndrome (PCOS)
 
• Having your ovaries removed (an oophorectomy)
 
• Chemotherapy and/or radiation
 
• Hyperprolactinemia (too much of the hormone prolactin)
 
• Turner syndrome (a genetic condition where your ovaries don't develop)
 
• A tumor on your pituitary gland
 
• Adrenal insufficiency (Addison's disease)
 
• Malnutrition (as an eating disorder might cause)
 
• Hypothalamic amenorrhea (loss of your menstrual period from extreme stress, weight loss, or exercise)
 
• Premature menopause (menopause before 40 years old)
 
• Taking hormonal birth control pills

Healthcare providers will use what symptoms you are experiencing to guide their treatment decisions.

What Symptoms Do Women With High Testosterone Experience?

Women report various symptoms if they have high T levels depending on their age, what medications they are taking, and any other medical conditions they may have. Some commonly reported side effects of excess testosterone include:¹⁰

 
• Excess hair on your face and body – Usually on the face, chest, or genital areas in women
 
• Acne and oily skin
 
• Irregular periods or missed cycles
 
• Infertility
 
• A deepened voice
 
• Hair thinning or balding on your scalp – Hair loss similar to male pattern baldness
 
• An enlarged clitoris (part of your genitals, located above your vagina, surrounded by your vulva)

If not recognized and treated, some of these changes may be permanent, such as changes in your voice or the size of your clitoris. It is important to be under the supervision of a healthcare provider who can monitor for side effects and test your T levels to make sure you do not have unsafe levels of testosterone, as can sometimes happen with testosterone replacement therapy.¹¹

Possible Causes of High Testosterone Levels in Women

Research shows that PCOS is the most common cause of women having high testosterone levels, but some of the other reasons for high testosterone levels in women are:^11,12

 
• Taking too much testosterone replacement therapy, using excessive testosterone supplements, or anabolic steroids
 
• Tumors or disorders of the adrenal gland
 
• Tumors on the ovary
 
• Genetic disorders or tumors of the adrenal glands
 
• A tumor on your pituitary gland (called Cushing's Disorder)
 
• Taking medications to prevent seizures (anti-epileptics)

Final Thoughts: Should Women Get Their Testosterone Levels Tested?

The biggest takeaway from this post is that if you are not experiencing any unpleasant symptoms and are in good health, then you do not need to have your testosterone tested.

You might want to talk to a healthcare provider about whether testosterone testing is for you if:

 
• You have symptoms (especially one or more from the symptom lists above).
 
• You have not been able to get pregnant.
 
• You are in the menopause transition.

Testosterone plays a crucial role in women's fertility, sexual health, and wellness, as well as potentially influencing long-term health. Ongoing research continues to explore what role testosterone plays in diseases such as osteoporosis, heart disease, obesity, dementia, and Type 2 diabetes.¹³ As more research is done on testosterone's role in women's health, you may want to consider testosterone testing.

If you're a woman experiencing symptoms of hormone imbalance, testing testosterone could help you get a clearer picture of your hormonal health and put you back on the path towards feeling more like yourself.

 
1. Scott A, Newson L. Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care. Br J Gen Pract. 2020;70(693):203-204. doi:10.3399/bjgp20X709265 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098529/
2. Cleveland Clinic. Low Testosterone In Women: Causes, Symptoms, and Treatment. Updated April 12, 2023. Accessed March 9, 2025. https://my.clevelandclinic.org/health/diseases/24897-low-testosterone-in-women
 
3. Islam RM, Bell RJ, Green S, et al. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754-766. doi: 10.1016/S2213-8587(19)30189-5. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30189-5/fulltext
 
4. Dratva MA, Banks SJ, Panizzon MS, Galasko D, Sundermann EE; Alzheimer's Disease Neuroimaging Initiative. Low testosterone levels relate to poorer cognitive function in women in an APOE-ε4-dependant manner. Biol Sex Differ. 2024;15(1):45. Published 2024 Jun 5. doi:10.1186/s13293-024-00620-4 https://bsd.biomedcentral.com/articles/10.1186/s13293-024-00620-4
 
5. LabCorp. Understanding Total Testosterone vs. Free Testosterone. Published May 30, 2024. Accessed March 10, 2025. https://www.ondemand.labcorp.com/blog/total-testosterone-vs-free-testosterone
 
6. Krakowsky Y, Grober ED. Testosterone Deficiency - Establishing A Biochemical Diagnosis. EJIFCC. 2015;26(2):105-113. Published 2015 Mar 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739343/
 
7. LabCorp. Testosterone, Total, Women, Children, and Hypogonadal Men. Accessed March 8, 2025. https://www.labcorp.com/tests/070001/testosterone-total-women-children-and-hypogonadal-men
 
8. Teede H, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility. 2023;120(4): 767 - 793. https://pubmed.ncbi.nlm.nih.gov/37580314/
 
9. Infertility Workup for the Women's Health Specialist: ACOG Committee Opinion, Number 781. Obstet Gynecol. 2019;133(6):e377-e384. doi:10.1097/AOG.0000000000003271 https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/06/infertility-workup-for-the-womens-health-specialist
 
10. Sharma A, Welt CK. Practical Approach to Hyperandrogenism in Women. Med Clin North Am. 2021;105(6):1099-1116. doi:10.1016/j.mcna.2021.06.008 https://pubmed.ncbi.nlm.nih.gov/34688417/
 
11. Vegunta S, et al. Androgen Therapy in Women. Journal of Women's Health. 2020;29(1):57-64. doi:10.1089/jwh.2018.7494. https://www.liebertpub.com/doi/10.1089/jwh.2018.7494
 
12. Cleveland Clinic. Hyperandrogenism. Updated January 23, 2023. Accessed March 9, 2025. https://my.clevelandclinic.org/health/diseases/24639-hyperandrogenism
 
13. Leinonen JT, Mars N, Lehtonen LE, et al. Genetic analyses implicate complex links between Adult testosterone levels and health and disease. Commun Med (Lond). 2023;3(1):4. Published 2023 Jan 18. doi:10.1038/s43856-022-00226-0 https://www.nature.com/articles/s43856-022-00226-0