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Why women need testosterone too
When you hear “testosterone,” you probably think of men. Muscle-building. Aggression. Gym culture.
But here’s what nobody told you: women produce testosterone too. And when levels drop — which happens naturally in your 30s and accelerates in perimenopause — the symptoms are real, they’re disruptive, and most doctors never test for it.
Women have testosterone. More than you think.
Testosterone is the most abundant biologically active hormone in women. Yes, you read that right.
Women produce testosterone in their ovaries and adrenal glands. By midlife, women produce more testosterone than estrogen. It’s not a “male hormone” — it’s a human hormone.
The problem: testosterone levels in women start declining in their early 30s. By perimenopause (usually mid-40s), levels can drop by 50% or more. And nobody talks about it.
This is the same pattern you see with other hormones that get ignored until they crash. I wrote about what happens when progesterone drops at 35 — testosterone follows a similar trajectory, but with even less medical attention.
What testosterone does in women
Testosterone receptors are everywhere in the female body — brain, bones, muscles, skin, bladder, heart. When levels drop, you feel it across all of these systems.
Brain and mood
- Mental clarity and focus
- Motivation and drive
- Confidence and resilience
- Reduced anxiety and brain fog
A 2025 pilot study found that transdermal testosterone therapy improved both mood and libido in perimenopausal women — and mood improved to a similar degree as libido, suggesting testosterone has specific effects on emotional regulation beyond sexual health (Glynne et al., Arch Womens Ment Health, 2025 — https://pubmed.ncbi.nlm.nih.gov/39283522/).
This connects directly to the brain fog epidemic in midlife women. If you’re struggling to think straight after 40, testosterone might be the piece your doctor isn’t checking.
Energy and body composition
- Muscle maintenance and strength
- Fat distribution (especially around the midsection)
- Stamina and stress recovery
- Overall energy levels
Dr. Louise Newson, a leading menopause specialist, notes that testosterone “helps with muscle mass and bone strength, cardiovascular health, and overall energy levels and quality of sleep.”
A 2025 review from the European Society of Medicine confirmed that testosterone “positively affects brain, skin, bone, and vascular health in women” and improves mood, energy, and body composition.
Bone and heart health
- Bone density maintenance
- Cardiovascular protection
- Skin elasticity and collagen production
The 2024 IMS World Congress on menopause highlighted testosterone as an underutilized tool for protecting bone density during the perimenopausal transition — a time when fracture risk begins climbing (Simon et al., Climacteric, 2025 — https://pubmed.ncbi.nlm.nih.gov/39928407/).
Why your doctor probably doesn’t test for it
Here’s the frustrating part: standard blood panels for women check estrogen, progesterone, and thyroid. Testosterone is often skipped entirely.
Why? Three reasons:
It’s labeled a “male hormone.” Even in medical training, testosterone gets associated with men. Female testosterone levels are considered “normal” across a wide range — so low levels get missed.
There’s no FDA-approved testosterone product for women in the US. Doctors can prescribe it off-label (which is common and safe), but without an approved product, there’s no standardized dosing guideline.
Symptoms overlap with other conditions. Fatigue? Must be thyroid. Low mood? Must be depression. Weight gain? Must be diet. The actual cause — declining testosterone — never gets checked. I wrote about this exact problem in why normal blood work might be lying to you.
A 2025 study specifically addressed the gap in testosterone treatment for women, noting that low desire in perimenopausal and postmenopausal women is the only licensed indication — but emerging evidence suggests broader benefits that aren’t yet reflected in guidelines (Kling, Obstet Gynecol, 2025 — https://pubmed.ncbi.nlm.nih.gov/40706034/).
What you can do
1. Ask for a testosterone panel
Specifically request: total testosterone and free testosterone (SHBG-bound vs. bioavailable). Don’t accept “everything looks normal” without seeing the actual numbers.
2. Know the symptoms of low testosterone in women
- Unexplained fatigue
- Brain fog and poor concentration
- Low libido
- Loss of muscle tone despite exercise
- Mood changes, anxiety, irritability
- Weight gain around the midsection
If you’re in your late 30s or 40s and experiencing several of these, testosterone might be the missing piece.
3. Consider bioidentical testosterone therapy
If your levels are genuinely low, bioidentical testosterone therapy (cream or pellet) can make a significant difference. It’s prescribed off-label by hormone specialists and menopause clinics.
Important: this is not about taking bodybuilder doses. Women need much smaller amounts. A qualified hormone specialist will monitor your levels and adjust accordingly.
4. Support natural production
While you’re figuring out the medical side, these habits support healthy testosterone levels:
- Strength training — resistance exercise naturally supports hormone production. If you’re just starting, Creatine Monohydrate pairs well with strength training for muscle and energy support.
Creatine Monohydrate Powder — Supports muscle preservation after 40, cognitive function, and strength training. One of the most researched supplements available.
- Sleep — poor sleep tanks testosterone. Magnesium Glycinate can help with sleep quality, which directly supports hormone production.
Magnesium Glycinate with Zinc — Supports sleep quality, muscle cramps, and cortisol regulation. Zinc is essential for hormone production.
- Reduce chronic stress — cortisol and testosterone have an inverse relationship. I wrote about how intermittent fasting can crash your hormones — the same cortisol-testosterone dynamic applies.
The bottom line
Testosterone isn’t just for men. Women need it for energy, mood, muscle, bone health, and cognitive function. When levels drop — and they will, starting in your 30s — the symptoms are real and disruptive.
The good news: it’s fixable. Ask your doctor for a testosterone panel. Find a hormone specialist. Don’t accept “it’s just aging” as an answer.
Glynne S et al., Arch Womens Ment Health (2025) — https://pubmed.ncbi.nlm.nih.gov/39283522/ Gatenby C et al., Best Pract Res Clin Endocrinol Metab (2024) — https://pubmed.ncbi.nlm.nih.gov/38171939/ Kling JM, Obstet Gynecol (2025) — https://pubmed.ncbi.nlm.nih.gov/40706034/ Simon JA et al., Climacteric (2025) — https://pubmed.ncbi.nlm.nih.gov/39928407/
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Coming soon on Quiet Inflammation:
- The supplement timing mistake that wastes your money — May 26
- How gut inflammation shows up on your skin — May 29