Under testing Hormones – When it is appropriate to test women for testosterone - Hormone Therapy Center of America

Under testing Hormones – When it is appropriate to test women for testosterone

Women produce testosterone, just not as much as men. Testosterone should be calculated into the equation when dealing with hormonal disruptions and the application of hormone replacement therapy. It can help reduce some of the problems associated with muscle retention and sexual desire when used appropriately.


We just need to help women understand what testosterone does in the female body, so they receive proper treatment.


Testosterone’s Role in Women



The average testosterone range in a woman is 6 to 80 nanograms per deciliter. In contrast, men average between 240 and 915 nanograms per deciliter.


Many tests measure testosterone work on the acceptable range for men, without considering the natural levels for women. When testosterone is tested at the lower levels, it can help you get a broader picture of what a woman is going through on a hormonal basis.


According to accepted theory, the levels of testosterone in women can be cut in half by the time she is 40 years old. It can make specific health issues more exasperated such as anemiasexual drive, and reproduction. Some studies even link it to heart issuesmemory problems, and weight gain.


Although many of the symptoms of low testosterone are associated with low estrogen and several other diseases, it tends towards affecting sexual desire and sexual satisfaction to a higher degree. Women who experience low testosterone levels also have depressed moods, lethargy, and muscle weakness.


Medical News Today published this first paragraph on the page dealing with women and testosterone: “A woman’s testosterone levels naturally change throughout her life, her menstrual cycle, and even at different times of the day. A woman with low testosterone does not contain enough to help produce new blood cells, maintain sex drive, or boost levels of other reproductive hormones.”


Problems with Testing Testosterone in Women


Aside from the inherent bias in medicine for under testing women in general, many of the symptoms women exhibit from low testosterone are dismissed as stress, depression, or menopause. Older doctors, in particular, need to take care of this bias.


Fortunately, women are becoming better educated about their health needs and can insist on the correct test to properly diagnose them.


Testing for low testosterone in women should be done over a series of 8 to 20 days, especially if she is menstruating. The levels of hormones fluctuate daily and could be exceptionally low one day and appear normal the next. Once a baseline average can be established, the woman’s total plasma testosterone level should come in above 25 nanometers per deciliter if under the age of 50. If over the age of 50, that number decreases to 20 nanograms per deciliter.


Sometimes, testosterone may be too high, especially in the case of PCOS or cancer. These conditions alter the balance of hormones in the body, drawing testosterone’s ability to promote cellular growth.


While some women may be better educated on the need to test testosterone, other women may not understand this testing. Based on some of the information above, you should explain to your patients what testosterone does in the body, particularly for sexual desire, muscle maintenance, and bone health.


Some women may have an inherent bias against taking a male-dominated hormone to offset some of their symptoms. Some of the issues that may arise could be increased breast cancer and facial hair (add link HRT risks). Patients need to be assured that the proper level of testosterone replacement therapy is not enough to cause an overgrowth of facial hair, nor is it enough to produce overly bulky muscles, as seen in bodybuilders.   


Most of the research on breast cancer and HRT has been done on estrogens. Synthetic estrogen causes the highest number of breast cancer risks, while both testosterone and bioidentical estrogen do not.


The Consistency Debate


Certain types of HRT provides a consistent dose of hormones for a woman, eliminating the highs and lows that come with the menstrual cycle. Even though testosterone does fluctuate, it doesn’t to the extent estrogen and progesterone do. After menopause, this variance is even smaller.


The Associates for Women’s Medicine says this about testing for testosterone in women: “It affects the brain, bone and muscle mass, fat distribution, the vascular system, energy levels, genital tissues, and sexual functioning… Free testosterone also may be tested for a person who has a condition that can change SHBG levels, such as hyperthyroidism or some types of kidney diseases.”


Your patients will have learned from you that testosterone varies throughout the month, and that was the reason for having the extended testing to determine a baseline number. So, many women might wonder that if testosterone is supposed to fluctuate anyway, why are they now taking a consistent dose.


Women who take a consistent dose of testosterone feel more balanced and stable throughout the month. They can control their temperaments and moods better and faster than without testosterone.


Consistently taking the correct dosage of hormones that includes testosterone provides the body with a steady supply of the hormone designed to build tissues. This can be critically important for women who exercise and are looking to prevent bone loss. Consistent testosterone supplementation and regular exercise will help a woman build long, lean muscle and strong bones much faster than without.


Testosterone supplementation offsets some of the factors for women’s experience from fractures, hospitalization, and removal from their home, particularly bone strength and muscular strength. Not being physically strong enough to remain in the house or accomplish all daily tasks is one reason many women end up in personal care facilities.


Additionally, correct dosages of testosterone can increase weight loss in pre-menopausal women. Many women in their 40s experience difficulty losing weight, even with a proper diet and exercise routine. Balancing hormones, especially testosterone, can help negate some of the factors that encourage fat accumulation. Although not an appropriate use of the term, many women will understand that testosterone can help increase their metabolism. They know it helps increase the conversion of fat to energy, so they feel better, lose weight fast, and build muscle quicker.


How To Talk About HRT Testosterone with Women


We’re assuming that you spoke to your patient about testosterone, and they accept the idea that testosterone is necessary for women. Of course, it could also be combined with other forms of estrogen to provide a balanced end complete formula. And it is the fact that having a balanced and complete formula for hormone replacement offers the best possible results for a woman.


Now comes the hardest part of convincing a woman that she needs testosterone in her hormone replacement therapy: the stigma of taking a male hormone.


As you work with your patient, reassuring them that it is reasonable and standard for women to use testosterone to balance the estrogens they’re taking will go a long way to overcoming objections. You may need to review the information that proper dose testosterone HRT will not cause excess facial hair, large muscle growth, or a massive increase in sexual desire.


Remind them that testosterone is responsible for building healthy tissue and can help reduce the risks of osteoporosis and certain types of cancer. It can help increase their sex drive and sexual fulfillment during sex. Testosterone can help improve their memory, feelings of satisfaction and happiness, and sense of self-worth.


One thing you should never do with your patience is to push them into taking this hormone replacement therapy or trying to shame them into it. Patient compliance goes way down when they do not feel they are in charge of their own health. Aside from the patient simply leaving your care, the misuse of pharmaceuticals amongst dissatisfied patients is exceptionally high.




The correct dosage of bioidentical testosterone can help a woman who feels fatigued, lethargic, and with a low to nonexistent sex drive feel more like herself. As you test other hormones, include testosterone to help get a better idea of the different factors that may be involved when your patient feels poorly.


If low testosterone is discovered in your patient, help educate them on what testosterone does in the body, and why correct dosages of bioidentical testosterone can help then feel more like themselves faster.


With the proper mix of bioidentical hormone replacement, a woman can become vibrant and productive in her life. She can feel at peace and reduce many of the factors of diseases and other health issues that may emerge later in life. Helping her avoid cancer, broken bones, and debilitation from muscle losses are critical factors as to why you should encourage your patients to consider bioidentical hormone replacement therapy.