When you think of “women,” estrogen is probably the hormone that comes to mind. Androgens, such as testosterone, are also vital for women’s health and wellbeing. Low testosterone is an increasing problem for women.
Plenty of studies document a 10 to 20 percent decline in testosterone among men, but studies in women are surprisingly scarce. Nevertheless, anecdotal reports show that low testosterone is an increasing problem for women that affects well-being, metabolic function, libido, and body composition.
There are several theories for the decline in testosterone, but one thing we know is that chronic stress is a contributing factor. This imbalance leads to negative physiological changes that harm both physical and mental health.
What Does Testosterone Do In Women?
Although women’s levels are generally about 10 percent of men’s, testosterone affects many physiological systems in the female body:
Protects The Heart
Testosterone affects the health of the heart, enhancing the production of nitric oxide that allows for relaxation of the blood vessels. Testosterone also influences cardiac output and strengthens cardiac muscle. If you have low testosterone, your heart will have to work harder to pump blood to working muscle. Testosterone also inhibits plaque development that leads to heart disease and affects potassium and calcium channels, lowering risk of high blood pressure.
Supports Cognition & Mood
Along with estrogen, testosterone has anti-inflammatory and protective effects on the brain. Research is lacking but studies show that testosterone has a protective effect against Alzheimer’s disease by reducing the accumulation of amyloid beta “plaques” within the brain that lead to memory loss. Testosterone also accelerates nerve regeneration, which may improve memory and executive function in the aging brain. One study found that older women taking testosterone gel for 26 weeks showed significant improvement in verbal learning and memory.
Testosterone plays a vital role in bone repair and growth. Lower testosterone is one reason women tend to have weaker bone density than men and are at much higher risk of osteoporosis. Studies show there are testosterone receptors present in the cells that form new bone. Low testosterone levels in women have been linked with increased risk of vertebral and hip fractures. Conversely, higher free testosterone levels in postmenopausal women have been associated with lower hip fracture risk.
Better Body Composition
Testosterone stimulates protein synthesis to maintain muscle and lean mass. Women who undergo testosterone replacement have improved lean body mass and muscle performance. Studies show the effects are dose-dependent, with women on supraphysiologic doses having the most improvement. However raising testosterone levels beyond natural physiological levels in not recommended due to lack of research and the likelihood of side effects including hair loss and the development of male sex characteristics.
Supports Metabolic Health
Testosterone improves insulin sensitivity and regulation of blood sugar. It also has a beneficial role in liver function and stimulates the gastrointestinal tract for better digestion and detoxification.
Protects Breast Tissue
When balanced, testosterone protects breast tissue from the development of cancer. Testosterone enables apoptosis (programmed cell death) of cancerous breast tissue and is antiproliferative, inhibiting breast cancer growth.
Supports Sexual Health
Low testosterone in women is linked with poor sexual function. Testosterone replacement can improve sexual function in women with decreased sexual desire, especially after menopause. Testosterone may also help with several symptoms of menopause, including genitourinary syndrome.
What Causes Low Testosterone In Women?
Many factors contribute to low testosterone in women. Stress and poor lifestyle habits, such as lack of sleep, poor diet, and lack of exercise may be the greatest contributing factor affecting the most women, especially young women who have not entered menopause yet.
Other factors include chronic dieting, low energy intake, and excessive exercise. Use of medications including oral contraceptives, opioids, corticosteroids, anti-androgenic agents, and oral estrogen therapy are also associated with low testosterone. Chemotherapy, radiation, ovarian failure or removal of the ovaries can also contribute.
Age is a factor. Androgens begin declining starting at mid-30s, continuing throughout menopause. Whether testosterone levels will stabilize following menopause requires more research.
Lifestyle Strategies For Balancing Testosterone
One of the most effective ways to overcome low testosterone in women is with a stress management program. The adrenal glands are the source of about 25 percent of testosterone. Chronic stress and poor diet deplete the adrenals. Here are several lifestyle actions you can take to support the adrenals:
Solve Sleep Issues
Sleep deprivation triggers an increase in cortisol and sends blood sugar up, triggering a drop in testosterone. Whether it takes a sleep routine (set bedtime, grateful log, dim lights at night), supplementation (melatonin, magnesium), or sleeping according to your chronotype (natural tendency toward being a morning or evening person), solving sleep issues is your first line of defense for improving hormone balance.
Eat A Healthy Whole Foods Diet
Choosing a diet based on whole foods including meat, seafood, plants, eggs, and dairy will help balance blood sugar and insulin, setting the stage for equilibrium among your hormones. A healthy diet also provides the building blocks for testosterone production, providing cholesterol to synthesize steroid hormones along with other nutrients that will minimize aromatase and inflammation.
Meditation is your go-to habit for stress management because it can improve release of testosterone. Meditation also helps you handle difficult challenges better by shoring up mental and biological resources.
Supplement With Zinc, Magnesium & Vitamin D
Certain nutrients have a powerful impact on hormone balance. Zinc has a mild effect on aromatase, reducing the transfer of testosterone to estrogen.
Best known as the anti-stress mineral, magnesium has been shown to help overcome testosterone deficiency in men.
Vitamin D inhibits aromatase and enhances the sensitivity of cell receptors that release testosterone. Supplementation has been shown to overcome testosterone deficiency in men.
Train With Weights
Intense exercise triggers testosterone release in women and helps reset the body’s stress response. Instead of logging hours on a treadmill or elliptical, do strength training with heavier weights that target the whole body: Deadlifts, squats, lunges, presses, and rows should make up the majority of your workout.
Testing for Testosterone In Women
Measuring testosterone in women is complicated because blood levels do not correlate with the amount of testosterone that is active in peripheral tissues where testosterone exerts is action. Additionally, in order for testosterone to “work,” cell receptors need to be sensitive to testosterone in a similar way they have to be sensitive to insulin to be able to use glucose. When a woman has low testosterone levels, cell receptors lose sensitivity, making it harder for any circulating testosterone to exert its action.
Scientists recommend using liquid or gas chromatography and tandem mass spectrometry assays to reliably measure testosterone. Serum DHEA-S is the most reliable measure for testosterone in women.
Testosterone Replacement Considerations For Women
For some women, it’s possible that lifestyle actions, including exercise, stress management, and a healthy, nutrient-rich diet can help overcome low testosterone. For others, replacement therapy may be indicated. According to a review of the issue, short-term testosterone cream is the preferred method of testosterone delivery for women. As a general rule, women should avoid supraphysiologic dosing and should be prescribed a tenth of the recommend male dose—or less.