What is Free Testosterone?
Free testosterone refers to the small portion of total testosterone in your blood that is not bound to proteins like sex hormone–binding globulin (SHBG) or albumin. Because it’s “free,” this fraction is biologically active — it can enter cells and activate androgen receptors to carry out testosterone’s functions.
In women, testosterone is produced in small amounts by the ovaries, adrenal glands, and through the peripheral conversion of other hormones. Even though testosterone is often considered a “male hormone,” it plays essential roles in female health, including:
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Supporting bone density and muscle strength
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Maintaining libido and sexual response
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Contributing to mood stability and cognitive function
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Helping with energy balance and overall vitality
Why Measure Free Testosterone?
Measuring free testosterone is often more informative than measuring total testosterone alone. This is because protein levels (especially SHBG) can fluctuate due to age, medications, thyroid status, weight changes, and other hormonal shifts.
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Normal total testosterone + low free testosterone can happen if SHBG is high.
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Low total testosterone + normal free testosterone can occur if SHBG is low.
For women, testing free testosterone can help investigate:
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Menstrual irregularities
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Symptoms of excess androgens (e.g., acne, unwanted hair growth, hair thinning on scalp)
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Low libido, fatigue, or low muscle tone
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Suspected polycystic ovary syndrome (PCOS)
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Hormonal changes during perimenopause or menopause
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Effects of hormone therapy
Reference Range – LifeLabs
LifeLabs provides its own method-specific reference ranges for free testosterone in females. Your report might show results in pg/dL or pmol/L, but the reference interval and cut-off for “normal” depend on the laboratory’s calibration.
For example, a lab might list:
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Reference interval: 0.7 – 2.0 pg/dL
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Or Less than: 30 pmol/L
Because LifeLabs uses its own validated method, ranges may not match those found in other labs or online charts. Always interpret your result in the context of the range shown on your report.
What Does a Low Free Testosterone Mean in Women?
Low free testosterone in females can be due to:
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Natural aging (especially after menopause)
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Ovarian insufficiency or surgical removal of ovaries
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Pituitary or adrenal disorders
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Chronic illness or inflammation
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Certain medications (e.g., oral estrogens, glucocorticoids, anti-androgen drugs)
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High SHBG levels (often linked to high estrogen, hyperthyroidism, or certain medications)
Possible symptoms of low free testosterone:
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Low sexual desire
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Decreased muscle mass and strength
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Reduced bone density
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Fatigue
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Low mood or cognitive fog
What Does a High Free Testosterone Mean in Women?
High free testosterone levels in females may be caused by:
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Polycystic ovary syndrome (PCOS)
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Ovarian or adrenal androgen-secreting tumors (rare)
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Late-onset congenital adrenal hyperplasia (CAH)
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Low SHBG (seen in insulin resistance, obesity, or hypothyroidism)
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Use of testosterone or other androgenic medications/supplements
Possible symptoms of high free testosterone:
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Excess facial or body hair (hirsutism)
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Acne and oily skin
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Scalp hair thinning (androgenic alopecia)
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Irregular or absent menstrual cycles
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Fertility difficulties
How to Support Healthy Free Testosterone Levels
Maintaining balanced free testosterone involves addressing underlying causes rather than chasing a “perfect” number. Strategies may include:
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For low levels: Address nutritional deficiencies, manage stress, maintain a healthy weight, and discuss hormone therapy options with your healthcare provider if symptoms are significant.
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For high levels: Manage insulin resistance, reduce refined carbohydrate intake, support weight balance, and treat underlying hormonal conditions like PCOS.
Key Takeaway
Free testosterone is the active fraction of testosterone in a woman’s blood and can provide valuable insight into hormonal health. LifeLabs uses its own testing method and reference ranges, so interpretation should always be done with your healthcare provider, considering symptoms, medical history, and other lab results.
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