Testosterone, Serum (Female)
Other names: TESTOSTERONE, TOTAL, MS, Testosterone, Total, LC/MS
Testosterone is a male sex hormone produced in a woman’s ovaries in small amounts as well. Combined with estrogen, the female sex hormone, testosterone helps with the growth, maintenance, and repair of a woman’s reproductive tissues, bone mass, and human behaviors.
The normal ranges of testosterone levels for females are:
| Age (in years) | Testosterone range (in nanograms per deciliter) |
| 10–11 | < 7–44 |
| 12–16 | < 7–75 |
| 17–18 | 20–75 |
| 19+ | 8–60 |
Resources:
- Hunter MH, et al. (2003). Evaluation and treatment of women with hirsutism.
aafp.org/afp/2003/0615/p2565.html
- Mayo Clinic Staff. (2017). Congenital adrenal hyperplasia: Overview.
mayoclinic.org/diseases-conditions/congenital-adrenal-hyperplasia/symptoms-causes/syc-20355205
- Mayo Clinic Staff. (2017). Polycystic ovary syndrome (PCOS): Symptoms and causes.
mayoclinic.org/diseases-conditions/pcos/symptoms-causes/dxc-20342150
- Sowers MF, et al. (2001). Testosterone concentrations in women aged 25-50 years: Associations with lifestyle, body composition, and ovarian status. DOI:
10.1093/aje/153.3.256
- Test ID: TTFB – testosterone, total, bioavailable, and free, serum. (n.d.).
mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83686
What does it mean if your Testosterone, Serum (Female) result is too high?
Symptoms of too much testosterone in females:
An imbalance of testosterone can have damaging effects on a woman’s health and sex drive.
Increased testosterone levels can cause symptoms that effect a woman’s physical appearance, such as:
- too much body hair, specifically facial hair
- balding
- acne
- enlarged clitoris
- decreased breast size
- deepening of the voice
- increased muscle mass
- irregular menstrual cycles
- low libido
- mood changes
- high testosterone can also cause infertility and obesity in some extreme cases.
Numerous diseases or disorders can cause hormonal changes in women. The most common causes of high testosterone levels in women are hirsutism, polycystic ovary syndrome, and congenital adrenal hyperplasia.
Hirsutism -- Hirsutism is a condition of unwanted, male-pattern hair growth in women.
Polycystic ovary syndrome (PCOS) -- Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age.
Congenital adrenal hyperplasia -- Congenital adrenal hyperplasia (CAH) is a group of inherited genetic disorders that affect the adrenal glands
Elevated testosterone levels in postmenopausal women:
Postmenopausal women may have higher testosterone levels because estrogen levels decline and the balance is skewed.
Elevated testosterone levels in postmenopausal women can be indicative of a variety of conditions. In addition to the above mentioned, here are some possible implications and causes for higher testosterone levels in postmenopausal women:
- Adrenal Gland Disorders: The adrenal glands, which are located above the kidneys, can produce excess testosterone. Conditions such as adrenal hyperplasia or adrenal tumors (benign or malignant) can result in elevated testosterone.
- Ovarian Tumors: Ovarian tumors, particularly those that are androgen-secreting, can lead to increased levels of testosterone.
- Medications: Some drugs, including certain hormone therapies or steroids, can raise testosterone levels.
- Insulin Resistance: Elevated testosterone can be associated with insulin resistance, a condition where the body's cells become less responsive to insulin. This is a risk factor for diabetes and is also related to metabolic syndrome.
Lowering elevated testosterone levels involves addressing the underlying cause of the elevation.
Treatments may include:
→ Lifestyle Changes: Adopting a healthy diet and regular exercise can help regulate hormones and improve insulin resistance, which can indirectly lower testosterone levels.
→ Medications: Depending on the cause, medications can be prescribed to lower testosterone levels. For instance, if insulin resistance is a factor, metformin may be used. Anti-androgen medications, such as spironolactone, can also be effective.
→ Hormone Therapy: In some cases, estrogen therapy may help to counteract the effects of high testosterone.
→ Manage Underlying Conditions: If a woman has PCOS, management of this condition can help reduce testosterone levels. This might include the use of birth control pills, which are sometimes prescribed even for postmenopausal women to regulate hormones.
→ Surgery: If the high testosterone level is due to a tumor on the ovaries or adrenal glands, surgery may be required to remove it.
→ Avoid Certain Medications and Supplements: Some over-the-counter supplements and medications can increase testosterone levels, so it's important to review all current medications with a healthcare provider.
→ Stress Reduction: High stress can lead to an increase in certain hormones, including testosterone. Stress reduction techniques such as meditation, yoga, and other relaxation exercises may be beneficial.
→ Limit Alcohol and Caffeine: These substances can affect hormone levels and should be consumed in moderation.
It's crucial for any woman experiencing elevated testosterone levels to work closely with a healthcare provider to identify the cause and develop an appropriate treatment plan. Self-treatment is not advised due to the complex nature of hormonal regulation and the potential for serious underlying conditions.
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What does it mean if your Testosterone, Serum (Female) result is too low?
Like estrogen and progesterone, testosterone normally declines with age. However, because women make testosterone in the ovaries and the adrenal glands, a low level of testosterone could indicate a problem with the function of either organ. Estrogen replacement therapy can also lower the level of testosterone.
If your testosterone level is low for your age and menstrual status, then you could be experiencing symptoms of low testosterone including:
- Decreased libido
- Muscle weakness
- Fatigue
- Depressed mood
- Weight gain
Testosterone also has some health-protective roles after menopause and low levels can increase some areas of health risk including:
- Bone loss/osteoporosis
- Muscle wasting/sarcopenia
- Obesity
- Depression
- Heart disease
Potential ways to increase testosterone:
There may also be some ways to boost testosterone naturally, including:
- eating a more balanced diet focused on fresh foods
- avoiding overeating
- avoiding obesity
- doing regular exercise
- getting plenty of sleep each night
Some foods can boost testosterone because they are high in certain vitamins or minerals, such as vitamin D or zinc, which are associated with increasing testosterone. The following foods can boost testosterone levels:
- Asparagus
- Beans (white/kidney/black)
- Pomegranate juice
Depending on your age, consider testosterone HRT or supplements that support low testosterone symptoms include Zinc, Maca, Tribulus, and Shatavari. If there are no symptoms of low testosterone, also carefully look at the 5a-metabolism and testosterone's downstream metabolites, 5a-androstanediol and 5b-androstanediol to confirm a low androgenic state.
If you are of Asian descent:
There is a very common genetic variant in this population that, if present, disallows much of testosterone from being converted into the water-soluble form found in urine. Actual testosterone levels, if this genetic variant is present, would be better assessed in a blood serum test (ideally total and free testosterone). This variant metabolism has no known clinical impact and impacts testosterone, 5a-DHT and 5b-androstanediol. It is not known to impact epi-testosterone, 5a-androstanediol or ther androgens as they are metabolized by a different enzyme.
If your testosterone level is very low (less than 1 ng per mg):
Androgens (DHEA and testosterone) in women help with muscle and weight maintenance, memory and brain function, mood, libido and a sense of wellbeing. If testosterone is very low, or low but without symptoms of androgen deficiency, it is best to test serum levels to confirm before starting a treatment program due to the potential of falsely low urinary testosterone. Lifestyle and diet modifications alone could be helpful to increase androgens such as:
- weightlifting
- high intensity interval training
- DHEA or TRT (testosterone replacement therapy) if appropriate and indicated.
- Tribulus, shatavari, maca
- Mitochondrial support and/or zinc
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