Normal female testosterone levels by age

Testosterone is a hormone responsible for male sex characteristics, sperm creation, and fertility. “The main function of testosterone is to control sex drive and sexual response, but it also plays a key role in the development and function of the reproductive organs, bones, heart, brain, and liver,” says Bruce Dorr, MD, an OB-GYN based in Littleton, Colorado, and senior medical advisor at Biote.

Both males and females produce testosterone in their bodies.

“While many think that testosterone is a male-only hormone, it has a functionality for women too,” says Kecia Gaither, MD, an OB-GYN in private practice and director of perinatal services and maternal-fetal medicine at NYC Health + Hospitals in Bronx, New York. “It is important for libido, bone health, and production of hematologic parameters like red blood cells. It also can impact mood.”

Over time, it’s normal for testosterone to fluctuate with age. “In men, testosterone peaks at age 20 and declines 1% to 2% every year after that,” Dr. Dorr explains. “Women similarly experience reduced testosterone, and by the time a woman reaches 40, testosterone blood levels will have declined by about 50%.”

Like other hormone types, there’s a chance that someone can have abnormal testosterone levels. According to Dr. Gaither, high levels of testosterone in females may indicate polycystic ovary syndrome (PCOS), adrenal tumors, ovarian tumors, or hermaphroditism (having both female and male sex organs).

Normal female testosterone levels by age

As mentioned, hormone levels, including testosterone, change as people age. Testosterone levels typically decrease as people get older, and this can lead to a “loss of production from the ovaries and adrenal glands in women and mainly the testes in men,” Dr. Dorr says.

Testosterone levels are measured and reported as nanograms per deciliter (ng/dL). Dr. Gaither says that the normal testosterone levels for women are typically between 9-55 ng/dL.

Below is a chart representing the normal range for female testosterone levels by age and ng/dL. 

*Source: Mayo Clinic Laboratories 

High testosterone in women

It’s important to note that for people assigned female at birth (AFAB), there’s no exact number for determining high testosterone levels, also known as hyperandrogenism.

“There are no established optimal testosterone levels for women, so most clinicians use a lab reference range to diagnose a woman with high testosterone,” Dr. Dorr says. “The lab ranges, however, can vary greatly from highs of 40 to 120 ng/dl.”

Aside from the available clinical references, high testosterone levels in women are often associated with certain medical conditions, such as the following:

• PCOS: A hormonal imbalance that occurs when the ovaries produce too much testosterone
• Congenital adrenal hyperplasia (CAH): Genetic changes that cause a shortage in adrenal gland enzymes, producing excess testosterone
• Ovarian tumors: These are testosterone-producing tumors that can produce too much testosterone
• Adrenal tumors: Rare tumors that can make excess testosterone, estrogen, or both sex hormones 

Symptoms of high testosterone in women

If a woman has too much testosterone in her body, she may begin to notice changes to her physical appearance. 

Dr. Gaither mentions the following as potential signs and symptoms of high testosterone:

• Cliteromegaly (enlarged clitoris)
• Acne
• Balding at the front of the hairline
• Hirsutism (excess body and facial hair)
• Increased muscle mass
• Deeper voice
• Reduction in breast size
• Weight gain

Many women with high testosterone levels will have irregular menses or no period at all. However, research reveals that some premenopausal women with high testosterone levels may be asymptomatic, meaning they never experience symptoms.

Treatment for high testosterone in females

If a woman is experiencing symptoms of too much testosterone, it’s best to seek treatment to find the underlying cause. Medical, natural, or a combination of both types of treatment may help regulate testosterone levels.

Medical treatments for high testosterone

A healthcare provider can develop a treatment plan that aims to lower ovarian or adrenal androgen production. 

Possible medical treatments for high testosterone in women may involve:

• Low-dose corticosteroids (for adrenal hyperandrogenism)
• Surgery (to remove ovarian or adrenal tumors)
• If medications are causing high testosterone levels, stopping the medication or starting a different one
• Oral contraceptives or birth control pills to treat acne, hirsutism, and irregular periods
• Spironolactone for hormonal acne and excess female body hair
• Cyproterone to treat PCOS and reduce testosterone levels

Natural remedies for high testosterone levels

Aside from medical treatment, there are lifestyle changes women can make to help lower their testosterone levels. 

Managing high levels of testosterone in a woman may include:

• Obtain and sustain a healthy weight, which can be helpful for women diagnosed with PCOS or who have fertility problems or irregular menstrual cycles.
• Eat a healthy, balanced diet to improve PCOS symptoms.
• Manage hirsutism by removing or covering unwanted hair.
• Cleanse the face regularly for acne or oily skin.

Low testosterone in women

Like high testosterone, there’s no definitive range as to what is considered low testosterone, or hypogonadism, in women. “Lab reference ranges are most often used when treating older menopausal women—so these ranges skew toward lower levels,” Dr. Dorr explains.

Aging plays a crucial role in the development of low testosterone or testosterone deficiency in women. “By the time a woman reaches 40, testosterone blood levels have declined significantly,” Dr. Dorr says. 

Menopause, which occurs as a woman ages, can lead to a lower amount of testosterone produced by the ovaries. Menopause is often the reason why women experience a change in their sex drive.

“Since testosterone plays a key role in a woman’s sexual response by increasing blood flow to the genitals as well as nerve sensitivity, this decline negatively impacts libido, responsiveness, and orgasm,” Dr. Dorr says.

Aside from aging and menopause, certain medical conditions and medicines may lead to a decrease in testosterone for women, such as: 

• Oophorectomy (surgical removal of the ovaries)
• Adrenalectomy (surgical removal of the adrenal glands)
• Adrenal disease
• Pituitary disease
• HIV infection
• Premature ovarian failure
• Turner’s syndrome
• High-dose corticosteroids 
• Certain estrogen preparations

Symptoms of low testosterone in women

According to Dr. Gaither, the symptoms of low testosterone levels in women include:

• Vaginal dryness
• Hot flashes
• Night sweats
• Fatigue 
• Dry skin
• Mood changes
• Hair thinning
• Muscle weakness 

While it’s known that many men with low T levels can be asymptomatic, the effects of low testosterone in women are not as well studied. 

Treatment for low testosterone in females

Here’s a look at medical and non-medical treatments for low testosterone in females. 

Medical treatments for low testosterone

In regard to therapies for women with low T levels, there’s very limited research on the topic. There are currently no Food and Drug Administration (FDA)-approved testosterone medical treatments for women. Yet, more than 30 FDA-approved therapies exist for men in the United States.

Despite the lack of targeted therapies for women with low testosterone, they have one option that may increase their levels. Hormone replacement therapy (HRT) is often the first-line treatment for low testosterone levels in women. Hormone replacement therapy  provides women with hormones that are typically lost or reduced during menopause. 

Typically, HRT supplements estrogen and progesterone (female hormones), but certain therapies can also deliver testosterone.

According to research, testosterone replacement in women may:

• Improve sexual function
• Increase brain function
• Increase bone density
• Improve urogenital (urinary and genital organs), psychological, and pain-related symptoms 

Dr. Dorr shares that HRT is available in pills, creams, gels, injectables, and pellets.

HRT isn’t right for everyone. There may be extra risks for women with cardiovascular or liver disease, or certain types of cancer. Your healthcare provider can help determine the best approach.

Natural remedies for low testosterone levels

While testosterone replacement therapy may provide better results in improving testosterone levels, some may want to know how to treat low testosterone in a woman naturally. It’s important to mention that some methods are similar to those mentioned for high testosterone treatment.

According to Dr. Gaither, certain nutrients, such as vitamin B, zinc, omega-3 fatty acids, magnesium, and protein, can naturally boost testosterone.

Other non-medical methods for increasing testosterone levels include:

• Maintain a healthy body mass index (BMI).
• Take measures to prevent diabetes. 
• Engage in a combination of aerobic and resistance exercises. 
• Get enough sleep. 
• Avoid tobacco products and excessive alcohol consumption.
• Avoid environmental toxins, such as bisphenol A (BPA), phthalates, and organophosphates.
• Keep stress levels down.
• Adopt a healthy diet that includes fruits, vegetables, nuts, fiber, ground flax seed, soy products, and green tea.

A healthcare provider can provide additional support on medical treatments and natural methods based on a person’s unique health problems.

How to test testosterone levels

To measure testosterone levels, a woman can have a testosterone blood test.

“Testosterone levels can be ascertained by a simple blood draw and sent to a laboratory for analysis,” Dr. Gaither says.

A healthcare provider, such as a primary care physician, OB-GYN, or endocrinologist, can  order a blood test for testosterone. There are at-home testing kits available online, but the results are best discussed with a healthcare provider.

Types of testosterone tests

There are three types of testosterone tests: total testosterone, free testosterone, and bioavailable testosterone:

• Total testosterone is the most commonly used blood test. 
• Free testosterone measures “active testosterone.” It is a less common test but helps diagnose certain health conditions.
• A bioavailable testosterone test measures free testosterone and testosterone attached to albumin, a type of blood protein. Like the free testosterone test, healthcare providers don’t use this test often, but it may help diagnose certain health conditions.

To prepare for a testosterone test, a healthcare provider may recommend fasting several hours before getting the blood sample. 

In some instances, insurance may fully or partially cover the costs of in-person or at-home testosterone testing. An individual can speak with their insurance provider to determine if testosterone testing is covered in their health plan.

The cost of at-home testosterone testing kits varies, with costs ranging from $50 to $200. 

Bottom line: Abnormal testosterone levels in women require medical care

It’s okay for testosterone levels to fluctuate for women in different stages of life. While there’s a clinical reference on “healthy” levels of testosterone, there’s no established information on the optimal range to diagnose abnormal levels in women.

Like men, women can also experience high or low testosterone. High or low T levels in women may indicate an underlying medical condition, such as hirsutism, PCOS, tumors, or CAH. 

If a woman has symptoms of high or low testosterone, it’s recommended that she visit a healthcare provider to get further testing and a diagnosis. Normal levels of testosterone may be achievable with hormone therapy and lifestyle adjustments.