Key takeaways
Testosterone is a normal hormone for women, and healthy testosterone levels shift with age.
Several types of blood tests can show how well your body makes and uses testosterone.
Both high and low testosterone can be treated.
Testosterone is a typically male sex hormone (androgen). Females use this naturally made hormone for healthy growth and reproduction, but in far smaller quantities than males. It’s normal for testosterone levels to change throughout a woman’s life, but having too much or too little can lead to health and reproductive issues. Blood tests can diagnose low or high testosterone in women, and both conditions are treatable.
What are normal testosterone levels in women?
A premenopausal adult woman typically has 8–60 nanograms per deciliter (ng/dL) of total testosterone. After menopause, a woman’s total testosterone usually falls between 7 and 40 ng/dL.
The “normal” range can vary slightly based on the laboratory processing your blood test. For example, LabCorp’s reference range for total testosterone in a premenopausal woman is 10–55 ng/dL, while Mayo Clinic Laboratories considers 8–60 ng/dL to be a normal range.
Total testosterone can also vary based on the time of day of your blood draw. It tends to be highest in the morning, so this is the ideal time to schedule blood work or perform an at-home test. Drawing testosterone between 8–10 a.m. after fasting for 12 hours is best.
Once you have the results of your testosterone test, talk to a healthcare provider for an accurate interpretation and recommended next steps.
Normal total testosterone levels by age for females
Female babies are born with a relatively high amount of total testosterone (20–80 ng/dL). By around 6 months of age, total testosterone drops to 20 ng/dL or less. It slowly increases again throughout childhood and puberty, peaking at about 20–75 ng/dL at the age of 17 or 18.
Total testosterone levels then fall to about 8–60 ng/dL around age 19. They’ll stay within this range throughout the reproductive years. Once a woman is in menopause (one year after her last menstrual period), her total testosterone often stays within a slightly narrower range of 7–40 ng/dL. This decline is much more subtle than the steep drop in estrogen women experience after menopause.
Testosterone levels by age chart for women |
||
|---|---|---|
| Age/life stage | Total testosterone range (ng/dL) | Notes |
| Childhood (prepubescent) | <7–20 | Very low; levels rise during puberty |
| Puberty/teens | <7–75 | Rises as the ovaries and adrenal glands become active |
| 20–49 (pre-menopause) | 8–60 | Typically highest in adult women |
| 50s+ (postmenopause) | 7–40 | Lower range; ovarian production decreases |
Women go through menopause at different ages. A postmenopausal woman typically has lower total testosterone than a pre-menopausal or perimenopausal woman of the same age. Testosterone levels may also drop about 25% more in women who have had their ovaries surgically removed.
Certain lifestyle factors, like recent physical activity or fasting, can also influence testosterone levels in women. Discuss your results with a healthcare provider to learn if your testosterone levels seem normal or healthy based on your medical history.
Free testosterone levels by age in women
Total testosterone measures all of the testosterone in your body. Most of this testosterone is already bound to proteins. Testosterone that isn’t bound to anything is called free testosterone. It is readily available for the body to use in supporting energy, muscle mass, bone density, mood, libido, and more.
Measuring free testosterone gives your healthcare provider better insight into your supply of usable testosterone. If you have very little free testosterone, you may experience symptoms of low testosterone despite having a normal amount of total testosterone.
Free testosterone levels in women tend to peak in early adulthood, then gradually decline starting around age 30. They’ll continue to decline for the rest of a woman’s life.
“By age 40, women have already decreased their testosterone by half, and that decline continues at a rate of 1% to 3% per year until around age 70,” says Bruce Dorr, MD, URPS, FACOG, IFM-CP, an OB-GYN and senior medical adviser at Biote.
“For some women, the drop is even more pronounced, accelerated by factors such as stress, trauma, surgery, pregnancy, or genetics. This can lead to a wide range of symptoms.”
Normal free testosterone levels by age chart for women |
||
|---|---|---|
| Age range | Free testosterone (ng/dL) | Notes |
| 18–29 | 0.06–1.08 | Typically highest in adult women |
| 30–39 | 0.06–1.03 | Gradual decline from the peak |
| 40–49 | 0.06–0.98 | Continued decline, perimenopause range |
| 50+ (postmenopause) | 0.06–0.92 | Lowest adult range, continues to decline with age |
What causes low testosterone in women?
Some laboratories flag total testosterone below about 7–8 ng/dL or free testosterone below 0.06 ng/dL as low. However, there is no universally accepted testosterone cutoff for diagnosing testosterone deficiency in women, so healthcare providers also consider symptoms, medical history, and other hormone levels.
Having surgery to remove your ovaries (called an oophorectomy) can cause low testosterone because the ovaries produce a substantial portion of a woman’s testosterone before menopause.
Several other conditions can cause low testosterone in women, such as:
- Chemotherapy or radiation
- Anorexia or malnutrition
- A tumor on the pituitary gland
- Too much of a hormone called prolactin
- Too little of hormones like cortisol and aldosterone (Addison’s disease)
- Undeveloped ovaries (Turner syndrome) or ovaries that stop working before the normal mid-life menopausal transition
Some medications can cause women to have low testosterone, including:
- Corticosteroids
- Opioids
- Hormone-based contraceptives
Symptoms of low testosterone in women may include:
- Low sex drive
- Fatigue
- Loss of muscle tone and strength
- Increased fat around the midsection
- Trouble conceiving
- Irregular periods
- Vaginal dryness
- Thinning hair
- Sleep problems
- Dry skin
- Depression or anxiety
- Brain fog
- Difficulty concentrating
- Memory problems
What causes high testosterone in women?
High testosterone in women is a form of hyperandrogenism, which means having excess androgen hormones. It can be caused by several conditions, but 80% to 90% of women with hyperandrogenism have polyendocrine metabolic ovarian syndrome (PMOS), formerly called polycystic ovary syndrome (PCOS).
“High testosterone might stem from a problem in how the body converts testosterone to estrogen through an enzyme called aromatase. That’s what we see in PMOS,” says Dr. Dorr.
Cushing’s disease, adrenal gland problems, certain types of tumors, seizure medications, synthetic progestins, and certain types of steroids can also trigger hyperandrogenism.
Common symptoms include:
- Irregular periods
- Trouble conceiving
- Oily skin
- Acne
- Excess body hair (hirsutism)
- Male pattern baldness
Untreated hyperandrogenism may increase the risk of chronic conditions, including Type 2 diabetes and heart disease. Fortunately, high testosterone is treatable.
How is testosterone tested in women?
Testosterone is usually tested through a blood sample. A phlebotomist (blood draw expert) usually takes a blood sample through a vein in the arm. It’s processed by a lab, and the results are sent to you and the ordering healthcare provider.
There are also some at-home testosterone tests. These involve collecting a saliva sample or using a sterile lancet included with the kit to obtain a small blood sample. At-home tests may be less accurate than clinic tests because of the method used to analyze the blood or saliva sample.
To get a complete picture of your testosterone levels, your healthcare provider can order several related tests:
- Total testosterone: Measures all the testosterone in your blood, including both bound and free testosterone.
- Free testosterone: Only measures the testosterone that isn’t bound with anything and is available for the body to use.
- Sex hormone binding globulin (SHBG): Measures the amount of SHBG in your blood, which is a protein that attaches to testosterone. If you produce too much SHBG, it could cause low levels of free testosterone.
“When a patient’s total testosterone looks normal, but she feels exhausted or notices her libido has dropped, I look at all three together (total, free, and SHBG) rather than any one in isolation,” Dr. Dorr says. Exhaustion and libido have many other causes. If the testosterone labs are normal, then your provider may widen the differential diagnosis and look for another cause.
To get accurate results, you may need to avoid certain things before giving a blood sample. Ask your healthcare provider if it’s okay to exercise, eat, or take medication before your appointment. Make sure the appointment is scheduled before 10 a.m. to catch testosterone at its highest level.
How is abnormal testosterone treated in women?
Treating abnormal testosterone in women depends on whether testosterone is high or low.
Treatment for low testosterone in women
The U.S. Food and Drug Administration (FDA) hasn’t approved any testosterone therapies for women. Testosterone injections, pills, patches, pellets, gels, and creams are FDA approved in the U.S. for men. These medications are made for men at much higher doses than what women require.
Although a healthcare provider may prescribe testosterone off-label for women, treatment is generally considered only for carefully selected patients, such as postmenopausal women with hypoactive sexual desire disorder. Because there is no FDA-approved female formulation or dosage, treatment requires careful dosing and regular monitoring.
“When the decline is simply part of aging, the goal is to restore what the body has lost. Standard hormone replacement therapy often replaces estrogen and progesterone [after menopause] while overlooking testosterone, even though a woman’s testosterone begins declining years prior,” says Dr. Dorr.
“Adding testosterone back can make a real difference. In my experience, and in the research, it may improve urogenital, psychological, and physical symptoms, may support bone density, and may help with cognitive performance. Many patients also notice improvements in mood, concentration, motivation, and energy.”
You can also talk to your healthcare provider about supplements and natural remedies for increasing testosterone. One option is an over-the-counter pill called DHEA, which the body can use to make more testosterone. Your healthcare provider can check the DHEA levels in your blood to see if you need more of this building block.
Lifestyle factors, like exercising and getting restful sleep, may also boost testosterone naturally.
Treatment for high testosterone in women
Treatment for high testosterone in women varies based on the underlying cause and the most concerning symptoms. Depending on the cause, treatment may include:
Your healthcare provider may also recommend symptom-specific treatments, like medications to help regulate periods or control acne and hair growth. Additional diagnostic tests may be needed to pinpoint the cause before treatment begins.
Expert takeaway
Leslie Greenberg, MD, is a Menopause Society Certified Practitioner and member of the SingleCare Medical Review Board. She notes that postmenopausal women who are optimized on estrogen and progesterone, who continue to have hypoactive sexual desire disorder and lower testosterone levels, may benefit from transdermal testosterone replacement. This can be done carefully with a comprehensive evaluation and supervision.
Frequently asked questions
What should female testosterone levels be?
A typical total testosterone reference range for adult women is about 8–60 ng/dL, although ranges vary by laboratory and menopausal status. LabCorp lists 10–55 ng/dL for pre-menopausal women and 7–40 ng/dL for postmenopausal women.
Why would a female have high testosterone levels?
The most common cause of hyperandrogenism in women is polyendocrine metabolic ovarian syndrome (PMOS). Other conditions, such as Cushing’s disease and adrenal disorders, can also cause high testosterone.
How can a female lower their testosterone levels?
Treatment depends on the underlying cause and may include medications that lower testosterone or reduce its effects. A healthcare provider can recommend the appropriate treatment after identifying the cause of the hormone imbalance.
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