Sex Hormones: Uncovering the Truth About Low Testosterone In Women

The importance of testosterone, “the male sex hormone” is often overlooked in women. When physical and mental health issues arise, most women do not question whether it could be related to low testosterone. However, testosterone level plays as much of a role in women’s health as it does men’s.

Testosterone Plays a Role in the Following:

• Sexual health – sex drive, sexual satisfaction, genital arousal, ability to orgasm, and overall ability to enjoy sex
• Muscle mass
• Fat distribution and storage
• Bone density
• Strength
• Fertility
• Menstrual cycles
• Energy levels
• Menopausal symptoms – hot flashes, night sweats, mood changes
• Skin health
• Vaginal health – vaginal dryness
• Mental health
• Red blood cell production

Unfortunately, symptoms of low testosterone (low T) are mimicked in other health conditions such as hypothyroidism, iron deficiency, and depression. Often doctors will look for other causes of these symptoms and overlook potential hormone imbalances. Many women get treated for conditions they may not have due to symptoms of low testosterone. In many cases, the symptoms they are experiencing do not go away because the real issue, low testosterone, has not been addressed.

Effects of Low Testosterone

Due to an abundance of misconceptions, the importance of testosterone in women’s health has been consistently overlooked. Young women’s ovaries produce 3-4 times more testosterone than estrogen daily¹. Testosterone is also the most abundantly biologically active sex hormone in the female body throughout a woman’s life. Low testosterone in women is a very real and very important health issue that needs to be addressed.

Sexual Dysfunction

One of the more common consequences of low T in women is overall sexual dysfunction. Low T affects almost every area of sexual health including but not limited to, libido, ability to climax, vaginal dryness, genital arousal, ability to enjoy sex, and in some cases infertility.

Chronic Inflammatory Conditions

Low T is also associated with the development of chronic inflammatory conditions, such as metabolic syndrome (a precursor to type 2 diabetes), cardiovascular diseases, and overall increased mortality risk². People with metabolic syndrome have dysregulated insulin production and control which results in increased fat storage, especially around the midsection. In the setting of chronic inflammation, the joints become stiff and painful as the cartilage, bones, tendons, and ligaments are continuously being damaged. Chronic inflammation can also affect the skin. It can give the appearance of puffy, inflamed skin and can cause redness and acne.

Brain Health

Brain health and function are also affected by low T. Women with low T may experience an increase in beta-amyloid. A protein that produces plaque buildup in the brain causing brain cells to die and often leading to brain atrophy³. An increase in beta-amyloid can also cause decreased brain cell glucose metabolism and a reduction in blood flow to the brain. The most common consequence of these brain function issues is the development and progression of Alzheimer’s Disease.

Bone Density

Another major complication of low testosterone, especially in women, is reduced bone density. Women experience significantly higher losses in bone density than men. Around 30 years of age female bone density begins to decline⁴ – male bone density does not begin to decline until age 50. It is estimated that within the first 5 years after menopause, women lose an average of 10% of their bone density. Testosterone plays a key role in the development of osteoblasts – cells that aid in bone growth. A study of 1,058 post-menopausal women found a positive correlation between low testosterone levels and low bone density⁵. Women with low T have a much higher risk of developing osteoporosis than women who have higher testosterone.

Testosterone Killers

Studies have found that 1 in 10 women suffer from low testosterone⁶. Unfortunately, because testosterone is commonly regarded as a male hormone, millions of individuals with undiagnosed low testosterone could benefit from lifestyle changes to boost their levels. Key factors that influence testosterone levels include diet, alcohol consumption, and physical inactivity.

Diet

Diet plays a significant role in hormone production and regulation. Consuming processed foods, sugar, and ultra-processed seed oils can negatively impact testosterone levels. Prioritizing a diet rich in whole foods as well as healthy animal-based fats is essential. Healthy fats provide a large proportion of bioavailable essential nutrients.

Cholesterol, while often demonized and wildly misunderstood⁷ is a vital nutrient found in animal-based foods. Cholesterol is a building block for testosterone. Women with higher levels of HDL (high-density lipoprotein) cholesterol and low triglycerides were found to have healthier testosterone levels. A study of women with protein-fat malnutrition found that women who ate low-protein and low-fat diets were much more likely to experience hypogonadotropic hypogonadism⁸ – a condition in which the body is not signaling the ovaries to make testosterone resulting in low T. Women need to consume sufficient protein, healthy fats, and minimal ultra-processed foods to maintain optimal testosterone levels.

Alcohol

The significant factor for alcohol and testosterone levels is the dosage. A low to moderate intake of alcohol⁹ (1-7 drinks per week) has not been linked to a significant reduction of testosterone or impaired testosterone production. The problems arise in heavy drinkers (8 or more drinks per week) and alcoholism. Alcohol is well known to lower testosterone in women within 30 minutes of the first drink¹⁰. Chronic consumption of alcohol will keep these levels consistently low.

Sedentary Lifestyle

One of the biggest factors in hormone regulation is physical activity. Although the biomechanics are not completely understood yet, it is well known that lean muscle mass triggers the production of testosterone. Women with a sedentary lifestyle are more likely to have low muscle mass and/or obesity which causes dysregulated hormone production and hormone imbalance. Inactivity also reduces the body’s ability to lower and control insulin levels, especially after eating, which can lead to type 2 diabetes. Women with type 2 diabetes often have an imbalance in the testosterone-to-estrogen ratio¹¹ leading to sexual dysfunction, infertility, polycystic ovary syndrome (PCOS), and heavy, painful, and dysregulated menstrual cycles.

The Truth About Low Testosterone In Women

Low testosterone in women often goes undiagnosed because it is commonly classified as a male sex hormone. If you’re noticing signs of low testosterone, it might be time to consider lifestyle changes to boost your levels. Start by incorporating daily walks and weight-based exercises into your routine. As you become more physically active, take the time to assess and improve your diet as well.

Try to eat meals that consist of single-ingredient foods (meat, vegetables, and fruit). Avoid sugar and processed foods and add healthy animal-based fats to your meals. If you drink, work on being more cognisant of the amount you are consuming. Aim to drink one less drink per week until you are at a low to moderate consumption rate.

It is very important that women, like men, get their testosterone levels checked if they are experiencing any of the common symptoms associated with low T. Just like men, a woman’s testosterone level declines with age, especially after menopause. It is common for women who have had their ovaries removed or have lost ovarian function (often due to chemotherapy) to have low testosterone levels. 50% of testosterone is made in the ovaries, due to this, women who have had their ovaries removed may need to get bioavailable testosterone therapy along with making lifestyle changes to support increased testosterone production.