Testosterone in Women - The Hormone Nobody Tests in Women — And Why That’s a Mistake

By Jill | Precision Health

There’s a pattern I see all the time in my practice. A woman comes in describing a slow fade — her workouts don’t build muscle like they used to, her libido has quietly disappeared, she feels flat instead of motivated, and she’s chalked it all up to “just getting older.” Her primary care labs check estrogen, maybe progesterone, maybe thyroid. Testosterone? Almost never.

And yet testosterone is the most abundant biologically active hormone in a woman’s body — more abundant than estrogen. We’ve just spent decades treating it like a footnote.

The Gap: Conventional Medicine Still Treats Testosterone as a “Men’s Hormone”

For years, testosterone in women was discussed almost exclusively in the context of one narrow diagnosis: hypoactive sexual desire disorder, and only in postmenopausal women. That’s where most guidelines still draw the line.

But the research conversation has moved. A 2025 review in Climacteric makes the point directly: testosterone’s role extends well beyond sexuality into muscle strength, bone integrity, energy balance, mood, and overall vitality — not just desire (Glynne et al., Climacteric, November 2025).

This is the gap we live in at Precision Health: the science is expanding faster than the standard of care is catching up.

What the Newest Research Actually Shows

Testosterone declines steadily with age — not because of menopause. A large 2025 analysis of more than 8,000 women aged 40–69, part of the Australian Women’s Midlife Years Study, found that testosterone concentrations decline gradually from around age 40, reaching their lowest point in the late 50s, with no sudden drop tied to menopause itself (Davis et al., eBioMedicine, October 2025). In other words, this isn’t a “menopause symptom” — it’s a slow, age-related shift that’s been happening for years before menopause is even on your radar.

Higher testosterone has been linked to stronger bones and more lean mass. Earlier work from the Cardiovascular Health Study found that older women with higher free testosterone had greater bone mineral density, more lean body mass, and more total fat mass — a combination that matters enormously for healthy aging (Rariy et al., Journal of Clinical Endocrinology & Metabolism, 2011).

Mood and cognitive symptoms may respond to treatment in some women. A 2025 pilot study on transdermal testosterone therapy in peri- and postmenopausal women found measurable effects on mood and cognitive symptoms (Glynne et al., Archives of Women’s Mental Health, 2025).

Where We Have to Be Honest About the “Normal Range” Problem

Here’s the part of this story that matters as much as the exciting findings: not everyone agrees on what to do with this information yet, and we think that’s actually useful to know.

At the 2025 Menopause Society annual meeting, researchers presenting a data-driven review of the literature cautioned that, as of now, there isn’t consistent trial evidence that testosterone therapy prevents muscle loss, protects bone, or improves mood and cognition across the board. Much of the encouraging data — including the bone and lean mass findings above — comes from observational studies, meaning we can see that women with naturally higher testosterone tend to have better outcomes, without yet proving that giving testosterone to someone with lower levels reproduces that benefit.

We tell you this not to deflate the conversation, but because it’s exactly the kind of nuance that gets lost when a topic goes viral. The honest version is more useful than the hyped version: testosterone is clearly connected to muscle, bone, mood, and energy in women. What’s still being worked out is exactly who benefits from supplementation, at what dose, and for how long.

Why This Still Matters for You

Even with that caveat, here’s what we think conventional care gets wrong: most women never even get the baseline information. If your testosterone has never been measured, you have no idea where you fall on that decline curve that starts in your 40s — or whether your fatigue, body composition changes, or low motivation might be connected to it.

You can’t have an informed conversation about a hormone you’ve never had measured.

What We Do Differently at Precision Health

When you come in for a hormone evaluation, testosterone is part of the picture — not an afterthought. We look at where your levels sit relative to your age and your symptoms, not just whether you fall somewhere inside a wide reference range built largely from data on men.

If your levels are notably low and your symptoms line up — persistent fatigue, loss of muscle tone despite consistent training, low libido, flat mood — we’ll talk through the real, current evidence on options, including where the data is strong and where it’s still developing. This is a collaborative decision, not a prescription pad reflex.

The Bigger Picture: Healthspan, Not Just Symptom Relief

This is really a story about healthspan. Muscle mass and bone density aren’t just “fitness” metrics — they’re two of the strongest predictors of how independently and energetically you’ll move through your 60s, 70s, and beyond. A hormone that’s even associated with both deserves a place in a proactive longevity conversation, long before you’re dealing with a fracture or a frailty diagnosis.

The Bottom Line

Testosterone in women is not a niche topic, and it’s not just about libido. It’s connected to your muscle, your bones, your mood, and your energy — and it quietly declines for decades before anyone thinks to check it. The research isn’t finished, and we won’t pretend it is. But “we don’t have all the answers yet” is very different from “don’t bother asking the question.” At Precision Health, we’d rather you have the data and an honest conversation about it than no data at all.

Curious where your levels stand?

and let’s find out what your body is actually telling us.

Sources

Glynne S, Kamal A, Kamel AM, et al. “Testosterone in women: beyond hypoactive sexual desire.” Climacteric, November 2025.

Glynne S, Kamal A, Kamel AM, et al. “Effect of transdermal testosterone therapy on mood and cognitive symptoms in peri- and postmenopausal women: a pilot study.” Archives of Women’s Mental Health, 2025;28(3):541–550.

Davis SR, et al. “Testosterone and pre-androgens by age and menopausal stage at midlife: findings from a cross-sectional study.” eBioMedicine, October 2025.

Rariy CM, Ratcliffe SJ, Weinstein R, et al. “Higher serum free testosterone concentration in older women is associated with greater bone mineral density, lean body mass, and total fat mass: the Cardiovascular Health Study.” Journal of Clinical Endocrinology & Metabolism, 2011;96(4):989–996.

Davis SR. Presentation, The Menopause Society 2025 Annual Meeting (as reported by AJMC).