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Top 7 Reasons Why You Should Have Normal Testosterone Levels in Women

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Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical OfficerRead Bio
Written ByWinona Editorial Team

Testerone levels in women typically peak in their mid 20s and then fall steadily with age. Once you hit your 50s your testosterone levels are only about half of the levels you had in your 20s.1 These lower levels of testosterone are among the reasons why women can experience profound physical and mental changes during their menopause years. Since the ovaries produce most of the testosterone in women, surgery to remove the ovaries, called an oophorectomy, can cause an immediate and precipitous drop in testosterone levels. Replacement to normal testosterone levels in women can have profound positive effects.

Most people think of estrogen and progesterone as the main hormones responsible for symptoms of menopause, but falling testosterone levels are also important and often ignored. So, what are the Top 7 Reasons Why You Should Have Normal Testosterone Levels?

In women, normal testosterone levels are responsible for many important physiologic properties. Testosterone levels in women help drive lIbido, sexual response, orgasm, and overall sexual satisfaction.2 Testosterone also helps improve lean muscle mass; this added muscle can increase metabolic rate and helps with weight loss.3 Beyond the improvements in muscle mass, correcting low testosterone levels can improve energy and decrease fatigue.4,5 

Testosterone also helps with brain function by improving concentration, clarity of thought, and overall cognition.5 Testosterone improves bone health and may be breast protective.1,3,5 Finally, testosterone replacement to your normal youthful levels has an anti-aging component for skin, hair, and nails and has been shown to improve the overall quality of life and a general feeling of wellbeing.5

Benefits of Testosterone Replacement to Normal Levels in Women

  1. Testosterone Is Important for Sexual Wellbeing
    While decreased sex drive or libido can happen due to lots of reasons, when you are a woman over the age of 40  it is low testosterone levels that have been found to be a major risk factor for low libido.2 Studies have shown that by simply replacing testosterone with normal youthful levels, you can reverse that lost libido and return your normal sexual desire.

    Beyond just desiring sex more, low testosterone levels can reduce the size and sensitivity of your clitoris which can make it more difficult to reach orgasm or even lead to loss of orgasm potential. Replacing testosterone to normal levels can reverse these changes and you can once again regain the ability to achieve orgasm. 

    Women who replace testosterone levels to their youthful levels report increased overall sexual satisfaction and increased quality of life. Sexual satisfaction spills over to satisfaction in other areas of life. The most obvious being an improvement in your relationships with intimate significant others which can lead to an improved overall mood, an increase in positive self-image, decreased anxiety, and overall performance.

  2. Testosterone Is Important for Lean Muscle Mass
    Testosterone is important for increasing lean muscle mass.3  Lean muscles are muscles that do not have a lot of fat around or within them. You want to maintain your lean muscle because it will reduce the risk of injury to your ligaments and tendons, and will improve your posture by creating and supporting stronger core and back muscles. While it may sound strange, lean muscle also protects your bones from becoming weaker in later life by increasing bone density and strength.4

    If you are low on testosterone, you can exercise the same amount (or more) than another person and will see less improvement in lean muscle mass than a woman with normal testosterone.4 When you improve your body’s response to exercise by increasing testosterone, you will likely notice the benefits in the mirror or the way your clothes fit. That positive feedback will likely encourage you to exercise more. It is motivational to actually see the changes and you will likely stick to an exercise routine when results are apparent more quickly. Testosterone can help you get there.

    Because testosterone is responsible for increased muscle mass and leaner body mass, you can better control your weight and increase your energy levels by taking testosterone. Research studies show that testosterone treatment can decrease overall body fat and increase muscle tone and strength.

    Muscle cells are always twitching or moving – even when you are asleep. Because they are always at work, muscles burn more calories than fat tissue even when you are resting. So, the more muscles you have, the higher your metabolic rate, which means that your body burns more calories while doing basically nothing. This means that women with more muscle will burn more energy at rest than women who weigh the same but have less of that weight from muscle.

    The basal metabolic rate (BMR), or resting metabolic rate (RMR), is the minimum amount of energy required to keep your body alive when at rest. Another way to look at it is the number of calories you need to keep your heart beating, your lungs working, etc. Any other activities, like walking or running, will require additional calories above the BMR.

    By increasing your muscle mass, you are increasing your BMR. Weight loss occurs when the amount of calories consumed is less than the number of calories burned. All else being equal, women with more muscle have a higher BMR, burn more calories at rest, and will lose weight more easily than women with less muscle. This is one of the reasons why it becomes so difficult to lose weight as we age. As testosterone drops with age, we require fewer calories. Returning testosterone to normal levels reverses this trend and we can burn more calories at rest.

    Increasing lean muscle mass also redistributes weight in a cosmetically pleasing fashion. We look better when we have more lean muscle mass. Women that experience a better response to exercise and have less fat and more muscle look better. Clothes fit better, posture improves and confidence improves.

  3. Testosterone Is Important for Maintaining Energy Levels
    Women with low testosterone are more prone to experience low energy and fatigue. Returning testosterone to normal levels will help to increase overall energy levels and can help you feel better! 

    Think about how much energy we had when we were in our 20s. One of the unfortunate parts of aging is the loss of energy and the body’s ability to refresh itself. One of the reasons we lose so much energy as we age is because of falling testosterone levels. Returning testosterone to normal levels will increase the body’s ability to refresh and increase overall energy levels.4

    Returning normal energy levels via testosterone replacement can have a profound impact on the quality of life. Decreasing fatigue can improve mood, boost confidence, and allow for activities that increase happiness.

  4. Testosterone Is Important for Brain Health
    In women, normal testosterone levels are key to brain health. Clarity of thought, improved concentration, and overall cognition come with normal testosterone levels. When testosterone levels lower due to decreased production in the ovaries, brain fog can be the result. Returning testosterone to normal levels in women can treat the brain fog and can help return brain function to optimal youthful levels.5

    Low testosterone levels in women are also associated with significant mood changes including anxiety, depression, and irritability. Replacing testosterone and returning levels to youthful numbers can reverse these symptoms and return women to a state of good mental health.

  5. Testosterone Improves Bone Health
    Loss of bone mineral density (osteopenia and osteoporosis) is associated with increased bone-breaking and fracture risk and is an important health concern for women as they age. Osteoporosis can lead to life-threatening bone fractures especially in the hip, Osteoporosis is also responsible for the loss of integrity of the spine leading to loss of height, fractures of the vertebrae, back pain, abnormal curvature of the spine, and even nerve damage.1,5

    Low testosterone levels have been found to be an important risk factor for bone mineral density loss in women. Replacing testosterone to normal levels in women can be an important part of maintaining bone mineral density.

  6. Testosterone Is Breast Protective
    Replacing testosterone, back to normal levels, has a beneficial effect on breast tissue. Testosterone actually decreases the stimulation of breast tissue which can help protect the breast from cancers. You can further enhance the protection testosterone provides by giving an additional aromatase inhibitor, such as Anastrozole. These protective effects on the breast are even more pronounced than with testosterone alone.1,5

  7. Testosterone Improves Overall Quality of Life and Feelings of Wellbeing
    Women with low testosterone feel better when their testosterone is replaced to normal youthful levels. Overall sexual health improves, lean muscle mass improves, weight loss becomes easier, and energy levels improve. All these positive changes lead to increased feelings of well-being and improved quality of life. Women tend to feel more confident and relationships improve.4

How to Replace Testosterone

Testosterone can be replaced in various ways. Testosterone preparations come in pills, patches, creams, and even implants. Replacing testosterone correctly can be tricky and if done incorrectly can lead to side effects. Replacing testosterone to normal levels has very few negative side effects and very little risk, but if too much testosterone is given the side effects and risks can become significant.

The goal is to return levels to normal youthful levels of testosterone. This can give all the benefits described above and help women return to their youthful vigor. Overshooting the dose and replacing testosterone to higher levels can cause virilizing side effects. Adding too much testosterone can cause serious health risks and serious masculinizing side effects.

At Winona, we use a novel approach to testosterone replacement utilizing Dehydroepiandrosterone (DHEA) and Anastrozole. This approach is a much more gentle way to replace falling testosterone levels without the risk of overshooting and causing unwanted side effects. In chemical terms, DHEA is a testosterone parent or precursor. The body naturally breaks down DHEA into testosterone and estrogen. For some women, taking DHEA alone is sufficient to return testosterone to desired levels, but for others, the addition of Anastrozole is an important part of converting DHEA to the right amount of testosterone.

Anastrozole is in a class of medications called “aromatase inhibitors” which block the conversion of DHEA into estrogen. Adding Anastrozole to DHEA will increase the levels of testosterone compared to DHEA alone. For many women, this combination of medications can raise testosterone to the appropriate normal levels. Anastrozole can decrease the production of estrogen in the body as well. For women that are no longer producing estrogen due to menopause, this is not a significant side effect. For some women, estrogen replacement can be given in addition to DHEA and Anastrozole to give additional benefits and mitigate the issues with low estrogen levels.


Testosterone is a very important hormone in women and yet it is often ignored in conversations about hormone replacement therapy. Female testosterone levels steadily decline after peaking in the ’20s and these reduced levels can have a significant impact on the quality of life. Replacement to achieve normal testosterone levels in women is a very important part of any conversation about hormone replacement therapy.

The risk of over-replacement of testosterone to too high levels can be mitigated with a strategy involving DHEA and Anastrozole. These medications can gently return levels to normal without the risks of over-replacement minimizing any unwanted side effects. Winona experts are here to keep women feeling young and can help women fight off the side effects of aging by replacing hormones with youthful levels.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”


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