Testosterone in Women: What Are Normal Levels by Age?

Testosterone has long been synonymous with all things manly—a deep voice, ripped muscles, and a roaring sex drive. But women also have testosterone, although in levels 10 times lower than in men. It’s actually an important hormone for us, playing a role in everything from libido to mood, metabolism, and cognition.

While female testosterone levels naturally decline with age, it’s a good idea to get tested any time you’re having symptoms such as low sex drive, lack of energy, or weak muscles. Understanding what a healthy testosterone range looks like at different ages can be a helpful conversation starter with your doctor.

About the Experts

Adrian Dobs, M.D., MHS, is an endocrinologist and director of the Johns Hopkins Clinical Research Network, focusing on sexual disorders among men and women.

Natalie Kunsman, M.D., who practices in Colorado Springs, is board-certified in family medicine and antiaging and regenerative medicine.

Normal Free Testosterone Levels in Females by Age

Free testosterone is the most biologically active form of testosterone in the body, contributing directly to a woman’s libido, muscle mass, energy levels, mood, sleep, and cognitive abilities.

Here are the normal free testosterone levels in females by age during certain stages of life (pg/mL): ¹

• Pre-menopause (18-45): 1-6 pg/mL
• Perimenopause (45-50): 1-4 pg/mL
• Menopause (50 and older): 1-3 pg/mL

A woman’s testosterone levels, including the amount of free testosterone in her bloodstream, gradually decrease with age. This decline is caused by reduced hormone production in both the ovaries and adrenal glands slows as you get older.

Free testosterone levels are a more accurate indicator of how testosterone levels are affecting your health than total testosterone, which measures all the testosterone in your blood—free and bound. ²

Total testosterone levels in women by age:³

• 19–49 years: 8–48 nanograms per deciliter (ng/dL)
• 50 years and older: 2–41 ng/dL

How to Measure Free Testosterone Levels in Women

Free testosterone travels through the bloodstream unattached to proteins, accounting for about 1-3 percent of the female body’s total testosterone levels. ¹ 

To determine whether you have a testosterone imbalance, your doctor can administer a blood test that measures these biomarkers: ⁴

• Free testosterone: active testosterone that is detached from proteins in the blood
• Total testosterone: all the testosterone in your blood, including free and bound
• Bioavailable testosterone: testosterone available for use in tissues throughout the body, either as free testosterone or bound to albumin proteins that can become free testosterone
• SHBG: sex hormone binding globulin, a protein in the blood that binds to testosterone and might indicate less free testosterone

Most of the body’s testosterone is bound to one of two proteins—albumin or sex hormone binding globulin (SHBG).⁵ There’s a good reason for the connection. “Testosterone is a fat-soluble compound made of cholesterol, and if it were not attached to carrier proteins it would float to the top [of the blood] like cream separating from milk! It wouldn’t get anywhere,” says integrative physician Natalie Kunsman, M.D.

Your doctor might also order tests of luteinizing hormone (LH) or follicle-stimulating hormone (FSH), which act on the ovaries, to get a better picture of what’s going on with your hormonal health. ⁶

Monthly Cycles & Female Testosterone Levels

Testosterone levels during perimenopause and menopause might appear inconsistent in blood test results due to natural hormonal fluctuations.⁷ Here’s why:

• Both total testosterone and free testosterone peak when a woman is ovulating.
• Total testosterone levels tend to be highest in the early morning and lowest in the late evening.
• You may need to get retested and also get tests of your estrogen, progesterone, and other health indicators to get a more accurate picture.

“Everything is a wide range of normal in the lab,” says Dobs. “Whatever you do has to be measured a few times.”

Because testosterone levels in women may be too low to reliably measure during perimenopause and menopause, doctors tend to treat midlife women based on their symptoms. “The patient gets treated first, and the numbers get treated second,” says Kunsman.

Signs of High Free Testosterone Levels

Signs of high testosterone in a woman include: ⁸

• Acne
• Deeper voice
• Enlarged clitoris
• Excess hair growth on your face and body (hirsutism)
• Hair loss on the scalp (male-pattern baldness)
• Irregular periods

Testosterone is a male hormone, and at high levels it acts like one, even in a woman’s body. Having too much of it can cause typically masculine symptoms—excess facial hair, body hair, and deep voice, says Adrian Dobs, M.D., an endocrinologist and director of the Johns Hopkins Clinical Research Network.

During perimenopause and menopause, hormone changes might impact the ratio of testosterone and estrogen in the female body, resulting in symptoms that feel like high testosterone. For example, if estrogen levels plummet rapidly in late perimenopause, the resulting imbalance in testosterone might contribute to symptoms like chin hair or belly fat. ⁹

The most common reason for women to have excess testosterone (also called hyperandrogenism) is polycystic ovarian syndrome (PCOS). ¹⁰ In PCOS, the ovaries are filled with tiny, fluid-filled cysts.

Other possible causes of excess testosterone levels include: ¹¹

• Congenital adrenal hyperplasia (CAH), a genetic disorder that affects hormone production in the adrenal glands
• Insulin resistance from a condition like obesity or metabolic syndrome
• Medications such as corticosteroids and birth control
• Tumors on the ovaries or adrenal glands that make these glands overproduce testosterone

Signs of Low Free Testosterone Levels

Symptoms of low testosterone in women can include: ¹²

• Infertility
• Irregular periods
• Lack of energy
• Low libido
• Mood changes or depression
• Reduced muscle strength and tone
• Weakness
• Trouble sleeping

Getting older is one of the main causes of low testosterone in women and men. By the time you reach menopause, your levels may be half of what they were when you were younger. Going into menopause early (before age 40) has the same effect. ¹³ Testosterone levels might also drop if your ovaries stop working or after surgery to remove your ovaries or adrenal glands, because you need these organs to make testosterone. ¹⁴

Other possible causes of low testosterone include: ¹⁵

• Addison’s disease, a condition where the adrenal glands don’t make enough hormones
• Amenorrhea, a loss of menstrual periods
• Cancer treatments such as chemotherapy or radiation
• High stress
• Low DHEA production
• Malnutrition, for example because of an eating disorder
• Tumor on the pituitary gland

How to Treat Low Testosterone Levels in Women

If your tests show low testosterone levels and you have symptoms like low libido, your doctor may prescribe testosterone as part of a hormone replacement therapy (HRT) plan. Testosterone therapy for women is controversial because studies haven’t been done to evaluate its safety. While the Food and Drug Administration (FDA) has approved more than 30 hormone therapies for men with low testosterone, it hasn’t approved a single one for women. ¹⁶

Women’s testosterone comes in many forms, including injections, creams, patches, gels, and pills. But doctors have to use caution when prescribing testosterone to women because many TRT medications are available only in higher doses meant for men. “We’re careful not to give too much because of the concern about masculinization,” says Dobs. Compounding pharmacies can make gels, creams, or injections in specific formulations that are dosed for women.

Another option is to take DHEA, which your body turns into testosterone. While not regulated by the FDA, it’s available over-the-counter or by prescription as part of an HRT treatment plan:

• DHEA cream
• DHEA oral supplements
• DHEA powders

How to reduce testosterone in women

High testosterone levels are typically treated with hormone medications such as birth control pills, which treat symptoms of high testosterone including acne, irregular periods, and excess body hair growth. Cyproterone and metformin can treat PCOS. And corticosteroids are a treatment for adrenal hyperandrogenism.

Lifestyle Changes for Testosterone Imbalance

When it comes to regulating hormone levels—up or down—lifestyle changes can make a difference. “The basics always help when you are in the menstrual or perimenopause/menopause age bracket: Sleep, low-inflammatory diet, keeping weight ideal, and low stress,” says Kunsman.

Here are a few lifestyle changes to try:

• Diet. Eating a diet high in protein—especially animal protein like beef or chicken—may lower testosterone levels. ¹⁷ A higher fat diet may increase testosterone levels. ¹⁸
• Exercise. Testosterone levels surge briefly after a workout, amping up the activity of testosterone receptors in the body. ¹⁹ This post-exercise testosterone spike might have a positive effect on women’s strength, cognition, and sexual function.²⁰ Because levels drop back again, exercising regularly is important for continuing to reap the benefits of those testosterone boosts.
• Stress management. Women with higher testosterone levels have higher perceived stress levels. ²¹ And stress exposure may increase testosterone levels. ²² Lowering stress with techniques like deep breathing, meditation, or yoga benefits your health in general and may help keep testosterone levels steady.
• Sleep. Your body produces testosterone while you sleep, which is why levels naturally rise at night. Lack of sleep could inhibit testosterone production.²³ A study in Andrology found that middle-aged women who slept six or fewer hours a night were more likely to have low testosterone than those who slept the recommended seven or eight hours per night. ²⁴

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About the author

Stephanie Anderson Witmer is a freelance journalist and content creator based in Pennsylvania. She's written health and lifestyle stories for Women's Health, Redbook, Prevention, Good Housekeeping, USA Today, Better Homes & Gardens, Giddy, Parade, Yoga Journal, and more.

About the reviewer

Dr. Shelly Chvotzkin, D.O., F.A.C.O.O.G., is a physician board certified in obstetrics and gynecology. She is a member of the American College of Osteopathic Obstetricians and Gynecologists (ACOG), the American Osteopathic Association (AOA), the American Society for Colposcopy and Cervical Pathology (ASCCP) and the Menopause Society (formerly known as the North American Menopause Society or NAMS).