Fertility: Why Women Need Testosterone

Fertility: Why Women Need Testosterone

Fertility Why Women Need TestosteroneExperts have long been aware of the role of testosterone for men, but few of us understand how testosterone fits into women’s health and fertility. We receive many questions on testosterone for women. While women produce much less testosterone than men, testosterone is a necessary hormone for a woman’s sexuality, libdo, and energy.

Testosterone is an androgen (male) hormone. In women, testosterone production is split between the ovaries and adrenals. Testosterone levels are highest in women during puberty and tend to peak in the early 20s. By the time a woman reaches menopause, her testosterone levels have usually dropped by 50%, less than the amount estrogen drops, but significant in terms of health and fertility.

Testosterone’s Role in Female Health

Like men, women need testosterone to build muscle and tone the body. A recent study shows overweight women given testosterone lose more body fat and abdominal fat, and gain more muscle than women given a placebo. Testosterone is critical for healthy bone mass, too. Reduced levels of testosterone are linked to lower bone mineral density and increased osteoporosis risk.

Testosterone offers benefits for energy, and cognitive health and has mild anti-stress activity. Testosterone fluctuations may trigger feelings of anxiety, and depression or can impact mood. Research suggests a testosterone deficiency leads to increased risk for heart problems for women who have had a hysterectomy.

Women need testosterone for a healthy libido and fertility. Research shows testosterone can increase a woman’s libido and even her fantasies. In a healthy woman, testosterone production is briefly increased mid cycle, for a libido boost during her prime conception time. Testosterone also increases circulation to the pelvic region, improving the production of cervical mucous that encourages fertility.

Do you have signs of low testosterone (low T)?

While testosterone deficiency has been most studied in menopausal women, there is growing evidence that premenopausal women are affected too. Saliva or blood tests can confirm if your testosterone is low. The healthy ranges for women are: 15 to 70 ng/dL total testosterone and 3 to 1.9 ng/dL free testosterone.

Signs of low testosterone (low T) look similar to low thyroid or are mistaken as signs of aging or depression:

  • Loss of energy
  • Low muscle mass
  • Poor sleep
  • Difficulty losing body fat
  • Feeling cold (yet thyroid tests are normal)
  • Depressed mood or lack of concentration
  • Loss of head hair or body hair
  • Low libido and vaginal dryness

Do you have signs of excess testosterone?

Research finds that between 4% and 7% of women produce too much testosterone in their ovaries. High levels of testosterone can cause fertility problems and are strongly linked to PCOS. Indicators of excess testosterone to watch for are:

  • Acne
  • PCOS
  • Infertility
  • Patchy head hair loss
  • Irregular or absent periods
  • Increased body hair growth on the face, chest or back (Hirsutism)
  • Low HDL cholesterol (good cholesterol)
  • Irregular or absent periods
  • Deepening of the voice
  • Enlargement of clitoris

Testosterone Replacement Therapy for Women

Doctors may prescribe short term testosterone replacement therapy (TRT) to enhance libido or revive energy for women with low T. Still, long term TRT is not advised because of its links to heart and liver disease. TRT isn’t suggested for women with a history of uterine or breast cancer because it could possibly trigger a relapse. Additionally, even short term TRT can lead to side effects like acne, moodiness, facial hair growth or head hair loss many women want to avoid.

The Role of DHEA (Dehydroepiandrosterone)

Today, many women we speak to use DHEA supplements as a safer way to address low T. Unfortunately, in our experience, DHEA isn’t a good fix for the problem. DHEA has weak activity and is often metabolized into other hormones like estrogen.

Natural Ways to Balance Testosterone for Women

Note: If you use oral contraceptives, be aware they suppress testosterone and other hormones.

1. If you suspect you have low T, avoid an extremely low-fat diet. An overly restrictive, low-fat diet is not good for overall health or hormone balance. Dietary fat is strongly linked to testosterone levels. Include healthy fats from avocado, pumpkin seeds, coconut oil, olive oil, and occasional grass-fed, organic meat in your diet to keep testosterone levels supported. Avoid extremely high protein diets as they tend to lower testosterone, too.

2. Cut back on refined carbohydrates and sugar. These foods trigger insulin spikes and contribute to imbalanced testosterone. Research finds that as many as half of men with diabetes have low T. In contrast, women with insulin resistance tend to have excess testosterone! A first sign of too much sugar in the diet and imbalanced testosterone in women is acne around the chin area. Choose healthy, gentle carbs!

3. Think zinc. An estimated 2 billion people around the world are low in zinc. In men, low zinc levels are directly tied to low testosterone and infertility. For women, zinc is needed for proper hormone regulation, egg development, and follicular fluid production. Low zinc levels can increase miscarriage risk, too. Include zinc-rich foods like oysters, organic chicken, grass fed beef, eggs, wild seafood, spinach, spirulina, wheat germ, legumes, nuts, and pumpkin seeds.

4. Exercise! It boosts testosterone production. Research finds endurance and resistance exercise increase testosterone production in women regardless of their age. The more muscle mass you have, the more testosterone you will produce. Yet, for fertility purposes, you don’t want your testosterone levels to be too high. Avoid extreme exercise and bodybuilding. Stick to low impact workouts instead, like walking, hiking, fertility yoga, or using low impact equipment at the gym. Note: If you have excess testosterone, the benefits of exercise outweigh the drawbacks, especially if you need to reduce your BMI or have PCOS.

5. Use herbs to help balance and support testosterone:

  • Saw palmetto (Serenoa repens): Saw palmetto helps regulate excess testosterone by inhibiting the enzyme, 5-alpha reductase, linked to head hair loss and facial hair growth. Saw palmetto shows particular benefits for women with PCOS-related hirsutism (hair on face, back or chest).
  • Spearmint (Mentha spicata): Preliminary Turkish research finds drinking spearmint tea can lower free testosterone levels, without impacting DHEA or total testosterone. In one study, drinking spearmint tea twice daily significantly reduced androgen hormones in women with hirsutism caused by PCOS.
  • Maca (Lepidium meyenii): Maca is known to nourish the endocrine system in both men and women. Maca supports the body in the healthy production of estrogen, testosterone, and progesterone, without containing hormones itself. Maca even has aphrodisiac qualities and supports circulation to the pelvic region. Maca is full of energy-enhancing nutrients and can be easily added to smoothies or taken in supplements.
  • Ginseng (Panax ginseng, Panax quinquefolius): Both Asian and American ginseng support healthy testosterone levels in men. While we don’t know if ginseng can increase testosterone in women, it’s a great choice for anti-stress support to encourage libido and fight fatigue. In many ways, ginseng is an ideal herb to relieve mild symptoms of low T in women even if all the research isn’t in.

6. Actively Work to Reduce Stress: High stress increases cortisol production and may impact testosterone production in women (as it does men). While more research needs to be done, daily stress management is a key to balancing all the reproductive hormones and encouraging natural fertility for women.


Hormones are tricky substances to work with. Small amounts can cause big reactions, both good and bad. Use care and common sense before pursuing TRT. In addition, some people naturally produce more testosterone than others. What may be normal for you may be too low for someone else.

Consider a hormone panel and look at your body signs to determine where you fall. Natural therapies can be a great choice to encourage healthy, balanced testosterone levels. Long term diet and lifestyle changes are paramount to resolving the imbalance and encouraging fertility.


Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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  1. Avatar

    This is a very revelatory article on why women should also need testosterone. Thank you for sharing this informative post.

  2. Avatar

    What improve libido for women?