Testosterone Replacement Therapy for Women — Why Estrogen Isn’t Always Responsible for the Way You Feel

Testosterone replacement therapy for women is a novel concept for many.

In fact, testosterone is often ignored in the publicity around hormone therapy for women — female low testosterone is frequently overlooked, or it may be misdiagnosed as some other issue altogether.

Testosterone Replacement for Women

Women’s bodies have 3 major sex hormones, but the primary focus when dealing with health and hormone balance has always been on the 2 “female” hormones: Estrogen and progesterone.

Women’s bodies need a bit of testosterone to regulate certain functions and remain healthy. If any of these hormone levels get out of sync with the others, you’ll likely develop one or more of the common symptoms of hormone imbalance.

The Symptoms of Low Testosterone in Women

The amount of testosterone in a woman’s body is only a fraction of that present in a man’s. However, if testosterone levels are insufficient, certain bodily systems begin to malfunction.

The following are a list of the common symptoms women experience when their testosterone level drops out the optimum range:

  • Fatigue
  • Muscle weakness
  • Anxiety
  • Difficulty concentrating
  • Low mood or mild depression
  • Mood swings
  • Low libido or loss of interest in sex
  • Weight gain or difficulty losing weight
  • Hair loss

These unpleasant symptoms can damage a woman’s self-image and quality of life.

More importantly, the symptoms of low testosterone in women are often misdiagnosed.

Low Testosterone Is Often Misdiagnosed as Low Estrogen or High Testosterone

If you look at the list of low testosterone symptoms above again, it might occur to you that it’s almost the same as the symptoms of low estrogen.

Or, it might even be a list of the symptoms indicating hormone fluctuation at the onset of the menopausal cycle.

In particular, low libido or low sex drive has traditionally been attributed to low estrogen caused by the beginnings of menopause.

It’s tough to know which type of hormone therapy is indicated until hormone levels (including testosterone) are measured through proper lab testing.

Interestingly, it might even be the case that your medical provider has misdiagnosed you with high testosterone, when in fact you have low testosterone.

When investigating options for hormone therapy, women should always consider testosterone replacement therapy as a possible treatment.

You May Be Getting Older, But That May Not Be the Source of the Problem Either

Often, the symptoms of low testosterone in women are simply written off as the less attractive aspects of growing old — weight gain, difficulty losing weight, and hair loss are more frequent with age.

While it’s true that hormones decrease as we age and cause physical changes, imbalance is not something that simply has to be lived with indefinitely.

Getting your hormone levels checked and back under control can be the first step towards feeling better.

When the source of the problem is diagnosed, the proper treatment course can be determined. Testosterone replacement therapy, for women, is not often the first choice, but it should always be considered as a possible solution.

The Causes of Female Low Testosterone Are Not Well Understood

The source of low testosterone in women is not well understood because there are so many possible causes.

Some research suggests a genetic abnormality that complicates the natural production of DHEA and DHEA-S, which are used to form testosterone in women’s bodies.

Another possibility is that catalytic enzymes needed to convert these precursors (DHEA and DHEA-S) into usable testosterone may be insufficient.

The following are other possible causes of low testosterone in women:

  • Getting older: As we mentioned above, most women’s testosterone levels decrease naturally from an early age
  • Oophorectomy: Ovary removal can reduce testosterone levels in women
  • Ovarian failure due to chemotherapy drugs or other drugs: Also known as chemical oophorectomy, any substance that affects your ovaries can decrease testosterone levels
  • Estrogen therapy: Estrogen suppresses production of the hormone responsible for stimulating testosterone production — this includes birth control
  • Hypothalamic amenorrhoea: Cessation of menstrual periods in a woman before menopause; possible causes could include stress, extreme weight loss, or extreme exercise
  • Early menopause (before the age of 40): Also known as premature ovarian failure
  • Adrenal gland issues: Also known as adrenal insufficiency
  • Pituitary gland issues: Hypopituitarism or hyperprolactinemia

Whatever the cause, if you’re a woman suffering from the symptoms of low testosterone, relief could be found in testosterone replacement therapy — for women (and men, too), this treatment can help you feel like yourself again.

Find Out More About Testosterone Replacement Therapy for Women

The number of female low testosterone cases we diagnose and treat would surprise many people.

The good news is that, once low testosterone is diagnosed in men or women, testosterone replacement therapy and related treatment options are available.

You can find more information about testosterone replacement therapy for women by clicking the button below.


Learn About TRT for Women


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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.


  1. RR on 05/30/2018 at 9:13 pm

    Hi thank you for all this wonderful info. Possibly not the best place to put these questions, but have gone to your most recent post in hopes you will see it. 42yo M here diagnosed with total T around 180 and was miserable for several years without realizing what was wrong. I know you do not recommend topicals but I have started the 4mg Androderm patch and got genuine results within 40 minutes and for the first several days. These were in the modalities of concentration, memory, physical endurance, anxiety levels, sweat stinking again, and feeling amazing each morning when I wake up (previously was a zombie in the morning for my whole life). I have made some lifestyle changes in concert with this treatment.

    My question for you is if it is normal to see a backslide of these symptoms so close to the beginning (possibly when your own limited production shuts down, or just as your body begins to “normalize”)?

    I’m certain the treatment is still working but the “high” I was on with it seems to have vanished, and I fear I have gone backward. Anxiety levels are up and some lethargy is back. Should I just give it time to work into my system properly? Can this type of roller coaster be expected when the patch first goes on?

    • RR,

      You’re most welcome! You are on the right track. Your body responds rather quickly to the introduction of exogenous testosterone. This is why testosterone REPLACEMENT therapy is such a fitting moniker. It replaces your natural production, it doesn’t augment it. So, it is likely that you will need titration of your dose. Careful assessment of your response, side effects, and your labs will be necessary.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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