Why is Testosterone Misdiagnosed or Underdiagnosed?

Lower levels of testosterone in women are often chalked up to aging, depression, stress, or just those pesky side effects of menopause. This “in your head,” excuse has caused many a woman to be frustrated and undertreated as she enters into menopause and beyond. Below, we’ll discuss some of the common symptoms women undergo when their testosterone levels decline and how replacing these levels can eliminate those symptoms and have far-reaching benefits.  

Poor Libido: When you consider that approximately 43% of women in the United States (almost half) between the ages of 18 and 59 experience sexual dysfunction, it’s surprising that, unlike male sexual dysfunction, it has not received ample amount of press or been extensively researched, particularly with regard to testosterone therapy. As the topic of female sexuality has become less taboo, and more and more women are approaching menopause, both doctors and their patients are regarding testosterone therapy as a viable option.

In healthy women, free testosterone levels have been linked to sexual desire, whereas antiandrogen therapy has been linked to a loss of sexual desire. Several randomized, controlled trials of testosterone therapy in postmenopausal women suggest improvements in sexual desire, sexual responsiveness, and frequency of sexual activity.

Mood: Although it’s almost cliché to say that women are moodier than men, there is scientific merit to why women suffer more from mood swings and depression—and hormone levels are the root cause. In particular, low levels of testosterone have been linked to lower energy, lack of motivation, and depression, while testosterone therapy has been linked to an improved sense of well-being in multiple studies. 

Weight and Muscle Mass: In 2016, 40% of the world’s adult female population was overweight and 15% of women were obese. This is important because abdominal obesity is linked to type 2 diabetes and coronary heart diseases and subcutaneous abdominal fat found in obese postmenopausal women has been linked to low androgen levels. Testosterone replacement therapy in hypoandrogenic postmenopausal women has been shown to protect against obesity, which can, in turn, reduce the risk of developing type 2 diabetes and coronary heart disease.

Bone Health: Decreased testosterone plasma levels are markers of osteoporosis in women. Studies have shown that lower testosterone levels are indicative of height loss in postmenopausal women. Neither estrone nor estradiol levels were significantly and independently related to height loss, but lower bioavailable testosterone levels predicted future height loss independent of age. Studies have shown that testosterone replacement affects bone mass and that including it with estradiol therapy being more effective in increasing bone mineral density in the hip and lumbar spine than just estradiol alone.

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