Women's hormones
Low Testosterone in Women: The Signs Nobody Tests For
Reviewed by a qualified clinician · analysed at UKAS-accredited UK labs (ISO 15189)
Last reviewed July 20267 min read
Every Helvy guide is written by our health editors, then checked by a qualified clinician before it goes live and re-checked as the science moves. We name clinical roles, not individuals, until each reviewer has agreed to be credited publicly. This is wellness guidance to help you understand your own data, not a diagnosis.
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Low testosterone in women can cause low sex drive, flat mood, poor energy and loss of muscle tone. A woman's testosterone roughly halves between her mid-20s and mid-40s. It is best judged from total testosterone, SHBG and the free androgen index read together, always alongside your symptoms rather than one number alone.
You feel flat. Your sex drive has quietly gone. You are tired in a way that sleep does not fix, and your usual drive at work or in the gym has thinned out. Blood tests come back “normal”, so nobody looks further. For many women, one hormone never gets checked at all: testosterone.
Testosterone is often called a male hormone. It is not. Women make it too, and it matters for sex drive, mood, energy, muscle and bone. When it falls too low, the effects are real. This guide covers the signs, the female ranges in UK units, what to test, and when to see your GP.
By Helvy Medical Team · 7 min read
1. What are the signs of low testosterone in women?
The symptoms are easy to blame on stress, age or a busy life. That is exactly why low testosterone is missed so often. The pattern women describe most is a loss of drive, in more than one sense.
- A low or absent sex drive that feels unlike you
- Flat mood, low motivation, a sense of blunted get-up-and-go
- Persistent fatigue that rest does not fix
- Harder to build or hold muscle tone despite training
- Reduced sense of wellbeing or confidence
None of these is proof on its own. Low mood and fatigue also come from thyroid problems, low iron, poor sleep and vitamin D deficiency. A blood test is what tells these apart. If your energy is the main issue, our full blood count guide explains the anaemia checks worth running at the same time.
2. What is a normal testosterone level for a woman?
Women carry far less testosterone than men, so the numbers are small. UK labs report total testosterone in nmol/L. A typical adult female range sits at roughly 0.3 to 1.7 nmol/L, though labs differ and the range narrows with age.
Here is the catch. Standard lab assays are least accurate at these low female levels. A single figure can mislead. That is why the free androgen index matters more. It is a simple calculation of total testosterone against SHBG, the protein that binds hormones and decides how much is active.
The takeaway is simple. Interpret the number with your symptoms, not in isolation. A “low-normal” result in a woman with the full symptom set means more than the same figure in a woman who feels well.
3. What causes testosterone to drop in women?
The biggest driver is age, not menopause. A woman's testosterone roughly halves between her mid-20s and mid-40s, well before periods stop. That is a gradual ovarian decline, and it explains why some women feel the change in their late 30s.
Other causes can pull it lower or faster:
- Having both ovaries removed, which causes a sharp drop
- Some contraceptive pills, which raise SHBG and cut active testosterone
- Problems with the pituitary or adrenal glands
- Long-term steroid medication
Because a raised SHBG can lock away testosterone that your body has made, the cause is not always low production. Sometimes the hormone is there but bound. That distinction only shows up when SHBG is measured alongside the testosterone itself.
4. How is low testosterone tested properly in women?
One number is not enough. To read a woman's testosterone properly, a panel needs three things together:
- Total testosterone— the headline figure
- SHBG — the protein that decides how much is active
- Free androgen index— the calculation that shows the usable fraction
Timing helps too. Take the sample in the morning, when testosterone peaks. If you still have a cycle, aim for the first half of the month. FSH and LH read alongside show whether you are heading into the perimenopause transition, which our menopause blood test guide covers in detail.
Our Hormone Balance panel (£99) measures total testosterone, SHBG and the free androgen index alongside FSH and LH, from one morning finger-prick sample, with every marker explained in plain English.
5. Can low testosterone in women be treated?
This is a conversation for your GP or a menopause specialist, not a decision to make from a blood result alone. UK guidance is cautious and specific. The NICE menopause guideline addresses testosterone directly.
“Consider testosterone supplementation for people with low sexual desire associated with menopause if HRT alone is not effective.”
— NICE guideline NG23, Menopause: identification and management (2015)
In short, testosterone for women is used mainly for distressing low sex drive after other steps, and usually after oestrogen is already settled. It is prescribed off-label and monitored with blood tests. Testing gives you and your clinician the starting picture. What happens next is a decision you make together.
CHECK YOUR HORMONES
The Hormone Balance panel (£99) reads total testosterone, SHBG, the free androgen index, FSH and LH from a simple home sample, with a clear explanation of every result. Build the test that fits you in two minutes.
6. Frequently asked questions
Can women have low testosterone?
Yes. Women produce testosterone in the ovaries and adrenal glands, and levels fall with age. A shortfall can affect sex drive, mood, energy and muscle tone. It is judged from symptoms plus total testosterone, SHBG and the free androgen index, not from one number alone.
What are the symptoms of low testosterone in women?
The most common are a low sex drive, flat mood, low motivation, stubborn fatigue and harder-to-hold muscle tone. These overlap with thyroid problems, low iron and poor sleep, so a blood test is the reliable way to tell them apart.
Does the NHS test testosterone in women?
Not routinely as a first step. A GP may test it if symptoms point that way, often alongside thyroid, iron and menopause markers. Many women use a private panel to get the full picture in one go, then take the results to their GP.
Is low testosterone the same as menopause?
No. Testosterone declines with age, mostly before menopause, while menopause is defined by falling oestrogen and the end of periods. They can overlap, which is why FSH and LH are usually read at the same time. Our perimenopause guide explains how the picture shifts.
Can low testosterone in women be treated?
NICE guidance supports considering testosterone for distressing low sexual desire linked to menopause when HRT alone has not helped. It is prescribed off-label by a GP or specialist and monitored with blood tests, so it is a decision to make with a clinician after testing, not on your own.
Medical disclaimer: This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Reference ranges and thresholds cited here are based on published research and UK guidance, and may differ from the ranges used by your local laboratory. Do not start, stop or change medication, HRT, supplementation or treatment based solely on information in this article; consult your GP or a qualified healthcare professional. All Helvy blood tests are processed by UKAS-accredited UK laboratories to ISO 15189.
Last updated: July 2026 · By Helvy Medical Team · Analysed at UKAS-accredited UK laboratories
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