How to Increase Testosterone Levels in Females

The trouble with low testosterone in females is that most doctors don’t think about low T when female patients come in with weight gain, fatigue, or depression - and they rarely run labs to check testosterone levels.

Yet, low T is common in females - most women experience a significant drop in testosterone between the ages of 20 and 40, often long before menopause.

What does low testosterone look like in females?

Symptoms may include low energy and fatigue, trouble losing fat or maintaining a healthy weight, decreased muscle mass or strength, loss of body hair or scalp hair (especially at the temples), decreased sex drive, joint or low back pain, and thinning or dry skin.

Optimal testosterone levels are needed to support mood and memory, bone density, and cardiovascular health.

That’s because testosterone is a “build-you-up” hormone that both helps your body with it’s “construction projects” - like maintaining healthy bones and muscles - and at the same time promotes the breakdown of fat.

If you’re recognizing some of your symptoms in this list, it’s important to test your testosterone levels to confirm. If you have an open-minded doctor, they may be willing to test your levels of testosterone in your blood, but there are a few things to be careful of.

First, be wary of large “normal” ranges.

Optimal ranges for total testosterone in women are between 2-5 pg/mL, and the younger you are, the more towards the top of that range you should be.

The second thing to be aware of is that total testosterone doesn’t tell the whole story.

That’s because testosterone can be bound up and inactivated by a compound called sex hormone binding globulin.

This is why it’s crucial to check free testosterone levels as well, so that you aren’t operating on the assumption that you have loads of usable, active testosterone when much of it is unable to bind to the receptors on your cells, meaning that you don’t get the build-you-up, revitalizing action of T.

Optimal ranges for free testosterone in women are between 1.1-2.2 pg/mL. If you see a large difference between total and free T, you can also measure SHBG in the blood to see if it’s high.

Helpful tip - one of the main things that raises SHBG in women is the birth control pill.

So, while testosterone levels can be measured accurately in the blood if done under the right parameters, my favorite way to assess for low T in females is the DUTCH test, because it not only measures active testosterone, but also DHEA, the hormone that gets turned into testosterone in women’s adrenals or fat tissue.

This is important from a Functional treatment strategy standpoint, because if you don’t have enough ingredients for testosterone, specifically cholesterol and DHEA, you’re going to have a very difficult time keeping your levels up!

Sidenote - you need a total cholesterol of at least 140 to make adequate levels of hormone, so if you’re taking medication to lower your cholesterol, you may want to make sure it’s not too low.

Low DHEA is one of the root causes of low T that I often see in practice, and it is usually connected to chronic stress.

The adrenal glands produce both DHEA and cortisol, your long-term stress hormone, so if you’re cranking out lots of cortisol in response to stress, the adrenals sometimes don’t prioritize making DHEA as well, which can lead to a deficiency of this testosterone pro-hormone.

In other people, their adrenals have been under so much stress for so long that they down-regulate the production of both DHEA and cortisol, which contributes to low T and other symptoms like fatigue, depression, and weight gain.

If you have chronic stress now, or if you’ve had a period of significant stress in the past, you may not be making crucial ingredients needed to support healthy testosterone levels.

This is particularly important if you’re post-menopausal, because most of your testosterone is being made in your adrenal glands.

The good news is that the DUTCH test can tell you how much DHEA and cortisol your body is making, so you can determine if low DHEA is one of the root causes of your low T.

If you do find that low DHEA is one of the reasons you’re struggling to make testosterone, there are several functional medicine strategies you can use to help.

The biggest thing you can do to promote healthy DHEA is to work on your stress resilience.

If lowering your stress triggers is an option, for example, quitting smoking, reducing alcohol intake, prioritizing sleep, and cultivating better mental and emotional boundaries, this is a great place to start.

But I know many women who are sick and tired of hearing that stress reduction is the only solution to their hormonal symptoms - not only is this untrue, but it’s also just not possible for many women.

Everyone has some level of stress, and most of the time it’s unavoidable. That’s why I like to focus on strategies that help rebalance your stress response system on a physical level, because the body treats all stress the same.

Stress resilience is a special interest of mine, so be sure to check my post about cortisol and stress - there are lots of resources waiting for you there.

Another option for raising DHEA to help support testosterone is to take a supplemental form of DHEA.

This can be particularly useful in menopause, when levels tend to drop along with female hormones like estrogen and progesterone. But be aware that going low and slow with DHEA is important.

It’s also important to be aware of your tendency to make extra-androgenic metabolites from DHEA like Androsterone and 5-alpha DHT. Because if you inadvertently promote these pathways, you could create symptoms like hair growth on the face, acne along the jawline, or even scalp hair loss and thinning.

Thankfully, the DUTCH test will help you determine if this is a tendency for you!

Another common root cause of low T in females has to do with an enzyme called aromatase.

Aromatase turns testosterone into estrogen, and if it’s dialed up too high, it can drain your healthy levels of T.

Several things can increase aromatase activity including obesity, chronic inflammation, high insulin, white peony, licorice root, and atrazine (a common pesticide used on crops like corn and sugarcane).

Medications to decrease aromatase activity are commonly prescribed for women who have had estrogen receptor-positive cancers in an attempt to reduce cancer recurrence, but the side effects are significant.

Thankfully, nature has given us many options for reducing aromatase activity and preserving healthy testosterone levels.

Food-based strategies for aromatase inhibition include dietary fiber, Flax seed, White button mushrooms, and Green tea. Stinging Nettle Root, Quercetin, Vitamin C, and Zinc also help reduce the transformation of testosterone into estrogens.

And just to make it easier for you, I’ve compiled my favorite functional medicine strategies for supporting testosterone levels in women into a FREE checklist for you - so be sure to download this resource HERE.

A third common cause of low testosterone activity in women is exposure to bisphenyl-A, or BPA.

BPA is an extremely common hormone-disrupting chemical found in plastics like single-use water bottles, canned food linings, and food storage containers.

This chemical can leach into food and water, especially when exposed to heat. BPA messes with the balance of T in your body, but it’s also what’s known as an obesogen - attaching to receptors that have to do with weight gain like insulin.

Unfortunately, research on BPA has been mostly focused on fertility and PCOS, so we’re waiting on data for its effects on low T in females.

That said, it’s still a great idea to decrease your BPA exposure by avoiding drinking from plastic cups and bottles, only heating food in non-plastic containers like ceramic or glass, replacing cling wrap with waxed paper, and washing plastic by hand instead of in the dishwasher.

You might be wondering if replacing testosterone directly, via creams, pellets, or other methods is safe.

Unfortunately, though some research has been done on testosterone treatment for men, we don’t have enough data on women’s use to know if these same treatments are safe.

Are there doctors willing to prescribe testosterone for women? Certainly. In my experience, it is extremely difficult to regulate testosterone externally, and supplementation with T can have significant side effects.

It’s my hope that as more women are becoming aware of their hormones and accessing reliable testing, the research on T supplementation will catch up.

Until then, there are other ways to boost testosterone in females.

Heavy weight lifting is one of my favorite ways for women to improve testosterone levels.

I’ve found that many menopausal women focus too much on cardio-style workouts because they think it will help them burn more calories and lose fat, but for boosting T, weights are the way to go.

When it comes to food, there are several categories of foods that are associated with lower testosterone levels in women. These include bread, pastries, and desserts made with refined flour.

Another big one is sugar-sweetened and diet beverages. And both caffeinated and decaf coffee decreased T in a randomized trial involving women.

Significantly limiting or avoiding these foods can help boost your testosterone levels.

Certain herbs can also help support healthy testosterone levels - herbs like fenugreek and tribulus. And adequate Zinc levels can help minimize your levels of sex hormone binding globulin.

Like I mentioned, I’ve compiled my favorite T-boosting strategies into a FREE checklist for you, so be sure to download your copy HERE before checking out the next video.