Testosterone is usually filed under men's health. Yet across most of adult life a woman's body makes more testosterone than oestrogen, in the ovaries and the adrenal glands, and it plays a part in desire, energy and how muscle and bone hold up with age. Levels fall gradually from the twenties, and much more suddenly after both ovaries are removed.
Many women notice the change as a loss of desire that doesn't match how they feel about their partner, and are told it is stress or just age. This guide explains what low testosterone in women looks like, what blood tests can and cannot tell you, what the research shows treatment does, and how we approach it at Alpha Medical in Limassol.
Signs that testosterone may be low
The symptom with the clearest link to low testosterone is a persistent drop in sexual desire that causes distress. Other changes often travel with it, though they have many possible causes, which is why they are a reason to assess rather than to prescribe on their own:
- Low desire and fewer sexual thoughts, even in a good relationship
- Less arousal and weaker or harder-to-reach orgasm
- Low energy and a flatter sense of wellbeing
- Loss of muscle tone despite training
- Symptoms that began after removal of the ovaries, or around perimenopause
What blood tests can and can't show
This surprises many women: no single testosterone level reliably separates women who will benefit from treatment from those who won't. The Global Consensus Position Statement on testosterone therapy for women, published in 2019 by an international group of medical societies, states that diagnosis rests on symptoms and history, not on a blood number alone.
Blood tests are still essential. They give a baseline before treatment, rule out other causes such as thyroid problems or anaemia, and show whether levels stay within the normal female range once treatment starts. We measure total testosterone and SHBG alongside oestradiol, FSH, thyroid function and a full blood count.
What treatment does, according to the research
A 2019 meta-analysis in The Lancet Diabetes & Endocrinology pooled the randomised trials of testosterone in women. Compared with placebo, testosterone improved desire, arousal, orgasm, pleasure and the number of satisfying sexual events, and reduced distress about sex. Testosterone through the skin did not change cholesterol, while oral forms raised LDL cholesterol, which is why we use transdermal treatment.
In one large study of postmenopausal women not taking oestrogen, a testosterone patch added about two satisfying sexual episodes a month, compared with less than one on placebo. The effect is real and meaningful for many women, and it is not a cure-all: the evidence is strongest for desire and sexual function, and weaker for mood, energy or cognition.
Side effects and how we keep them away
The aim is to bring testosterone back into the range a woman would have before menopause, not higher. At those doses the most common side effects are mild acne and a little extra hair growth where the cream is applied. Changes such as a deeper voice come from doses far above the female range, which is exactly what monitoring prevents.
We check blood levels about six weeks after starting and then periodically. If there has been no meaningful benefit by around six months, we stop, as the consensus guidance recommends, rather than continuing in hope.
Testosterone alongside HRT
Most women who start testosterone are in perimenopause or menopause, and many are already on oestrogen and progesterone. Oestrogen comes first: it treats hot flushes, sleep and vaginal dryness, and it raises SHBG, which binds testosterone, so a woman's symptoms can change once her HRT is right. Testosterone is then added if low desire persists.
Our menopause HRT guide covers the oestrogen and progesterone side of treatment in detail.
How we approach it at Alpha Medical
Every woman starts with a consultation with a physician who works in female hormone health, about symptoms, cycle and reproductive history, relationship context and goals. We then run the blood panel, review it with you and agree a plan, which may start with HRT, testosterone, both, or neither.
Treatment is a small daily dose of transdermal testosterone, a fraction of a man's dose, with follow-up bloodwork and reviews built in. Women come to our Limassol clinic from Nicosia, Larnaca and Paphos, and many reviews after the first visit can be done remotely.
Ready to take the next step? Book a consultation at our contact page — or request an introductory HRT guide below.