August 22, 2026, 6:28 am | Read time: 8 minutes

“Testosterone is considered a typical male hormone, but it also plays an important role in the female body,” explains Dr. Heidi Gößlinghoff, a gynecologist, hormone expert, and mentor for women and couples with unfulfilled desires to have children. “It influences muscle strength, bone health, libido, mood, and performance. When testosterone levels drop, symptoms often develop gradually and are therefore often not recognized as hormonal.” But how can you recognize a testosterone deficiency? And what can you do to support your hormone balance? Dr. Gößlinghoff explains which symptoms can occur and when treatment is advisable.

Which Hormones Play the Main Role in Women?

The female body produces a variety of hormones that work closely together. They regulate the menstrual cycle, metabolism, fertility, mood, sleep, and many other bodily functions. The most important female hormones include:

• Estrogens are responsible for building the uterine lining, healthy bones, elastic skin, and protecting the cardiovascular system.
• Progesterone, also known as the corpus luteum hormone, prepares the body for a possible pregnancy and has a calming effect on the nervous system.
• Testosterone is often referred to as a male sex hormone but is also essential for women. It is mainly produced in the ovaries and adrenal glands.
• Other hormones like DHEA, cortisol, insulin, or thyroid hormones also play an important role. Since they influence each other, an imbalance often leads to symptoms that cannot be attributed to a single hormone.

Also interesting: The longer women have to live without estrogen, the worse it is for the heart and brain

What Does Testosterone Do in the Female Body?

Testosterone is not only important for men but also takes on numerous tasks in the female body. “It supports the maintenance of muscle mass and strength, promotes bone density, and contributes to a healthy body composition. It also influences sexual desire, general well-being, motivation, concentration, and mental performance,” explains Dr. Gößlinghoff. Women produce ten to twenty times less testosterone than men, yet it is essential for their health. “I often see that women with balanced testosterone levels feel more resilient, energetic, and capable. The hormone also seems to play an important role in recovery after physical exertion.”

Why Does Testosterone Level Decrease with Age?

“Unlike estrogen, testosterone does not suddenly drop with natural menopause. Instead, it is a gradual, age-related decline starting around the age of 30,” explains Dr. Gößlinghoff. “With menopause, egg cell maturation in the ovaries ends. The production of estrogen and progesterone decreases significantly. However, even after menopause, small amounts of male hormones are still produced in the ovaries, although less than before menopause.” Not every woman notices this change equally. Whether and how strongly symptoms occur depends, among other things, on individual hormone sensitivity and interaction with other hormones.

Also interesting: How women can prepare for menopause

Testosterone Deficiency in Women: What Symptoms Can Occur?

A testosterone deficiency usually does not manifest through a single symptom but through various complaints that develop gradually over months or years.

Physical Signs

Many women first notice a decline in their muscle strength. Although they continue to move or exercise regularly, building muscle becomes more difficult. At the same time, body fat percentage often increases, especially in the abdominal area. Physical performance also often decreases. They feel exhausted more quickly and require longer recovery periods after exertion. In the long term, a low testosterone level can also be a factor that promotes bone loss and increases the risk of osteoporosis.

Psychological and Mental Changes

Changes in mood are also typical. Many women describe persistent lack of drive, less motivation, and the feeling of not having the usual energy. Concentration problems, declining mental performance, and depressive moods are also common. However, it is difficult to distinguish which complaints are due to changes in female hormones and which are actually related to testosterone levels.

Sexual Desire

“A common but little-discussed symptom is declining sexual desire. Some women also report that they find it harder to become aroused or that sexual touches feel less intense,” says Dr. Gößlinghoff. “However, libido and sexuality are influenced by many factors, including the quality of the partnership, ongoing stress, sleep habits, medications, and other hormones.”

Also interesting: Regular sex has health benefits for women over 40

Is It Really Testosterone? Why Diagnosis Is Often Difficult

Fatigue, lack of drive, or declining libido can have many causes. In addition to testosterone deficiency, thyroid disorders, iron deficiency, depression, chronic stress, or menopause may be considered. Therefore, a single blood value is not sufficient for diagnosis. The overall view of symptoms, lab values, and individual life situation is crucial.

What You Can Do About Testosterone Deficiency

Medical Treatment

“The treatment of testosterone deficiency depends on the cause and should never be done on your own, but always in consultation with a gynecological or endocrinological specialist,” advises Dr. Gößlinghoff. “If there is a proven testosterone deficiency with corresponding symptoms, a low-dose testosterone therapy may be considered in selected cases. This particularly applies to women after menopause with a pronounced loss of sexual desire. A general testosterone therapy to increase energy or performance is not currently recommended. Since there are no testosterone preparations specifically approved for women in Germany, treatment is only carried out after careful benefit-risk assessment. It is also important to treat possible accompanying conditions such as thyroid disorders or other hormonal imbalances.”

What You Can Do Yourself–Even Preventively

• Strength training supports the maintenance of muscle mass and has a positive effect on various hormone systems.
• Adequate sleep and good stress management should be a priority, as persistently high cortisol levels can disrupt hormonal balance.
• A protein-rich diet provides the building blocks for muscles and supports recovery. Healthy fats are also important as they are needed for hormone production.
• Overweight, smoking, and heavy alcohol consumption can further burden the hormonal balance and should be reduced as much as possible.

Over-the-Counter Testosterone Boosters? Stay Away!

“Those who search online for solutions quickly come across over-the-counter supplements that promise a natural increase in testosterone levels. Such claims should be viewed with caution. Testosterone is prescription-only in Germany, and there are no over-the-counter products that effectively treat a proven testosterone deficiency. Many so-called testosterone boosters contain vitamins, minerals, or plant-based ingredients whose benefits are not sufficiently scientifically proven. If there is a suspicion of testosterone deficiency, you should refrain from self-experimentation and always have the cause clarified by a doctor,” recommends Dr. Gößlinghoff.

More on the topic

Advice From a Gynecologist How Menopause Changes the Vagina

Urologist Explains How Aging Affects Male Genitalia

Too Much of a Good Thing: What Are the Consequences of Excess Testosterone?

Testosterone therapy should only be handled by medical professionals, as an excessive dosage can lead to unwanted side effects. These include acne, oily skin, increased hair growth on the face or body, hair loss in a male pattern, and a deepening of the voice. Additionally, elevated testosterone levels can affect fat metabolism and potentially increase cardiovascular risk.

What Happens If Testosterone Deficiency Remains Untreated?

“A testosterone deficiency does not necessarily lead to serious illnesses, but it should still be taken seriously,” says Dr. Gößlinghoff. “If left untreated, quality of life can suffer permanently. Muscle mass and physical performance continue to decrease, which increases the risk of falls and injuries, especially in older age. At the same time, bone density can decrease, and thus the risk of osteoporosis can increase in the long term. In addition, persistent exhaustion, concentration problems, or sexual dissatisfaction can affect mental health.”

This short self-check does not replace a medical diagnosis. However, it can help you assess whether a conversation with your gynecologist might be worthwhile.

Ask Yourself:

• Have you felt unusually weak or lacking in drive for months?
• Has your muscle strength significantly decreased despite regular training?
• Has your body fat percentage increased even though your lifestyle has hardly changed?
• Do you feel that you can concentrate less well than before?
• Has your sexual desire significantly decreased?
• Do you recover more slowly from physical exertion?
• Are you in or after menopause?

If several of these points apply to you and the symptoms persist over a long period, a medical evaluation may be advisable. It is always important to look at the overall picture, as not every fatigue or lack of desire is automatically due to a testosterone deficiency.