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Anthea Rowan

If you thought testosterone was only a male hormone, think again.
Not only is it a female hormone too, but women produce more of it – in the ovaries and adrenal glands – than they do oestrogen. And low levels of testosterone affect libido in both men and women.
However, despite being dubbed the “third” female hormone, it does not yet routinely form part of conventional hormone replacement therapy.
Even though its safety for use in women has been evaluated for the past 80 years, it is still only licensed to treat low libido in women – and then only in some parts of the world.

Hong Kong-based Dr Susan Jamieson says women with lower testosterone may report a poor sex drive.
But they will also notice lower energy levels and, no matter how much they exercise, poor muscle tone, she says.
10 testosterone truths: sex drive, baldness, why women need it
Testosterone targets receptors in the brain responsible for sexual activity. But it also targets many other receptors – as many receptors as oestrogen does – and across many areas of the brain.
These include the amygdala, which drives motivation; the hippocampus, which is involved in storing long-term memories and in making those memories resistant to being forgotten; and the striatum, which is responsible for decision-making and the formation of emotions and habits.
Testosterone plays a powerful role cognitively: it helps to manage mood, boost concentration, promote verbal learning and improve spatial awareness. It might even help ward off dementia later in life, as it supports memory.

Studies have shown that in women, both testosterone and oestrogen can counter the biochemical reactions in the brain associated with Alzheimer’s disease, reactions that can cause an increase in amyloid plaques – protein deposits that form between nerve cells – poor brain glucose metabolism and reduced blood flow.
But testosterone receptors have been identified in other parts of the body too: in breast tissue, the skeleton, muscles, adipose tissue or fat, and genital tissues.
It is a whole-body hormone whose impact – whether the level is too high or too low – is widely felt. For example, it can have an impact on the eyes: testosterone supports the function of our Meibomian glands, the sebaceous glands in eyelids which produce a secretion that helps keep our eyes healthy and well lubricated.
Testosterone is seen as a ‘male’ hormone, but it’s actually important for both men and women
Dr Louise Newson
Advocates of testosterone use in women are excited by the news that a UK company is trying out a testosterone patch, called Tepi, specifically for postmenopausal women.
“Currently, there is no approved testosterone patch available for women,” says Dr Louise Newson, of Newson Health in Stratford-upon-Avon in the UK.
“AndroFeme 1 – developed in Australia in 2020 – is a testosterone cream designed for women which contains testosterone identical to the testosterone the ovaries and adrenal glands in women produce.”
It is not licensed in Hong Kong and requires a special import permit, says Laurena Law, a Hong Kong family doctor, or general practitioner. Many women are not aware of its use in treating low libido.
‘Love and lust don’t retire’: why sex after 60 is good for you
“Not all women need it and sexual health is complex,” Law says. “But for some, it could be part of the solution in combination with sex therapy, couples therapy and/or counselling.”
Previously the only testosterone available to women in transdermal preparations – that is, via the skin – were the gels manufactured for male use and applied in minuscule amounts, such as Androgel, which is licensed for use in men in Hong Kong.
“Traditionally, medicine and research has viewed women’s health through a lens of reproduction rather than overall health,” Newson says. “Testosterone is seen as a ‘male’ hormone, but it’s actually important for both men and women” – although women have much lower levels.

However, she says, it should not be viewed only in terms of reproduction. “We know that testosterone can work to maintain muscle and bone strength and can help with your overall sense of well-being and zest for life,” Newson says.
Low oestrogen levels were always blamed for osteoporosis in women – and women suffer disproportionately from the condition that leads to brittle bones. Yet in men, the condition was put down to testosterone levels dropping off.
Why would testosterone play a role in bone strength in men and not women? Indeed, a study published in the science journal Nature in 2022 suggests low testosterone levels affect the bone health of both genders.
The study showed a positive correlation between testosterone levels and bone density in women aged 40 – ie. pre-menopausal – to 60.
‘Your bones might be like chalk’: woman’s painful osteoporosis lesson
Several theories have been put forward as to why testosterone supports bone density. One is that testosterone seems to regulate the formation of osteoclasts, a type of bone cell that breaks down bone tissue.
Another theory is that testosterone might inhibit the production of B cells and thus prevent bone loss.
While testosterone levels drop off with age – hence its value to postmenopausal women if taken as a supplement – both sexes can experience low levels of the hormone at any age. Obesity, diabetes and anabolic steroid or illicit drug use have all been associated with low testosterone levels in young men.
Young women rarely consider their testosterone level, but if it is low they can experience a host of problems. Ideally, women should have 15 to 70 nanograms of testosterone per decilitre of blood.

Low testosterone levels in both men and young women can exacerbate fertility problems if they are trying to conceive.
Sometimes birth-control pills interfere with healthy testosterone production in younger women; they work by interfering with the ovaries, where testosterone is manufactured. Adrenal stress is another factor.
More women are becoming aware of the value of maintaining a higher testosterone level. The UK’s National Health Service recently revealed that the number of women using transdermal testosterone had increased by a factor of 10 in the past seven years.
The word is out.
Can’t make a baby? Check the man first – 50pc of fertility issues down to them
How to boost testosterone
The jury is still out as to whether you can increase your testosterone levels naturally.
However, by losing some weight and getting active your overall health and outlook will improve – and often that is enough to get the level of this hormone moving in the right direction. Here are some other things to consider.

1. Manage your stress levels
Chronic stress depletes testosterone because stress prompts the production of cortisol, which has a negative effect on the production of testosterone.
Further, in men, high levels of cortisol can increase fat deposition, resulting in conversion of testosterone to the female hormone oestrogen.
2. Have more sex
This might sound tricky if testosterone is lacking, but it is worth just getting on with it, as some studies suggest that regular sex also has a positive effect on testosterone.
Five myths about testosterone
3. Eat well and have more foods rich in magnesium, zinc and B vitamins
Some foods and food groups are thought to boost testosterone, such as nuts and seeds – especially pumpkin seeds – wild fish, green vegetables, and beans, especially black beans and kidney beans.
Onions and ginger are also examples. A small 2012 study found that taking ginger supplements for three months increased testosterone levels by 17.7 per cent. Both of these foods are good for health and easy to add to many recipes – onions in a curry, ginger in tea, for example.

Some nutritionists advocate supplements including dehydroepiandrosterone or DHEA. DHEA is a precursor to testosterone and is found in the adrenal glands. Its supply is depleted by cortisol – the stress hormone.
Another, similar small study found that drinking pomegranate juice for just two weeks elevated testosterone levels in the saliva of both men and women by nearly 25 per cent, as well as lowering blood pressure.
Both vitamin D and magnesium might be beneficial too – from food, supplements or, in the case of vitamin D, exposure to the sun.
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Wellness

Why women need testosterone and how to boost yours if it’s low – from using creams and, perhaps soon, skin patches to diet and exercise

Low testosterone levels in women can result in a poor sex drive, among other things. But there are ways to boost it. Photo: Shutterstock

Dr Susan Jamieson says women with low testosterone may report a poor sex drive.

Louise Newson is a doctor at Newson Health in Stratford-upon-Avon in the UK. Photo: Louise Newson

Laurena Law is a Hong Kong family doctor, or general practitioner. Photo: Laurena Law

Some foods and food groups are thought to boost testosterone, such as nuts and seeds, wild fish, green vegetables and beans. Photo: Shutterstock

Some studies suggest that regular sex has a positive effect on testosterone levels. Photo: Shutterstock

A study found that drinking pomegranate juice for two weeks elevated testosterone levels in men and women by nearly 25 per cent. Photo: Shutterstock

How to lose weight the healthy way: more exercise won’t cut it, but switching your diet will, says professor who studied hunter-gatherers

Exercise will keep you alive but won’t help you lose weight, an anthropologist says. Photo: Shutterstock

Exercise is not a weight-loss tool, says US professor Herman Pontzer, who studied the activity and energy expenditure of an African hunter-gatherer society (above). Photo: Shutterstock

Associate professor of evolutionary anthropology and global health Herman Pontzer compared the lifestyles and energy expenditure of Tanzanian hunter-gatherers with people in industrialised societies. Photo: Harvard University

The Hazda, a hunter-gatherer society in Tanzania, live a rigorous lifestyle, doing up to 10 times more physical activity than most people living in the US. Photo: Shutterstock

Members of the Hazda society expend the same amount of energy as sedentary people in the US, says professor Pontzer. Photo: Shutterstock

The cover of Herman Pontzer’s book. Photo: Amazon

“Once we started processing our food and making it in factories, we started pouring all sorts of energy into it,” says Pontzer. Photo: Shutterstock

How to age well: 6kg lighter and mistaken for someone over 10 years younger, she feels the benefits of a whole food, plant-based diet

Removing animal-based and processed foods from her diet has had multiple health benefits for Connie Wong (above). 
Photo: Xiaomei Chen

Connie Wong Wai-ling switched to a wholefood, plant-based diet, and feels much healthier for it. Photo: Xiaomei Chen

Sautéed green beans, onion and bell peppers; a typical WFPB dish Connie Wong Wai-ling makes at her home in Kwun Tong. Photo: Xiaomei Chen

Dr Anna Herby, nutrition education programme manager at the Physicians Committee for Responsible Medicine in the US. Photo: Physicians Committee for Responsible Medicine in the US

Althea Tan Hutchinson and Tansy Tan are founders of the Happy Plantarian, which offers plant-based nutrition workshops and cooking classes. Photo: Happy Plantarian 

Sperm health: half of fertility problems lie with men, researcher says, as study highlights ways to safeguard the ability to have children

This couple were lucky in being able to conceive. Many have problems, and half the time it’s the man who has fertility issues. New research lists major risks to sperm health including smoking, diabetes and age. Photo: Shutterstock

Dr Zsolt Kopa, head of the Andrology Centre in the Department of Urology at Semmelweis University in Budapest, Hungary. Photo: Semmelweis University

Smoking has been found to be one of the main contributors to DNA fragmentation, which can reduce the chances of fertilisation. Photo: Shutterstock

Relatively few men consider having a premarital health check, possibly because it has not occurred to them that any fertility issues could lie with them. Photo: Shutterstock

Anett Szabó, the lead author of the Semmelweis University study. Photo: Semmelweis University

Dr Andrew Yip, a Hong Kong-based urologist. Photo: Jonathan Wong

Lifestyle

Health & Wellness

Health

Family & Relationships

Low testosterone in women can result in a poor sex drive, low energy levels, poor muscle tone and more – their eyes can be affected, for example
Skin creams containing the hormone are one option, and a UK company is trying out a testosterone patch for use by postmenopausal women


Testosterone is thought of as a male hormone, but women need it too. If their bodies do not produce enough, there are limited medical means to raise their levels of it. Exercise and following the right diet can help.


Sex and relationships

Healthy eating

Reproductive health

5050

Why women need testosterone and how to boost yours if it’s low – from using creams and, perhaps soon, skin patches to diet and exercise

Low testosterone in women can result in a poor sex drive, low energy levels, poor muscle tone and more – their eyes can be affected, for example Skin creams containing the hormone are one option, and a UK company is trying out a testosterone patch for use by postmenopausal women

Low testosterone in women can result in a poor sex drive, low energy levels, poor muscle tone and more – their eyes can be affected, for example

Skin creams containing the hormone are one option, and a UK company is trying out a testosterone patch for use by postmenopausal women