Importance of Testosterone Hormone Test in Fertility

Quick Bites

  • Testosterone is an important hormone that affects the energy, sexuality, and libido of a woman
  • Testosterone helps secrete hormones that are important in the menstrual cycle of a woman
  • Testosterone is responsible for growth of hair in the pubic region, face, and underarms



The testosterone hormone test is a simple blood test to measure levels of testosterone in the body. Everyone has been aware of the role of testosterone in men for long, but only a few understand the role it plays in women's health and fertility. Even though women produce much less testosterone than men, it is an important hormone that affects a woman's energy, sexuality, and libido.

Testosterone is an androgen, meaning it is a male hormone. While testosterone is often considered to be a male sex hormone, woman's ovaries also secrete testosterone in small amounts. Testosterone is vital to both male and female health and fertility. The highest level of testosterone in women is during puberty, and it usually peaks in the early 20s. A woman's testosterone levels drop by 50% by the time they reach menopause. Testosterone hormone level testing is a critical part of any fertility assessment.

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In this article


What is the role of testosterone hormone?

In women, the testosterone hormone plays an important role. Testosterone hormone, along with estrogen hormone, helps in the growth, maintenance, and repair of a woman's reproductive tissues and bone mass. Testosterone also helps in maintaining a healthy libido and fertility in women. Testosterone is produced in the ovaries and adrenal glands in women. The level of testosterone hormones produced in the body varies each day and throughout the day. Testosterone levels are highest in the morning hours and decrease gradually as the day passes.

Testosterone produced from the ovaries turns into estradiol hormone, within the ovaries. The production of testosterone increases mid- menstrual cycle, indicating healthy ovulation in women. It also helps to boost sexual desires during her prime conception time (Ovulation). Testosterone also improves the production of cervical mucus, which in turn encourages fertility by increasing circulation to the pelvic region.[1]

In men, testosterone is known to be one of the most important male hormones. Testosterone hormone affects everything in a man, from the sexuality and reproductive system to muscle mass and bone density. It also affects the:

  • Endocrine System
  • Reproductive System
  • Sexuality
  • Central Nervous System
  • Skin and Hair
  • Muscle, Fat, and Bone
  • Circulatory System
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Why is Testosterone test performed?

In women, testosterone tests may be recommended by a doctor when they notice or when women share her symptoms and changes that are happening in her body. Changes related to high testosterone level in women includes: [2]

  • Excessive, male pattern hair growth, for example growth of excessive facial hair (Idiopathic hirsutism)
  • Polycystic ovarian syndrome (PCOS/PCOS - a condition of hormonal imbalance in which cysts grow on the ovaries and testosterone levels are abnormally elevated)
  • Irregular or absent periods
  • Infertility
  • Reduction in breast size
  • Increase in muscle mass
  • Patchy head hair loss
  • Deepening of the voice
  • Low good cholesterol
  • Enlargement of clitoris
  • Obesity
  • Decreased sex drive

Apart from this usually, menopausal women have a deficiency of testosterone, but recently a growing number of premenopausal women are found being affected by low testosterone. A blood or saliva test can confirm if your testosterone is normal. Signs of low testosterone are similar to signs of low thyroid, or depression, or aging. They are:[3]

  • Feeling cold even after thyroid tests are normal
  • Loss of head hair or body hair
  • Poor sleep
  • Low muscle mass
  • Loss of energy
  • Difficulty losing body fat
  • Depressed mood or lack of concentration
  • Low libido and vaginal dryness

If you notice any of the mentioned signs, you must get a testosterone level check after visiting a doctor.

In men, a testosterone levels test may be used to diagnose several conditions, including:

  • Decreased sex drive
  • Infertility
  • Erectile dysfunction
  • Tumors of testicles
  • Early or delayed puberty in boys
Read more:Estradiol (E2) Hormone Test and its effect on fertility

How is the testosterone level test done and how should you prepare?

During a testosterone level test, your health care provider will take a blood sample from your vein in the arm with a small needle. You might feel a slight pinch during the process. The sample collection takes less than five minutes. Apart from blood, testosterone levels can also be detected from saliva. This method does not require the use of a needle or blood draw. Home-testing kits are available for this method of testing. Very few doctors order this method of testosterone testing because very few studies support its validity.

There are no special preparations required for a testosterone test. Having a blood test is mostly risk-free. You may find bruising or have slight pain at the spot of needle injection. The bruising goes away quickly.

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Normal Testosterone levels in female and male

Levels of testosterone were measured with a blood test in nanograms per deciliter (ng/dL). The amount of testosterone can vary throughout their life. Testosterone levels are measured with a morning blood sample, as testosterone levels fluctuate throughout the day and are highest in the morning. Testosterone levels depend on a person’s age, gender, and health conditions. Male usually have much higher levels of testosterone than females. Testosterone levels for male and female are,

In Female- [4]

  • Age 17 to 18 years: 20-75 ng/dL
  • Age 19 years and older: 8-60 ng/dL

In Male-

  • Age 17 to 18 years: 300-1,200 ng/dL
  • Age 19 years and older: 240-950 ng/dL

People will have different levels of testosterone hormone within this healthy range. If your results are not the usual, it does not necessarily mean that you have a medical problem that needs treatment. Alcoholism and certain medications can also affect your results. If you have any queries about your test result, talk to your doctor.

Read more:Luteinizing Hormone Test and Its Importance in Fertility

Understanding testosterone test results

A testosterone test result may mean different things to different people, depending on your gender and age.[5] Testosterone test results vary from woman to man. Let's try to understand what your test result means,

For Women:

High levels of testosterone in women might signal a condition called polycystic ovary syndrome or PCOS. PCOS is a hormone disorder that affects women at the childbearing age. It is also a leading cause of female infertility.

High testosterone may also signal towards cancer of the adrenal glands or ovaries. Women with high levels of testosterone may grow facial hair, develop a deep voice, or experience decreased breast size. It can also cause acne in women.

If the testosterone level increases too much in the body, it can cause congenital adrenal hyperplasia (CAH - Congenital Adrenal hyperplasia). CAH is an inherited disorder that results in low levels of cortisol and high levels of male hormones, causing the development of male characteristics in females and early puberty in both boys and girls.

Low levels of the testosterone hormone are considered normal, but if the hormone levels are very less, it is an indication of Addison disease, which is a pituitary gland disorder. Low testosterone levels in women can also cause a decrease in sexual desire and satisfaction, mood swings or depressed mood, weakness in muscles.

For men:

High levels of testosterone in men signals towards a tumor in the adrenal glands or the testicles. High testosterone levels in boys is generally an indication of cancer in the adrenal glands or the testicles.

Low levels of testosterone in male mean that there is a chronic or genetic disease. It can also mean that there is a problem with the pituitary gland. Low testosterone level leads to Low sex drive, erection problem, development of breast tissue, Fertility problems, Hair loss, Weak bones

and Loss of muscle mass

Low levels in boys may indicate that there is some other issue with the testicles, like an injury.

Read more:Progesterone Test and Its Importance in Female Fertility

What is the connection between testosterone and fertility

Testosterone hormone plays a vital role in maintaining good reproductive health in both men and women. Women only need a small quantity of testosterone as compared to men. Too much or too little of testosterone can interfere with the fertility of women. Let's understand the role of testosterone hormone in maintaining the reproductive health of women.

Testosterone hormone helps to promote the development of follicles (structures that hold and release eggs during ovulation), but high testosterone levels are not beneficial for egg health. When the testosterone levels are too high such as in the case of women with PCOS, the follicles and egg quality declines. The high level of testosterone hormone also interferes with ovulation, causing irregular menstruation and problems in conception.

Testosterone is also closely related to libido and sex drive, indirectly affecting the fertility of women. High testosterone levels can signal a potential fertility problem in women.[6] Elevated maternal testosterone levels during pregnancy are associated with growth restriction of the fetus.

In men, testosterone plays a crucial role in making sperm. A low sperm count makes it harder to conceive a child and may lead to infertility.

Apart from the general reproductive health, testosterone hormone also helps during IVF treatment. According to one study, women with diminished ovarian response undergoing in vitro fertilization (IVF) may benefit from testosterone therapy. Testosterone replacement therapy (TRT) available in the form of injections, testosterone hormone patches, testosterone gels. One study shows that the testosterone gel has a positive impact on the fertility rate in women with a poor response to IVF cycles.[7]

Read more:Prolactin Levels and Its Impact on Your Fertility

Natural ways to balance testosterone level in Women

Note: If you are on oral contraception, you must know that they suppress testosterone and a few other hormones.

Making good lifestyle changes can affect testosterone levels in both men and women. Some lifestyle changes may reduce high testosterone in women, while others manage the testosterone imbalance symptoms.

Exercise! boosts testosterone secretion

Regardless of age, endurance, and resistance exercises increase the production of testosterone in women. There will be more production of testosterone if you have more muscle mass.

Although, for fertility purposes, you do not want too high testosterone levels. It is advised to avoid extreme exercises and bodybuilding. Sticking to low impact workouts like hiking, walking, fertility yoga, or low impact equipment at the gym is recommended.

Note: even if you have high levels of testosterone, the benefits of exercising outweigh its drawbacks, especially if you have PCOS or need to reduce your BMI.

Actively Work to Reduce Stress

High stress increases the production of cortisol hormone, which affects testosterone production in both men and women. Daily stress management is the key to encouraging natural fertility and balancing all the reproductive hormones in women.

Cut back on refined carbohydrates and sugar

Refined carbohydrates and sugars trigger insulin spikes and also contribute to imbalanced testosterone. Women who are insulin resistant tend to have high testosterone levels. A sign of imbalanced testosterone and too much sugar in the diet in women is acne around the chin area.

Avoid an extremely low-fat diet if you have low testosterone

Too many restrictions and a low-fat diet are not good for the overall health and hormone balance. There is a strong link between dietary fat and testosterone levels. Therefore, you must include healthy fats from pumpkin seeds, avocado, olive oil, coconut oil, and organic meat in your diet for keeping your testosterone levels balanced. You must avoid very high protein foods in your diet as they lower testosterone.

Think zinc

In women, zinc is necessary for egg development, proper hormone regulation, and the production of follicular fluid. Low levels of zinc increase the risk of miscarriage. You should include foods that are rich in zinc like organic chicken, oysters, eggs, grass-fed beef, spinach, wild seafood, spirulina, legumes, wheat germ, pumpkin seeds, and nuts.

Use herbs to help balance testosterone

Spearmint: Research has found that drinking spearmint tea can lower the levels of free testosterone without impacting DHEA or total testosterone. It also helps in reducing androgen hormones in women with PCOS.

Saw palmetto: Saw palmetto helps in regulating the excess testosterone by curbing 5-alpha reductase, an enzyme that is linked to hair loss and facial hair growth.

Ginseng: Even though there is no proof that ginseng can increase testosterone in women, it is a great option for anti-stress support. It also encourages libido and fights fatigue.

Maca: Maca supports the production of testosterone, progesterone, and estrogen, even though it does not contain hormones itself. It also has aphrodisiac qualities and helps in circulation to the pelvic region.

Herbs for High levels:

If you find that your testosterone levels are high, the following foods and herbs help reduce the levels naturally:

  • Flaxseed
  • Green tea
  • Vegetable oil
  • Chaste tree (chaste berry)
  • Soy
  • Licorice root
  • Black cohosh
  • Reishi
  • Nuts
  • White peony

Before adding any of these foods to your diet, consult with your healthcare provider about how they may interact with any medications you are currently taking or affect any treatment that you are having.

Testosterone therapy is widely used in menopausal women. Testosterone therapy appropriate if women show symptoms like reduced sex drive, depression, and fatigue after surgically induced menopause and when estrogen therapy hasn't relieved your symptoms.[8]

Read more:Semen Analysis in the diagnosis of Male infertility


Hormones are known to be tricky chemicals. Small amounts can cause massive reactions, both bad and good. Consider getting a hormone panel and keep an eye for signs to determine where you fall. Natural therapies are a great choice for encouraging balanced testosterone levels. Lifestyle changes and long term diet plans are paramount to resolving the imbalance in hormones.

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List of ReferencesHide

1 .

Vineet Tyagi, Michael Scordo, et al. “Revisiting the role of testosterone: Are we missing something?”. Rev Urol. 2017; 19(1): 16–24, PMID: 28522926.

2 . “Low Testosterone in Women”., 5 Aug 2020.

3 .

Sheryl Kraft and Barb DePree. “Signs of High Testosterone in Women”., 19 Jun 2017.

4 . “Test ID: TTFB-Testosterone, Total, Bioavailable, and Free, Serum”., 5 Aug 2020.

5 . “Testosterone Levels Test”., 31 July 2020.

6 .

Saharkhiz N, Zademodares S, et al. “The effect of testosterone gel on fertility outcomes in women with a poor response in in vitro fertilization cycles: A pilot randomized clinical trial”. J Res Med Sci. 2018;23:3. Published 2018 Jan 29, PMID: 29456560.

7 .

Olooto WE, Amballi AA, Banjo TA. “A Review of Female Infertility: Important Etiological Factors and Management”. J Microbiol Biotech Res. 2012;2(3):379-385.

8 .

Rakibul M. Islam, Robin J. Bell, et al. “Effects of testosterone therapy for women: a systematic review and meta-analysis protocol”. Published online 2019 Jan 11, PMID: 30635029.

Last updated on: : 28 Sep 2020

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