A No-Nonsense Guide to Testosterone: Hormonal Balance, & Supportive Lifestyle Changes

Published on July 19, 2023

By Kristen Boye BS, Natural Health

Kristen Boye

Kristen Boye is a natural health expert, writer, copywriter, and editor. Kristen was raised on an organic farm in British Columbia which inspired her life’s work. She holds a Bachelor’s Degree in Natural Health, is a Certified Natural Foods Chef, co-owner of a medicinal herb farm, and is a natural foods and children’s health advocate. Kristen lives with her husband and two children on their medicinal herb farm in Western North Carolina.

Most of us know testosterone as a male hormone responsible for libido and bodily changes in men*, or males assigned at birth, during puberty.

However, did you know women*, or females assigned at birth, also produce testosterone? 

Or that testosterone plays a critical role in red blood cell production, bone mass, fat distribution, and metabolism?

That’s just the tip of the testosterone iceberg.

In this article, you’ll learn all about this miraculous and often misunderstood hormone, including: 

  • How testosterone works in men and women
  • What causes testosterone imbalances?
  • How to recognize symptoms of testosterone imbalance in men and women
  • Which tests measure testosterone levels
  • Medication, lifestyle factors, and supplements that may support overall hormonal balance

*Throughout the remainder of this article, we will use the terms “men” to refer to men or males assigned at birth, or “women” to refer to women or females assigned at birth. We recognize, respect, and support all people, lifestyles, races, creeds, and genders.

What is Testosterone?

Testosterone is a sex hormone primarily produced by testicles in males and ovaries in females from substrates (substances acted upon by enzymes) of cholesterol and acetate. REF#2316 REF#2317

The adrenal glands also play a role in testosterone production by creating the hormone DHEA (dehydroepiandrosterone), which is then converted into testosterone and/or estrogen.

Testosterone is the main androgen hormone responsible for creating and sustaining male characteristics.

Hence why men have naturally higher levels of testosterone than women.

What Does Testosterone Do?

Testosterone functions differently in men and women.

In men, it’s thought to regulate or play a role in: REF#2318 REF#2319 REF#2320

  • Bone mass 
  • Development of male reproductive organs in-utero
  • Growth spurts in puberty
  • Fat distribution 
  • Facial and body hair
  • Fertility/sperm health
  • Heart health via its effects on metabolism
  • Libido
  • Metabolism
  • Mood
  • Muscle mass and strength
  • Production of red blood cells and sperm
  • Puberty (enlargement of penis and testes, lowering of voice, development of facial and pubic hair)
  • Sex hormones 
  • Testosterone also triggers the development of male reproductive organs in-utero

Testosterone functions a little differently in women. Mainly because women’s bodies convert testosterone, and other androgens, into female sex hormones.

In women, testosterone plays a role in: 

  • Bone health
  • Breast health
  • Fertility
  • Libido
  • Menstrual health
  • Puberty (breast development)
  • Vaginal health

Since men and women produce testosterone, maintaining normal levels as we age is important in all sexes.

What Causes Testosterone Imbalance?

Testosterone imbalance—overproduction or underproduction—can occur in men and women and cause varying symptoms (which we’ll discuss next).

Causes of overproduction of testosterone may include: REF#2320

  • Adrenal virilization/adrenal tumors
  • Being overweight or underweight
  • Cushing syndrome
  • Hyperthyroidism
  • Ovarian or testicular tumors
  • Polycystic ovarian syndrome (PCOS)
  • Steroid use

Causes of under-production of testosterone may include: REF#2320 REF#2321 REF#2322

  • Age—androgen hormones, including testosterone, tend to reduce as we age
  • Certain medications
  • Chemotherapy
  • Cryptorchidism and orchitis
  • Endocrine-disrupting chemicals, such as phthalates found in plastics and fragrance REF#2323
  • Genetic disorders such as Klinefelter and Kallmann syndrome
  • Hypothyroidism
  • HPA (Hypothalamus Pituitary Adrenal) Axis Dysfunction
  • Imbalances in other hormones
  • Primary hypogonadism
  • Use of steroids 
  • Stress

Given the interconnectedness of the body and new findings about how internal and external factors can influence hormonal balance, there are likely other causes and correlations of testosterone imbalance yet to be confirmed by science. 

If you suspect you may be experiencing fluctuations in testosterone, talk with your doctor or healthcare practitioner to rule out a disease.

9 Symptoms of Testosterone Increase or Decrease In Men

As you’ve just learned, testosterone imbalance in men is possible and may cause the following symptoms:REF#2320

  • Changes in mood
  • Cognitive issues such as difficulties with focus or memory
  • Erectile function
  • Fatigue
  • Hot flashes
  • Loss of body hair
  • Low libido
  • Osteoporosis
  • Unexplained muscle weakness

Having one or several of these symptoms does not necessarily indicate an age-related decline in testosterone, and symptoms vary based on age.

Also, some men experience no symptoms of testosterone related to a dip in their testosterone.

Talk to your doctor if you suspect a problem so they can run the proper tests (which we’ll discuss later in this article).

8 Symptoms of Testosterone Increase or Decrease In Women

Until recently, few people recognized the possibility of testosterone imbalance in women. 

This is partly because the primary symptom is low libido, which is often mistaken as a side effect of fatigue, stress, or depression.

However, women can and do experience testosterone imbalance, especially if they have certain pre-existing conditions such as PCOS (Polycystic Ovarian Syndrome).

Here are some symptoms women may experience: REF#2320 REF#2324 REF#2325

  • Acne (increase)
  • Excess facial or body hair (increase)
  • Hair loss (increase)
  • Low libido (the most common symptom)(decrease)
  • Menstrual irregularities (increase and decrease)
  • Muscle weakness (increase)
  • PCOS (Polycystic ovarian syndrome)
  • Vaginal dryness (decrease)

Having one or several of these symptoms does not necessarily indicate a concern regarding testosterone levels. 

Talk to your doctor if you suspect a problem so they can run the proper tests and determine an appropriate treatment plan if it is serious

What Tests Measure Testosterone Levels?

If your healthcare provider suspects testosterone concerns may be causing unwanted symptoms, they may order one or more of the following tests:

  • Follicle-stimulating hormone (FSH) blood test
  • Luteinizing hormone (LH) blood test
  • Total testosterone blood test 

Integrative Functional Medicine providers may recommend a comprehensive hormone panel like a DUTCH test, which measures various sex and adrenal hormones, metabolites, nutrients, and more.

7 Lifestyle Factors That May Influence Testosterone Levels in Men & Women

Can lifestyle affect testosterone levels? You bet.

Although more research is needed to fully understand the impact lifestyle choices have on hormonal health, we know the following can support healthy hormone balance: REF#2326 REF#2327 REF#2328 REF#2329

  • Avoiding endocrine-disrupting chemicals, such as plastics, fragrances, and certain cleaning chemicals
  • Eating a diverse and healthy diet with plenty of fruits and vegetables
  • Getting regular exercise
  • Getting enough sleep
  • Maintaining a healthy weight
  • Not smoking
  • Strength train

    What About Medications or Supplements for Testosterone?

    Testosterone medication is available by prescription. 

    However, it comes with side effects and risks that should be considered based on the benefits with the doctor. Plus, the risks of long-term testosterone replacement therapy, including potential cardiovascular and prostate issues, are unknown. REF#2330 REF#2331

    Although many supplements claim to enhance testosterone, there is insufficient evidence to support most of them for use in improving testosterone levels due to age-related decline.

    However, there is limited evidence that these vitamins and minerals may support normal testosterone levels: 

    • Vitamin D, REF#2332
    • Magnesium, REF#2333
    • Zinc, REF#2334
    • DHEA REF#2335

    More research is needed.

    Certain herbs that show some promise in supporting normal testosterone levels, including, as we age: REF#2336 REF#2337

    However, more research is needed to make a recommendation.

    Integrative functional medicine practitioners specializing in whole-body hormone balancing may have other drug-free recommendations, if that is your preference

    To Recap 

    Testosterone is a sex hormone in men and women, with larger concentrations in men.

    It is responsible for various bodily functions, including sex drive, fertility, bone health, sperm production, different aspects of puberty and development, red blood cell production, cognitive health, and more.

    Fluctuating testosterone levels in men and women can occur due to various factors, including aging, pre-existing conditions, lifestyle, exposure to endocrine-disrupting chemicals, and genetics.

    Symptoms of an increase or decrease in testosterone levels are different in men and women and include low libido, facial hair, mood imbalances, osteoporosis, muscle weakness, and more.

    If you have concerns regarding testosterone levels, talk to your doctor, who can order the appropriate tests as it is the only method in determining whether your testosterone has either increased or decreased and whether it is simply age-related or there is an underlying condition that may need to be treated..

    Testosterone replacement therapy may be an option for age-related decreases in testosterone production in men, but there are side effects, and the long-term risks are unknown.

    Lifestyle factors such as getting optimal sleep, exercising, and practicing good nutrition, can all help support normal testosterone levels.

    There is limited evidence that Certain supplements, such as vitamin D, magnesium, zinc, and DHEA, may also help support testosterone levels. However, most brands claiming their product(s) “boost testosterone” have not been validated by rigorous scientific research.

    Have more questions or concerns? Talk to your doctor or healthcare practitioner, and keep practicing a healthy and active lifestyle!


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