Androgen Physiology in Women: Understanding Hormones

Androgen Physiology in Women: Why Testosterone Matters

Abstract

Testosterone is often called a “male hormone,” but that description is incomplete. Testosterone and other androgens are normal parts of female physiology. Women have much lower testosterone levels than men, yet these hormones participate in sexual function, reproductive biology, muscle and bone signaling, metabolism, and brain function. Current research also shows that a woman’s androgen health cannot be understood from a single testosterone number alone. Age, ovarian and adrenal function, sex hormone-binding globulin, medications, metabolic health, and symptoms all matter.

An integrative approach connects hormone evaluation with nutrition, exercise, rehabilitation, pain management, sleep, metabolic health, and medical oversight. Chiropractic care does not replace medical evaluation of hormone disorders. Instead, when musculoskeletal pain or limited movement is also present, integrative chiropractic care may help improve comfort and mobility so patients can remain active and participate more fully in their overall health plan.

Testosterone Is a Normal Female Hormone

Androgens are a family of sex hormones that includes testosterone, androstenedione, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), and dihydrotestosterone. Although men generally produce much larger amounts, women need androgens too.

Research has reported female testosterone concentrations roughly 10 to 15 times lower than adult male levels, while other literature has described differences of about 20 to 25 times. The exact comparison varies with age, laboratory method, population, and the form of androgen being measured (Hunter, 2025; Horstman et al., 2012).

What matters is that “lower” does not mean unimportant.

Davis and Wahlin-Jacobsen (2015) describe testosterone as a physiologically important hormone in women. It acts directly through androgen receptors and can also be converted into estradiol inside tissues. The clinical white paper makes a similar point: testosterone circulates at meaningful concentrations throughout much of adult female life and supports sexual function, musculoskeletal physiology, and tissue maintenance.

A recent review also argues that the traditional idea of testosterone as exclusively “male” does not match modern endocrine science. Researchers are studying female androgen signaling in reproduction, muscle, bone, cardiovascular physiology, and brain function (Faucett et al., 2026).

Where Do Female Androgens Come From?

Unlike men, women do not have one overwhelmingly dominant source of testosterone.

The ovaries and adrenal glands both participate. They produce testosterone directly while also producing larger amounts of androgen precursors such as DHEA, DHEAS, and androstenedione. Peripheral tissues can then convert those precursors into active hormones.

This helps explain why a blood test only shows part of the story.

The white paper describes an important concept called intracrinology. According to this model, tissues can take up circulating DHEA and convert it locally into testosterone, dihydrotestosterone, or estradiol. Some of those hormones are then used and inactivated within the same tissue without causing a large change in the bloodstream.

The diagram on page 3 of the supplied PDF illustrates this process: the adrenal glands and ovaries provide hormone precursors, while local enzymes inside tissues determine whether those raw materials become testosterone, DHT, estradiol, or inactive metabolites.

That is one reason female hormone health is more complicated than looking at a single lab number.

What Does Testosterone Do in a Woman’s Body?

Androgen receptors are found in many tissues. Testosterone can also be converted to estradiol through an enzyme called aromatase. This allows androgen physiology to overlap with estrogen physiology (Davis & Wahlin-Jacobsen, 2015).

Some of the major areas under study include:

• Sexual health: Testosterone has the strongest established clinical relationship with sexual desire and sexual function in women.
• Muscles: Androgen receptors are present in skeletal muscle, and testosterone participates in anabolic signaling and muscle physiology.
• Bones: Testosterone may act directly through androgen receptors and indirectly after conversion to estradiol.
• Reproductive physiology: Androgens contribute to ovarian and follicular function and serve as estrogen precursors.
• Metabolism: Androgen status interacts with body composition, insulin resistance, and sex hormone-binding globulin.
• Brain function: Androgen receptors are found in the nervous system, although the clinical effects of testosterone treatment on cognition and mood remain much less certain than its effects on sexual function.

(Cleveland Clinic, 2024; Faucett et al., 2026; Hunter, 2025).

An important distinction is needed here: normal physiology does not automatically prove that testosterone treatment will improve every function associated with an androgen receptor.

The supplied white paper emphasizes this point. Androgen receptors are found in bone, muscle, adipose tissue, cardiovascular tissues, and the brain, but the presence of a receptor does not by itself prove that giving testosterone will produce a clinical benefit in that tissue.

Female Testosterone Changes With Age

Female androgen levels generally decline gradually rather than falling suddenly at menopause.

DHEA and DHEAS begin decreasing earlier in adulthood, and testosterone also changes as women age. This pattern differs from estradiol, which usually declines much more sharply around menopause. The removal of both ovaries is different because bilateral oophorectomy can produce a much more abrupt loss of ovarian androgen production.

This is clinically important because menopause alone should not automatically be treated as proof of “testosterone deficiency.”

Symptoms, reproductive history, medications, ovarian status, metabolic health, other hormones, and laboratory trends all deserve consideration.

Why One Testosterone Test May Not Give the Whole Answer

Measuring testosterone in women can be technically challenging because concentrations are much lower than in men.

The supplied white paper notes that some routine testosterone immunoassays become less reliable at these lower concentrations. Liquid chromatography-tandem mass spectrometry, or LC-MS/MS, is generally more dependable when accurate measurement is especially important.

Sex hormone-binding globulin, or SHBG, also matters. SHBG binds testosterone in the bloodstream. Changes in SHBG can therefore change the amount of free hormone available to tissues even when total testosterone remains similar.

For example, oral estrogen and excess thyroid hormone can raise SHBG, while insulin resistance and obesity may lower it.

For this reason, a thoughtful evaluation may consider total testosterone alongside SHBG, calculated or measured free testosterone when appropriate, DHEAS, ovarian function, symptoms, medications, thyroid status, metabolic health, and clinical history.

Low Numbers Do Not Automatically Equal a Disease

There is currently no universally accepted blood-test cutoff that diagnoses a general “female androgen deficiency syndrome.”

Women with lower testosterone measurements may have no symptoms, while women experiencing fatigue, low desire, reduced well-being, or other concerns may have testosterone results within a laboratory reference interval. Current guidance therefore warns against diagnosing androgen deficiency based on a single laboratory value.

The strongest evidence for testosterone therapy remains relatively narrow. International guidance has supported carefully evaluated postmenopausal women with hypoactive sexual desire disorder, or HSDD, after other biological, psychological, medication-related, relationship, and genitourinary causes have been considered. The evidence is much less established for using testosterone specifically to treat fatigue, cognition, body composition, bone health, or general aging.

This distinction helps protect patients from the “more is better” approach.

Excessive androgen exposure can cause unwanted effects such as acne, increased facial or body hair, scalp hair changes, menstrual disturbances, and metabolic concerns. Cleveland Clinic likewise emphasizes that androgen health depends on balance rather than simply maximizing testosterone.

How Integrative Chiropractic Care Fits Into Women’s Hormone Health

Chiropractic care should not be presented as a treatment for low testosterone or an endocrine disorder. Its value in an integrative hormone program is different.

A woman dealing with hormonal changes may also have back pain, neck pain, joint stiffness, poor mobility, reduced exercise tolerance, previous injuries, muscle weakness, or disrupted sleep because of pain. Addressing those physical barriers can make it easier to move, exercise, build strength, and participate in a broader wellness plan.

For low-back pain specifically, systematic reviews have found that spinal manipulation can provide modest improvements in pain and function in appropriately selected patients, although responses vary and temporary soreness or other minor effects can occur (Paige et al., 2017).

The patient-centered goals of integrative chiropractic care may therefore include reducing musculoskeletal pain, improving movement, helping a patient return to exercise, restoring functional confidence, and indirectly supporting better sleep when pain has been interfering with rest.

Whenever appropriate, conservative and non-drug approaches can also provide patients another option before escalating treatment for a musculoskeletal problem. This does not mean medications or surgery are always avoidable. It means the medical principle of doing no unnecessary harm is supported by starting with reasonable, lower-risk options when clinically appropriate and escalating care when necessary.

Coordinated Care Means Working With the Existing Medical Team

True integrative care should add coordination, not create competing treatment plans.

A patient’s primary-care clinician, gynecologist, endocrinologist, internist, prescribing clinician, chiropractor, rehabilitation team, and other specialists may each contribute different information. Communication becomes especially important when hormone therapy, cardiovascular risk, diabetes, thyroid disease, medications, bone health, or other medical conditions are involved.

At Injury Medical Clinic PA in El Paso, Texas, the practice’s multidisciplinary model combines the chiropractic and rehabilitative work of Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, with internal medicine oversight from Maria Guadalupe Cardenas, MD. Practice materials describe Dr. Cardenas as a board-certified internist with more than 40 years of clinical experience who serves as Medical Director and Collaborative Physician.

Dr. Jimenez’s published clinical materials emphasize viewing hormone concerns together with movement, pain, nutrition, metabolic health, rehabilitation, sleep, and overall function rather than treating one laboratory result in isolation. His LinkedIn materials similarly describe a multidisciplinary model connecting chiropractic care, medical oversight, functional medicine, and rehabilitation. These are clinical observations and practice philosophy, not proof that chiropractic treatment directly changes androgen levels.

Within this model, Dr. Jimenez may focus on biomechanics, chiropractic treatment, functional rehabilitation, personal injury recovery, exercise, and functional-medicine strategies, while Dr. Cardenas contributes internal-medicine evaluation and medical oversight. The goal is a well-coordinated plan in which each discipline stays within its proper role.

The Bigger Picture: Hormones, Movement, and Healthy Aging

Androgen physiology is part of a larger biological system.

Muscles respond to resistance exercise. Bones respond to loading. Nutrition, physical activity, body composition, sleep, and insulin sensitivity influence metabolic health. Hormones interact with all of these systems without acting alone.

Older research on sex hormones and aging also supports the link between endocrine changes, muscle, bone, and physical function, while stressing that important questions remain about cause, treatment, and long-term outcomes (Horstman et al., 2012).

For patients, this means hormone care should rarely become simply a search for a higher testosterone number.

The better question is: What combination of medical evaluation, movement, nutrition, sleep, rehabilitation, metabolic care, and appropriate hormone management will safely improve how this patient feels and functions?

Conclusion

Testosterone is not merely a male hormone. It is a normal and biologically active part of female physiology. Women have much lower absolute testosterone concentrations than men, but androgens still participate in reproductive physiology, sexual function, muscle and bone signaling, metabolism, and numerous tissue-level processes.

At the same time, recognizing the importance of testosterone does not mean every symptom is caused by low testosterone or that every woman benefits from testosterone treatment. Female androgen physiology is complex, laboratory testing has limitations, and the best treatment decisions depend on symptoms, history, examination, medications, metabolic health, reproductive status, and careful medical monitoring.

Integrative chiropractic care can complement that process by addressing pain, mobility, strength, rehabilitation, and other physical barriers to healthy activity. When chiropractic care, functional medicine, personal injury care, rehabilitation, and medical oversight communicate with the patient’s existing healthcare team, the result is a more complete and safer approach centered on what matters most: helping the patient move better, hurt less, sleep better, remain active, and make informed decisions about her long-term health.

“Understanding why testosterone matters is a powerful step toward reclaiming your health and vitality. You don’t have to guess your way through confusing hormonal changes or navigate your symptoms alone—reach out to our clinical team today to learn how safe, monitored protocols can help restore your body’s natural balance.”

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References

Cleveland Clinic. (2024). Androgens: Function, levels & related disorders. Androgens: Function, Levels & Related Disorders

Davis, S. R., & Wahlin-Jacobsen, S. (2015). Testosterone in women—The clinical significance. The Lancet Diabetes & Endocrinology, 3(12), 980–992. Testosterone in women—The clinical significance

Faucett, K., Giles, L. A., & Sing, E. (2026). Testosterone: Vital to female physiology. Women’s Health, 22. Testosterone: Vital to female physiology

Hatzilabrou, T. A. (n.d.). Testosterone and androgen physiology in women. Worldborne Medical.

Horstman, A. M., Dillon, E. L., Urban, R. J., & Sheffield-Moore, M. (2012). The role of androgens and estrogens on healthy aging and longevity. The Journals of Gerontology: Series A, 67(11), 1140–1152. The Role of Androgens and Estrogens on Healthy Aging and Longevity

Hunter, S. K. (2025). Testosterone and androgen receptors in females: What is possible with resistance training? The Journal of Physiology, 603(18), 5227–5228. Testosterone and androgen receptors in females

Jimenez, A. (2026). Women’s hormonal health insights on testosterone deficiency. Women’s Hormonal Health Insights on Testosterone Deficiency

Jimenez, A. (2026). Professional profile and clinical publications. Dr. Alexander Jimenez LinkedIn profile

Paige, N. M., Miake-Lye, I. M., Booth, M. S., et al. (2017). Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. JAMA, 317(14), 1451–1460. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm

Thomas, L. (2022). The role of testosterone in women’s health. News-Medical. The Role of Testosterone in Women’s Health