Most conversations about testosterone skip women entirely, and most women’s panels skip testosterone. Both are a mistake. Here is what the markers actually show, and why they are read differently for women.
Women make testosterone too
Testosterone in women comes from the ovaries and adrenal glands, and it circulates at a fraction of male levels. Total testosterone in premenopausal women typically falls in a low range, often cited around 15 to 65 ng/dL, and it shifts across the menstrual cycle. Even at these small concentrations it contributes to sexual desire, energy, mood, and the maintenance of bone density and muscle tone. Low does not mean unimportant.
The three markers, read on a female scale
The same three numbers that tell a man’s testosterone story tell a woman’s: total T (all of it), free T (the small unbound fraction that is biologically active), and SHBG, the protein that binds most of your testosterone and changes how much is actually available. The difference is the scale. A female panel reads these against female reference ranges, alongside estradiol, progesterone, and thyroid and metabolic markers, never against a male range. Read in isolation, a single testosterone figure is as misleading for women as it is for men. (See what your testosterone numbers actually mean.)
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How levels change with age
Female testosterone does not fall off a cliff at menopause the way estrogen can. Instead total and free testosterone decline gradually, beginning in the early reproductive years, so a woman in her forties may sit well below where she was at twenty-five without any single dramatic event. Surgery that removes the ovaries can drop production sharply, by as much as half. This slow slope is one reason symptoms like low libido and fatigue often get attributed to everything except a hormone that was never measured. (See perimenopause by the markers and HRT in perimenopause: options.)
The honest regulatory picture
There is no FDA-approved testosterone product designed and dosed for women in the United States. When testosterone is used in women, it is prescribed off-label, at low doses, by a physician using clinical judgment and monitoring. That is not a reason to ignore the marker; it is a reason to measure it properly and to keep any decision inside a real clinical relationship. Honesty about approval status is part of reading the labs well.
What your physician does with this (labs before molecules)
At Telos the model is measure first. The panel you complete is reviewed by a licensed physician through the affiliated medical group, who reads total T, free T, and SHBG on a female scale, alongside estradiol, progesterone, and your core hormone and health markers, and decides what, if anything, fits. Telos markets and refers; it does not prescribe, dispense, or take payment for care. The numbers inform a clinical judgment, and nothing here is medical advice.