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Hormone health

Testosterone, Total

Also known as: Total testosterone test, Serum testosterone test, Androgen level test

Although testosterone is commonly thought of as a “male hormone,” it’s also an essential biomarker of female health. Women produce testosterone in smaller amounts than men, mostly through the ovaries and adrenal glands. In women, testosterone supports sexual health, bone density, muscle mass, cognitive function, mood, and energy levels. 

A total testosterone test measures the amount of testosterone circulating in the blood. This includes both levels of the free hormone and the portion bound to carrier proteins, such as sex hormone-binding globulin (SHBG) and albumin. Because most testosterone in women is bound and inactive, total testosterone labs don’t always capture the full picture of health related to levels of the sex hormone. For example, a woman may have a “normal” total testosterone level but still experience symptoms of excess or deficiency if SHBG is unusually high or low. This is why providers may order total testosterone labs in conjunction with related tests.

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Key takeaways

  • Sample required: Blood

  • Tests for: Measures total testosterone in women to evaluate androgen levels, which may influence reproductive health, sexual function, and overall well-being

  • Healthy range: About 7–55 nanograms per deciliter (ng/dL), though ranges vary by age, menstrual status, and laboratory method

What can a total testosterone test tell you?

The results of a total testosterone test will not diagnose a condition. But the information can provide important clues about a woman’s hormonal health that can guide the next steps. 

Providers may order a total testosterone test for women to:

  • Evaluate androgen excess. Androgen excess may contribute to symptoms of PCOS, including acne, scalp hair thinning, hirsutism (excess hair growth), or irregular periods.

  • Support fertility evaluation. Elevated or abnormal testosterone levels, which are common in women with PCOS, can interfere with ovulation.

  • Assess androgen deficiency. Very low testosterone in women has associations with fatigue, decreased sexual desire, and bone loss.

  • Monitor therapy. Providers may order testosterone labs while tracking the effects of hormone replacement therapy or other medications that affect androgen levels.

  • Investigate underlying disorders. Abnormal testosterone may prompt evaluation for underlying disorders, such as congenital adrenal hyperplasia, Cushing’s syndrome, or — rarely — androgen-secreting tumors.

What is being tested?

The total testosterone test measures the sum of free and bound testosterone in the bloodstream.

  • Bound testosterone: Most testosterone is attached to proteins, primarily SHBG. This bound portion is biologically inactive, meaning your body can’t use it.

  • Free testosterone: A small fraction of testosterone circulates in females unattached and is biologically active. This means it can bind to receptors and exert effects in the body.

Because SHBG levels vary with age, weight, thyroid function, and medications, the “free” amount of testosterone available to act in tissues may not always align with the total amount. For that reason, providers often order total testosterone alongside free testosterone and SHBG to get a clearer picture of a woman’s hormonal profile.

Where is the testosterone test typically included?

The total testosterone test is not a standard part of standard panels like the basic metabolic panel (BMP) or comprehensive metabolic panel (CMP). Instead, it is usually included in:

  • Reproductive hormone panels. These may also measure estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).

  • Androgen evaluation panels. This lab work is often bundled with free testosterone and SHBG.

  • Fertility and PCOS workups. Providers often order testosterone testing with LH and prolactin to evaluate menstrual cycle disturbances or infertility.

Who should get a testosterone test?

A provider may recommend a total testosterone test if you have signs or symptoms of hormone imbalance. 

Common signs of high testosterone in women include:

  • Irregular or absent menstrual cycles

  • Acne

  • Hirsutism (excess facial or body hair)

  • Scalp hair thinning (female-pattern hair loss)

  • Infertility

Signs of low testosterone in women include:

  • Low libido or decreased sexual satisfaction

  • Fatigue and reduced energy

  • Loss of muscle strength or bone density (especially after menopause)

Providers may also recommend getting tested if they suspect you have an endocrine condition like PCOS, adrenal disorders, or an androgen-secreting tumor.

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Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

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What causes changes in total testosterone levels?

Testosterone levels in women can fluctuate due to overall health status, certain medications, or lifestyle factors.

Factors that could contribute to high testosterone in women include medical conditions like PCOS, congenital adrenal hyperplasia, Cushing’s syndrome, or androgen-secreting ovarian or adrenal tumors (rare), medications like testosterone replacement therapy, danazol, valproic acid, and oxcarbazepine, diets high in refined carbohydrates and saturated fat, and weight gain or a higher body fat percentage.

Factors that could contribute to low testosterone in women include menopause or ovarian insufficiency, surgical removal of the ovaries, or pituitary or hypothalamic disorders, estrogen therapy or birth control, medications like metformin and statins, weight loss, and calorie restriction.

Do I need to fast before a testosterone test?

Not usually. However, you should always ask your provider for special instructions.

Can you test for testosterone at home?

Yes, some at-home kits can measure testosterone.

What is a normal testosterone level for women?

Typical adult female levels are about 7–55 ng/dL, with ranges differing by lab, age, whether or not you’ve been through menopause, and other factors. 

What conditions cause high testosterone in women?

PCOS, congenital adrenal hyperplasia, Cushing’s syndrome, and rare androgen-secreting tumors may cause elevated testosterone levels.

What are the symptoms of low testosterone in women?

Common symptoms of low testosterone in women include fatigue, low libido, mood changes, and sometimes decreased bone or muscle mass.

What tests are related to this biomarker?

• Free testosterone

• Sex hormone-binding globulin

• Estradiol (E2)

• Follicle-stimulating hormone

• Luteinizing hormone

• DHEAS (dehydroepiandrosterone sulfate)

• Thyroid and adrenal hormone panels

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

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Insulin-like Growth Factor 1 ( IGF-1)

Insulin-like growth factor 1 (IGF-1) reflects your body's growth hormone activity. A healthy level means your body has what it needs to support your muscle, bone, and tissue health.

Learn more about Insulin-like Growth Factor 1 ( IGF-1)

IGF-1 Z-score

Insulin-like growth factor 1 (IGF-1) reflects your body's growth hormone activity. Because IGF-1 levels vary significantly with age, sex, and pubertal stage, this Z-score is important in indicating how your IGF-1 level compares to other women in your age group, measured in standard deviations. 

Learn more about IGF-1 Z-score

Estradiol

Estradiol is a form of estrogen that men make from testosterone. At a healthy level, it supports bone strength, libido, brain function, and heart health.

Learn more about Estradiol

Follicle Stimulating Hormone (FSH)

Follicle-stimulating hormone (FSH) is a hormone produced by part of your brain called the pituitary. It is essential for sperm production and reproductive function.

Learn more about Follicle Stimulating Hormone (FSH)

Luteinizing Hormone (LH)

Luteinizing hormone (LH) is produced by part of your brain called the pituitary. It is a crucial hormone that stimulates testosterone production in the testicles.

Learn more about Luteinizing Hormone (LH)

Progesterone

Progesterone supports the menstrual cycle, preparing the uterus for pregnancy and balancing estrogen effects.

Learn more about Progesterone

Sex Hormone Binding Globulin (SHBG)

Sex hormone-binding globulin (SHBG) is a protein that carries testosterone and estrogen in the bloodstream. Unlike some other carrier proteins, it holds on to testosterone and estrogen very tightly, making them less available for your body to use.

Learn more about Sex Hormone Binding Globulin (SHBG)

Free Testosterone

Free testosterone is the part of your total testosterone that your body can use immediately to support daily energy, libido, and muscle performance, and a key marker of overall vitality. A healthy, balanced level means your body has what it needs to function at its best.

Learn more about Free Testosterone

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Reviewed by Felix Gussone, MD

Published 12/04/2025