Know Your Numbers Series Part 8: Androgens: When (and When Not) to Test These Hormones in Women

 

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Welcome to Part 8 of the "Know Your Numbers" series, your go-to guide for understanding the lab results behind your health. This week, we're breaking down androgens.

When you hear the word “testosterone,” you might immediately think of men. But androgens, a group of steroid hormones that includes testosterone, are incredibly important for women, too. From energy and mood to muscle mass and libido, androgens have a wide-reaching impact on female health.

So when should we test them? And just as importantly, when shouldn’t we?

Let’s break it down.


🩺 Why Androgens Matter for Women

Androgens in women play key roles in:

Ovarian function

Bone health

Muscle mass

Libido

Mood regulation

However, too much androgen activity can lead to frustrating and distressing symptoms, including:

Acne

Hirsutism (excess dark or coarse hair, often on the face, chest, or abdomen)

Female pattern hair loss (thinning at the crown or temples)

Irregular menstrual cycles

These symptoms often raise suspicion for PCOS (Polycystic Ovary Syndrome) which is a common condition that is frequently linked to elevated androgen


✅ When It Makes Sense to Test Androgens

1. If PCOS is Suspected
Testing androgens can be helpful if you’re experiencing:

  • Acne

  • Hirsutism

  • Irregular or absent menstrual cycles

  • Hair loss in a typically male pattern

Testing can support a diagnosis of PCOS, although it's important to note that some women with PCOS may still have normal androgen levels. A diagnosis is based on a combination of symptoms, cycle patterns, and imaging — not just labs.

2. If You’re Using Testosterone Therapy
Some women, particularly postmenopausal, are prescribed testosterone off-label for libido or energy support. In these cases, baseline testing is important to:

  • Ensure levels aren’t already elevated before treatment

  • Monitor hormone levels during therapy


⚠️When Testing Doesn’t Always Help

1. For Libido Concerns
Although testosterone plays a role in libido, testosterone levels don’t reliably correlate with sexual desire in women. In other words, low libido doesn't necessarily mean low testosterone, and vice versa.

2. For Hair Loss Evaluation
Female pattern hair loss is complex. While androgens can contribute, there’s often no clear correlation between lab values and symptoms. Even with normal androgen levels, some women still respond well to treatments that lower androgen activity. Clinical assessment is often more valuable than testing in these cases.

3. If You’re on Oral Contraceptives
Hormonal birth control, particularly oral contraceptives suppress androgen levels, making lab results unreliable. If you're on the pill, testing won't provide an accurate picture of your hormone status.


The Bottom Line: When in Doubt, Go Beyond the Numbers

Hormone testing can be a helpful tool, but only when used in the right context. Androgens, especially testosterone, can fluctuate throughout the day and be influenced by diet, stress, and medication. A "normal" result doesn’t always mean hormones aren’t involved, and an "abnormal" result doesn’t always require treatment.


Summary: When to Test and When to Trust the Symptoms

✔️ Test androgens if PCOS is suspected
✔️ Test if you’re starting or currently using testosterone therapy
❌ Don’t test solely for low libido, as symptoms will offer more insight
❌ Don’t rely on levels alone to evaluate hair loss
❌ Avoid testing while on hormonal birth control


Need help navigating hormonal symptoms or PCOS?

I offer personalized evaluations that go beyond lab results to understand the whole picture. Reach out to schedule a consult, your hormones (and your peace of mind) are worth it.


Hi, I’m Dr. Janine, ND

I’m a Naturopathic Doctor currently practicing in Guelph, Ontario, Canada.

I truly believe that our enjoyment of life is closely tied to how we feel physically. When we’re healthy, we can take on anything. But when we feel off, even the simplest tasks become overwhelming. I’ve been through hormonal shifts, sleepless nights as a parent, and the stress of balancing everything. But I also know that with the right strategy, we can go from surviving to thriving—and create a healthy, thriving family in the process.

I look forward to meeting you soon.

- Dr. Janine, ND


Follow me on social media, @dr.janine.nd