Testosterone in men and women: what it does and why it matters
Testosterone matters in both men and women. Both genders produce it naturally, and it helps support sexual wellbeing, mood, energy, muscle strength, and bone health. Low testosterone is not always obvious from one symptom alone, so it is usually about noticing patterns over time.
What does testosterone do?
Testosterone is a hormone that helps support how the body feels, functions, and recovers. In men, it plays an important role in sexual function and is linked with sexual desire, erections, fertility, muscle mass, bone density, energy, and mood. Women produce testosterone too, and it contributes to libido, sexual arousal, orgasm, muscle and bone strength, urogenital health, mood, cognitive function, and normal metabolic function. Hormonal changes around menopause can make its role more noticeable for some women.
It plays a wider role than sex drive alone and can influence how you feel day to day, including motivation, body composition, confidence, and general wellbeing. Low testosterone does not automatically explain every symptom, but it can be one part of the picture. When symptoms have been going on for a while, or happen alongside other risk factors, it can be worth further exploration rather than putting everything down to stress, age, or a busy life.
Why testosterone matters in men
In men, testosterone is strongly linked with sexual health, but it also reaches far beyond that. The British Society for Sexual Medicine says the diagnosis of symptomatic testosterone deficiency requires both characteristic signs and symptoms and reduced testosterone levels. Sexual symptoms are often the most prominent, although it can also affect cognitive function, mood and sleep.
Many of these symptoms are non-specific and can be linked with lifestyle and psychological factors or with normal ageing, which is why symptoms should never be judged in isolation.
Wider health factors can matter too, including weight, sleep, alcohol intake, stress, medication use and conditions such as type 2 diabetes. Obesity and type 2 diabetes are among the factors associated with testosterone deficiency, therefore, it is important for clinicians to take a full history, including alcohol intake and medicine use, when assessing symptoms.
Why testosterone matters in women
Testosterone is an important female hormone as it contributes to libido, sexual arousal, orgasm, normal metabolic function, muscle and bone strength, mood, and cognitive function. Testosterone levels decline through a woman’s lifespan and can fall more sharply after surgical or medical menopause and in premature ovarian insufficiency.
For many women, testosterone becomes more relevant around menopause, when changing hormone levels may affect energy, mood, libido and bone health. Testosterone is not currently licensed in the NHS to treat menopause symptoms in general, but a specialist doctor may prescribe it in some cases, usually for postmenopausal women with low sex drive when HRT alone has not helped.
Testosterone is not a catch-all answer for every symptom that shows up in midlife, and it should not be started casually or without proper advice. Individualised care, discussion of risks and benefits, support for bone health, and the importance of maintaining muscle mass and strength through physical activity should form part of the management of menopause.
Symptoms of low testosterone
The pattern of symptoms can differ between men and women. In men, the strongest clues are often sexual symptoms, especially low sexual desire, fewer morning erections, and erectile dysfunction. Other possible symptoms include fatigue, poor sleep, low mood, changes in concentration, reduced energy, loss of strength, and changes in body composition including reduced muscle mass.
In women, low testosterone may be linked with low sexual desire, reduced arousal, and changes in orgasm. Other symptoms may include tiredness, depression, headaches, cognitive problems, and bone health issues.
The key point is that these symptoms do not prove testosterone is the cause. NHS and National Institute for Health and Care Excellence (NICE) guidance both support a careful, individual approach rather than jumping straight to treatment. This is especially important if symptoms are new, persistent, affecting daily life, or appear alongside weight gain, poor sleep, low mood, medication use, or other health issues.
What can affect testosterone levels?
There is no single reason why testosterone levels may change. In women, levels naturally decline over time and may become more relevant around menopause. In men, levels may fall with age, but many cases in older men are closely linked with obesity, type 2 diabetes, and chronic illness rather than age alone. Other contributors can include stress, malnutrition, excessive alcohol intake and certain medications.
People with testosterone deficiency may also benefit from support with weight management, lifestyle changes, and any related health conditions that need attention. This reflects the fact that improving overall health can be an important part of managing symptoms, not just focusing on hormone levels alone.
In women, NICE guidance for menopause also advises discussing changes people can make to support health and wellbeing and specifically highlights the importance of bone health and physical activity to maintain muscle mass and strength.
Good sleep, a healthier weight, regular movement, and support for general health can all make a meaningful difference to how you feel. Even when testosterone is only one part of the picture, these areas still play an important role in day-to-day energy, strength, and wellbeing.
That said, lifestyle advice should not be used to dismiss symptoms. If symptoms are persistent or affecting your relationships, confidence, energy, or daily routine, it is reasonable to seek proper advice. The safest approach is to look at symptoms, risk factors, and test results together which is best done by a healthcare professional.
The role of at-home testing
A testosterone blood test can be a practical next step when symptoms suggest testosterone may be low, but a result should not be used as a diagnosis on its own. Symptomatic testosterone deficiency in men should be based on signs and symptoms plus low testosterone results, not a blood result alone.
For people who want a convenient first step, the Boots Testosterone Blood Test is an at-home capillary blood test that is taken in the morning before 9am and posted to the laboratory. It measures albumin and free androgen index, free testosterone, sex hormone binding globulin, and total testosterone, with results usually available within 48 to 72 hours of the sample arriving at the laboratory.
At-home testing may be helpful if you have noticed symptoms over time, want more clarity before speaking to a clinician, or prefer the privacy and convenience of testing at home. If the result is outside the expected range, or symptoms continue despite a normal result, speak to your GP or specialist.
When to speak to a doctor
Speak to a doctor if low sex drive, erectile problems, ongoing tiredness, low mood, poor concentration, changes in strength, or menopause-related symptoms are not improving or are affecting your quality of life. In women, speak to a GP if you think testosterone may help with low libido after menopause.
Frequently asked questions
1. What does testosterone do in men and women?
Testosterone helps support sexual wellbeing, mood, muscle strength and bone health in both men and women.
2. Can low testosterone make you feel tired?
Tiredness and low energy can be linked with low testosterone, but sleep, stress, weight, menopause, medicines and other health issues can also play a part.
3. Do women need testosterone too?
Yes. Women produce testosterone naturally, and it contributes to libido, mood, cognitive function, and muscle and bone strength. Around menopause, it may become more relevant for some women, especially if low libido is a concern.
4. When should I speak to a doctor about testosterone symptoms?
Speak to a doctor if symptoms are ongoing, getting worse, or affecting your daily life, relationships, or wellbeing, especially before starting any treatment.
In summary
Testosterone in men and women matters more than many people realise. It supports sex drive, mood, energy, muscle strength, and bone health, and low levels can sometimes be linked with symptoms such as low libido, tiredness, reduced strength, poor sleep, or low mood. If you want a practical first step, the Boots Testosterone Blood Test can help you check key testosterone-related markers at home and support a more informed conversation with a healthcare professional.
References
1. National Institute for Health and Care Excellence. Menopause: identification and management. London: NICE; 2015. https://www.nice.org.uk/guidance/ng23
2. GPnotebook. Screening and assessment for testosterone deficiency (TD). Oxford: GPnotebook; 2025. https://gpnotebook.com/en-GB/pages/diabetes-and-endocrinology/screening-and-assessment-for-testosterone-defiency-td
3. Hackett G, Kirby M, Rees R, Edwards D, Jones TH, Wylie K, et al. The British Society for Sexual Medicine guidelines on male adult testosterone deficiency, with statements for practice. World J Mens Health. 2023;41:e33. https://bssm.org.uk/wp-content/uploads/2023/08/WJMH22-1027-4-Copy.pdf
4. GPnotebook. Testosterone therapy in women in the menopause. Oxford: GPnotebook; 2025. https://gpnotebook.com/en-GB/pages/gynaecology/testosterone-therapy-in-women-in-the-menopause
5. NHS. Types of hormone replacement therapy (HRT). London: NHS; 2025. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/types-of-hormone-replacement-therapy-hrt/
6. Traish AM, Miner MM, Morgentaler A, et al. Testosterone deficiency. Am J Med. 2011;124(7):578–587. doi:10.1016/j.amjmed.2011.02.033. https://www.amjmed.com/article/s0002-9343(11)00274-9/fulltext