Several factors can contribute to low testosterone levels in females:

Aging and Menopause

Testosterone levels naturally decline with age, especially after age 30. By the time a woman reaches perimenopause and menopause, her levels can drop significantly—sometimes by more than 50%.

Chronic Stress

Long-term stress increases cortisol levels, which can suppress the production of sex hormones like testosterone. This is part of the “pregnenolone steal,” where your body prioritizes stress hormone production over sex hormones.

Hormonal Birth Control

Certain forms of hormonal birth control (like oral contraceptives) can lower free testosterone levels by increasing sex hormone-binding globulin (SHBG), which binds testosterone and makes it unavailable for use in the body.

Ovarian Dysfunction or Removal

Because women produce testosterone in the ovaries and adrenal glands, any condition that affects ovarian function—like PCOS, early menopause, or surgical removal of the ovaries—can lower levels.

Adrenal Fatigue or HPA Axis Dysfunction

The adrenal glands also produce small amounts of testosterone. When your stress response system (HPA axis) is out of balance, adrenal hormone output—testosterone included—can drop.

Undereating or Over-Exercising

Not eating enough (especially carbs and fats) or excessive high-intensity exercise can suppress the hypothalamic-pituitary-gonadal axis, leading to reduced testosterone and estrogen levels.

Thyroid Disorders

An underactive thyroid (hypothyroidism) can affect testosterone production and metabolism, contributing to low levels and worsening fatigue, mood issues, and weight gain.

Medications

Certain medications can interfere with testosterone production, including:

• Corticosteroids
• Some antidepressants
• Opioids
• Chemotherapy agents