Androgens in Women: Testosterone, Health, and Balance

Subcutaneous Testosterone Injections and Androgen Physiology in Women

Abstract

Testosterone is often described as a male hormone, but it is also a normal and important hormone in women. Female testosterone levels are much lower than male levels, yet testosterone and other androgens still play a role in sexual health, muscle physiology, bone health, metabolism, brain signaling, and tissue maintenance. Women produce androgens in the ovaries and adrenal glands, and through local hormone conversion within tissues.

Subcutaneous testosterone injections place the medication in the fatty tissue beneath the skin rather than deep in a muscle. This route may offer a practical option for carefully selected patients, but research specifically studying subcutaneous testosterone therapy in women is still limited. Current evidence supports careful medical evaluation, female-appropriate dosing, monitoring, and individualized decision-making rather than treating a laboratory number alone.

At WellnessDoctorRx.com, we view women’s hormone health as part of a larger wellness picture that includes metabolic health, nutrition, musculoskeletal function, rehabilitation, and lifestyle. This article explains female androgen physiology, testosterone testing, subcutaneous injections, current evidence, and how integrative medical and chiropractic care can work together.

Testosterone Is a Normal Hormone in Women

Many people hear the word testosterone and immediately think about men. However, women naturally produce testosterone throughout life.

Testosterone belongs to a group of hormones called androgens. Other androgens include:

• Dehydroepiandrosterone, or DHEA
• DHEA sulfate, or DHEA-S
• Androstenedione
• Dihydrotestosterone, or DHT

Women normally maintain much lower testosterone concentrations than men. Even at these lower levels, testosterone remains biologically active.

The supplied clinical whitepaper emphasizes that testosterone is a normal female hormone and is present at physiologically meaningful levels throughout adult life.

Research has also challenged the older idea that estrogen is the only major female sex hormone. Testosterone works directly through androgen receptors and can also be converted into estradiol inside certain tissues (Davis & Wahlin-Jacobsen, 2015).

Where Do Female Androgens Come From?

Women do not depend on one organ for testosterone production.

The female androgen system involves several sources.

The Ovaries

The ovaries produce testosterone and several androgen precursors. Their contribution remains important during the reproductive years and may continue, at a lower level, after menopause.

The Adrenal Glands

The adrenal glands produce large amounts of DHEA and DHEA-S. These hormones act as building blocks that tissues can use to make more active sex hormones.

Peripheral Tissues

An important part of female hormone physiology happens inside tissues themselves.

Fat, skin, muscle, bone, and other tissues contain enzymes that can convert androgen precursors into testosterone, DHT, or estradiol.

The diagram in the supplied paper describes this process as intracrinology. Hormone precursors can enter a tissue, be converted into active hormones inside that tissue, perform their local function, and then be broken down without large amounts ever entering the bloodstream.

This helps explain why a blood testosterone level does not tell the entire story about androgen activity in a woman.

Testosterone Can Work as an Androgen or Become Estrogen

Testosterone has multiple pathways in the female body.

It can:

• Bind directly to androgen receptors
• Be converted into DHT through 5-alpha-reductase
• Be converted into estradiol through the aromatase enzyme

This connection between testosterone and estrogen is important.

For example, testosterone may influence a tissue through the androgen receptor, but in another tissue some of its effects may occur after conversion to estradiol.

Because of these factors, hormone care should not focus on testosterone in isolation. A broader evaluation may also consider estrogen status, SHBG, DHEA-S, medications, thyroid function, metabolic health, age, symptoms, and medical history.

What Does Testosterone Do in Women?

Androgen receptors are present in many parts of the female body.

Researchers continue to study testosterone’s role in:

• Sexual desire and sexual response
• Skeletal muscle
• Bone metabolism
• Brain signaling
• Adipose tissue
• Cardiovascular physiology
• Skin and hair
• Reproductive tissues

This does not mean testosterone therapy has been proven to treat every problem involving these systems.

That difference is critical.

A hormone may have a normal biological function, but additional hormone therapy has not been proven to improve every function related to that hormone.

Current clinical evidence is strongest for testosterone therapy in carefully selected postmenopausal women with hypoactive sexual desire disorder, or HSDD, after other possible causes have been evaluated (Davis et al., 2019; Parish et al., 2021).

Evidence is not strong enough to recommend testosterone simply as a general treatment for weight loss, memory, energy, bone improvement, or muscle building in all women.

The supplied whitepaper makes this same distinction: androgen receptors are present in bone, muscle, brain, fat, and cardiovascular tissues, but receptor activity alone does not prove that giving testosterone produces meaningful clinical benefits in each area.

Female Androgens Change With Age

Female androgen levels generally decline gradually.

This is different from estrogen, which can change much more sharply around menopause.

DHEA and DHEA-S begin declining years before menopause. Testosterone also generally decreases across adulthood.

Natural menopause alone does not always create a sudden testosterone deficiency.

However, when both ovaries are removed, the decline is much more abrupt because the body immediately loses an important source of ovarian androgen production. The supplied whitepaper describes this difference between natural aging and surgical menopause.

This is one reason hormone decisions should be based on the complete clinical history rather than age alone.

Why Female Testosterone Testing Is Complicated

Testosterone testing can be more difficult in women than in men.

Female concentrations are relatively low. Some routine testosterone laboratory tests were originally designed for much higher male levels and may be less accurate at the lower female range.

When available, liquid chromatography-tandem mass spectrometry (LC-MS/MS) may provide better accuracy at low testosterone concentrations.

Clinicians may consider several measurements depending on the patient’s situation:

• Total testosterone
• SHBG
• Free testosterone
• DHEA-S
• Estradiol
• Other endocrine and metabolic markers

Why SHBG Matters

Sex hormone-binding globulin, or SHBG, attaches to testosterone in the bloodstream.

Changes in SHBG may affect how much testosterone is freely available to tissues, even when total testosterone remains similar.

Factors that may affect SHBG include:

• Oral estrogen
• Thyroid hormone status
• Insulin resistance
• Obesity
• Androgen excess
• Pregnancy

The whitepaper stresses that major clinical guidelines do not recommend diagnosing generalized female androgen deficiency based on a single testosterone value. Testing is more useful when interpreted together with symptoms, history, medications, examination findings, and treatment monitoring.

What Are Subcutaneous Testosterone Injections?

A subcutaneous testosterone injection places testosterone into the fatty layer located just beneath the skin.

This differs from an intramuscular injection, which places medication deeper into muscle tissue.

Subcutaneous injections may offer practical advantages for some patients, such as:

• Smaller needles
• Less deep tissue penetration
• Easier self-administration
• Measured dosing
• Potentially less injection discomfort
• An alternative for people who prefer to avoid deep intramuscular injections

Testosterone cypionate and testosterone enanthate can be absorbed through subcutaneous tissue.

However, an important limitation remains.

Most published evidence on subcutaneous testosterone administration comes from studies involving male hypogonadism or testosterone-based gender-affirming therapy rather than women receiving low-dose female hormone therapy (Figueiredo et al., 2022).

Subcutaneous Testosterone in Women: What We Know

Some clinicians may use subcutaneous testosterone in individualized treatment plans, but they should not describe it as an established standard route for women.

Research supporting testosterone therapy in women has mainly studied transdermal testosterone, meaning testosterone delivered through the skin.

The supplied whitepaper specifically points out that:

• Research supporting subcutaneous testosterone primarily comes from male populations.
• Randomized testosterone trials in women have mainly used transdermal treatment.
• Current women’s health guidelines have not established the subcutaneous route as the standard method for women.
• Treatment should remain within the physiologic female range.

This distinction is especially important for patients researching hormone therapy online.

Subcutaneous delivery may be convenient, but convenience should not replace medical evaluation.

There Is No “More Is Better” Rule

Testosterone treatment should not aim to make a woman’s testosterone level as high as possible.

Normal female physiology exists within a range.

Excess androgen exposure can produce unwanted effects, including:

• Acne
• Increased facial or body hair
• Scalp hair changes
• Oily skin
• Changes in menstrual patterns in some women
• Other signs of androgen excess

Very high or prolonged exposure may increase the risk of more significant androgenic effects.

The supplied whitepaper describes both low and excessive androgen states as reasons for careful interpretation rather than assuming higher testosterone always produces better health.

Medical Evaluation Comes Before Treatment

At WellnessDoctorRx.com, we approach hormone wellness through a complete health evaluation, not a hormone number alone.

A clinical evaluation may consider:

• Symptoms
• Menstrual and reproductive history
• Menopause status
• Previous ovarian surgery
• Sexual health
• Medications
• Thyroid function
• Blood sugar and insulin resistance
• Lipid health
• Body composition
• Sleep
• Nutrition
• Exercise
• Stress
• Musculoskeletal function
• Personal treatment goals

Other medical conditions can produce symptoms that may resemble hormone imbalance. Fatigue, reduced exercise tolerance, weight changes, sleep problems, mood changes, and reduced sexual interest can have many possible causes.

That is why personalized assessment matters.

Integrating Hormone Care With Chiropractic and Functional Wellness

Hormone therapy and chiropractic care do different things.

Chiropractic care does not replace medical hormone management.

However, it may complement a broader wellness program when pain, joint restriction, previous injuries, muscle weakness, or movement problems interfere with exercise and healthy activity.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, describes an integrative clinical approach that connects functional medicine, musculoskeletal assessment, rehabilitation, nutrition, exercise, metabolic health, and medical care.

This may be particularly useful when a woman wants to improve both hormone health and physical function.

An integrated care program may include:

• Chiropractic adjustments when clinically appropriate
• Corrective exercise
• Strength training
• Mobility rehabilitation
• Functional movement assessment
• Nutrition support
• Metabolic assessment
• Lifestyle modification
• Medical hormone evaluation

The goal is not to claim that chiropractic treatment raises testosterone.

Instead, chiropractic and rehabilitation care can address mechanical and functional barriers that may prevent a patient from exercising comfortably and maintaining muscle strength.

Why Muscle Health Matters

Muscle responds strongly to physical activity.

Resistance exercise remains one of the most important ways to support muscle strength, mobility, bone loading, glucose metabolism, and healthy aging.

Testosterone and androgen receptors play a role in normal muscle physiology, but hormone status is only one part of muscle health.

Other important factors include:

• Adequate protein
• Resistance training
• Sleep
• Recovery
• Vitamin and mineral status
• Healthy glucose metabolism
• Joint mobility
• Neuromuscular control
• Progressive rehabilitation

For many women, the most useful strategy is therefore not hormone therapy alone but a coordinated plan that supports the whole system.

Multidisciplinary Wellness Care in El Paso

At Injury Medical Clinic PA in El Paso, Texas, Dr. Jimenez works with Dr. Maria Guadalupe Cardenas, MD, a board-certified internal medicine physician with more than 40 years of clinical experience who serves as Medical Director and Collaborative Physician.

This multidisciplinary structure coordinates medical oversight with chiropractic, functional medicine, personal injury care, rehabilitation, and musculoskeletal services.

Dr. Cardenas provides internal medicine and medical oversight, while Dr. Jimenez contributes chiropractic, advanced-practice nursing, functional medicine, injury care, rehabilitation, and biomechanical perspectives.

For patients exploring hormone health through WellnessDoctorRx.com, this type of model supports a broader question:

What combination of medical evaluation, lifestyle improvement, movement restoration, nutrition, rehabilitation, and carefully selected treatment best supports the patient’s overall health?

A Better Way to Think About Women’s Testosterone

The most useful starting point is simple:

Testosterone is a normal female hormone.

Women have much less testosterone than men, but it is still important.

At the same time, recognizing the importance of testosterone does not mean that every woman needs testosterone treatment.

Current evidence supports careful evaluation, appropriate patient selection, informed consent, conservative dosing, and monitoring.

When subcutaneous testosterone is considered, patients should understand that the route is promising and practical but has less female-specific evidence than transdermal testosterone.

The overall goal should be to restore healthy physiology when treatment is appropriate—not chase a laboratory number.

At WellnessDoctorRx.com, this broader view can connect hormone education with functional medicine, nutrition, metabolic wellness, chiropractic care, rehabilitation, and healthy lifestyle strategies designed around the individual.

“Your body thrives when its internal biochemistry is in perfect harmony, but navigating hormone shifts shouldn’t be a guessing game. Reach out to our wellness team today to discuss how a targeted, evidence-based approach to your unique lab values can safely help you feel like yourself again.”

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References

Cleveland Clinic. (2024). Androgens: Function, levels & related disorders.

Davis, S. R., Baber, R., Panay, N., et al. (2019). Global consensus position statement on the use of testosterone therapy for women. Journal of Clinical Endocrinology & Metabolism, 104(10), 4660–4666.

Davis, S. R., & Wahlin-Jacobsen, S. (2015). Testosterone in women—The clinical significance. The Lancet Diabetes & Endocrinology, 3(12), 980–992.

Faucett, K., Giles, L. A., & Sing, E. (2026). Testosterone: Vital to female physiology. Women’s Health, 22.

Figueiredo, M. G., Gagliano-Jucá, T., & Basaria, S. (2022). Testosterone therapy with subcutaneous injections: A safe, practical, and reasonable option. Journal of Clinical Endocrinology & Metabolism, 107(3), 614–626.

Hatzilabrou, T. A. (n.d.). Testosterone and androgen physiology in women. Worldborne Medical, Clinical Frontiers: Androgen Series.

Horstman, A. M., Dillon, E. L., Urban, R. J., & Sheffield-Moore, M. (2012). The role of androgens and estrogens on healthy aging and longevity. The Journals of Gerontology: Series A, 67(11), 1140–1152.

Hunter, S. K. (2024). Testosterone and androgen receptors in females: What is possible with resistance training?. The Journal of Physiology.

Parish, S. J., Simon, J. A., Davis, S. R., et al. (2021). International Society for the Study of Women’s Sexual Health clinical practice guideline for the use of systemic testosterone for hypoactive sexual desire disorder in women. The Journal of Sexual Medicine, 18(5), 849–867.

Thomas, L. (2022). The role of testosterone in women’s health. News-Medical.