The Radically Well Podcast · Season 2, Episode 12
Testosterone for Women: Libido, Muscle, Mood, Brain Fog and the Truth About HRT
Testosterone is the most abundant biologically active hormone in a woman’s body, and it does far more than drive libido. In this feature from the Luminescence podcast, Rosie Acosta joins Dr. Jolene Brighten and Dr. Mariza Snyder to talk about what falling testosterone actually feels like, what the testing really measures, and why so many women are told it does not matter.
Not a “guy hormone”
Most women are never told that testosterone is the hormone their body produces in the largest quantity, or that it starts declining in their twenties, long before perimenopause arrives. What they are told is that feeling less driven, less strong and less clear-headed is simply what getting older feels like.
This conversation takes that apart. Dr. Jolene Brighten, a naturopathic endocrinologist, and Dr. Mariza Snyder, a functional wellness practitioner, walk through what testosterone actually does in a woman’s body, what the symptoms of low levels look like, and why access to treatment is so uneven.
What this episode covers
- Why testosterone affects energy, motivation, muscle, bone and mood, not only libido
- The signs of low testosterone women describe: brain fog, flat motivation, poor recovery, low desire
- The difference between total and free testosterone, and what SHBG has to do with it
- Why testosterone is not FDA-approved for women in the US, and what that means for access
- Delivery methods compared: creams, gels, injections and pellets
- Possible side effects, including acne, hair changes, mood shifts and cholesterol changes
- How chronic stress, insulin resistance and endocrine disruptors lower testosterone
- What the guests suggest supports natural levels: strength training, protein, vitamin D, sleep
What testosterone actually does
The cultural shorthand treats testosterone as the male hormone and estrogen as the female one, which leaves most women with no framework for a hormone their body relies on daily. In the episode the guests describe its role across muscle maintenance, bone density, cognition, motivation, mood stability and sexual desire.
That range is why low levels rarely show up as a single tidy symptom. It is more often a cluster: harder workouts with worse recovery, a flatter emotional baseline, a mind that will not sharpen, and a libido that has quietly gone.
Why one number is not the answer
A single total testosterone reading can look unremarkable while a woman feels anything but. The guests explain the distinction between total testosterone and free testosterone, and the role of sex hormone binding globulin in determining how much is actually available to the body.
They also discuss what they look at alongside it, and why symptoms matter as much as the panel. If you are asking your own clinician about this, the episode is a useful primer on which questions to bring.
This conversation is educational and is not medical advice. Hormone testing and any hormone therapy should be discussed with a qualified healthcare professional who knows your history.
Why so many women are turned away
There is no FDA-approved testosterone product for women in the United States. Prescribing therefore happens off-label, which the guests describe as one of the main reasons women are dismissed, under-dosed or sent away entirely, even when their symptoms and labs point the same direction.
They compare the delivery methods women are actually offered — creams, gels, injections and pellets — and are candid about the trade-offs of each, including the ones that are hardest to adjust once started.
What modern life does to testosterone
Levels do not only fall with age. The conversation covers how chronic stress, insulin resistance, poor sleep and endocrine-disrupting chemicals all push in the same direction, often years before perimenopause begins.
The practical counterweights the guests point to are unglamorous and familiar: strength training, adequate protein, vitamin D, better sleep, and reducing exposure where it is easy to do so. None of it is a replacement for treatment where treatment is warranted, and all of it helps regardless.
Timestamps
| 00:00 | Introduction to testosterone and why it matters |
| 03:09 | Testosterone’s role in women’s health |
| 05:50 | The knowledge gap in hormonal health |
| 09:05 | The impact of testosterone on mental health |
| 12:02 | Testing and accessing testosterone therapy |
| 14:53 | Delivery methods compared |
| 18:10 | Natural ways to support testosterone |
| 20:49 | Navigating the healthcare system |
| 24:06 | Potential side effects of therapy |
| 26:54 | Monitoring hormonal health |
| 30:36 | Hormone therapy and health risks |
| 33:37 | Why monitoring and data matter |
| 42:05 | Understanding different forms of testosterone |
| 48:10 | The complexity of hormonal responses |
| 55:44 | Empowering women through knowledge and community |
Explore the conversation
Questions explored in this episode
Do women need testosterone?
Yes. Testosterone is the most abundant biologically active hormone in a woman’s body and contributes to muscle, bone, cognition, mood and sexual desire. Levels begin declining well before menopause.
What are the symptoms of low testosterone in women?
The guests describe brain fog, low motivation, reduced strength and slower recovery from exercise, a flatter mood and low libido. Because these overlap with other conditions, symptoms should be assessed alongside proper testing.
What tests measure testosterone in women?
The episode covers total testosterone, free testosterone and sex hormone binding globulin, and why a total reading alone can be misleading when SHBG is high.
Is testosterone therapy approved for women?
There is no FDA-approved testosterone product for women in the United States, so prescribing is off-label. The guests discuss what that means for availability, dosing and the experience of asking for it.
What are the side effects of testosterone therapy for women?
Possible effects discussed include acne, hair changes, mood shifts and changes in cholesterol. The episode stresses monitoring over time rather than treating and hoping.
Can you raise testosterone naturally?
The guests point to strength training, sufficient protein, vitamin D, better sleep and reducing endocrine-disruptor exposure. These support the system but are not presented as a substitute for treatment when it is clinically indicated.
Symptoms are information, not a verdict.
Rosie offers mindfulness coaching grounded in self-compassion and practical tools for anxiety, sleep loss and the emotional side of midlife. Coaching is available in English and Spanish.
This episode is educational in nature. It does not replace care from a qualified healthcare or mental health professional, and nothing in it should be used to start, stop or change hormone therapy.