This Unsuspecting Hormone May Be The Reason Women Lose Muscle & Bone

When women hit 30 and start to have a harder time building muscle and losing weight– especially around their midsections–it’s easy to blame waning estrogen. But the culprit is actually another hormone we start to lose every year from age thirty on: Testosterone. 

Women lose 1%-3% of testosterone each year, just like men. But because we start with so much less, the impact is far more dramatic, younger. It’s even worse for women on birth control pills, because the pill actually suppresses ovarian production of testosterone. 

It's a case of an unfair reputation

It is not only crucial for maintaining muscle and bone mass; it helps you sustain energy; support brain health, memory, and cognition; and heart health. Testosterone even prevents certain cancers. 

Ready for one of the biggest double standards in medical longevity? Astoundingly, testosterone isn't approved for use in women in the US, despite many scientific studies in men reporting reduction in chronic disorders of aging, such as: 

What the science shows

A 2026 study published in the Journal of Personalized Medicine1, found that testosterone replacement therapy (TRT) was associated with improved hormonal, hematologic, and cardiometabolic biomarkers. More than 89% of women undergoing TRT reported better quality of life; more than 84% experienced increased energy; 65% reported improvements in depression, cognitive function, and sexual interest.

An earlier study2 of testosterone therapy in women assessed the effect of six months of testosterone supplementation in elderly female patients with chronic heart failure. Hormone therapy safely improved their exercise capacity, muscle strength, and insulin sensitivity.

Recently, The Lancet3 found that the men with the lowest baseline testosterone concentrations were more likely to develop cancer and die, while normal T levels were associated with lower cancer risk.

What to ask your doctor for

I recommend women have a blood test to establish a baseline biomarker of "free testosterone," the active hormonal component. The optimal range for free testosterone in women is 6 to 30 pg/mL. If it's lower than 6, explore therapy with a physician skilled in hormone optimization therapy who is willing to prescribe testosterone off-label. 

The takeaway

I've been on testosterone optimization therapy for 30 years to reverse osteopenia. It's safe and effective, and I prescribe the hormone off-label to women with great success, especially to optimize healthy longevity for mind and body.