Women – The Physical Signs of Testosterone Deficiency

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What are the physical symptoms that identify a woman suffering from Testosterone Deficiency?

Did you know that 30 years of practicing Gynecology gave me the ability to immediately recognize a woman with testosterone deficiency? In fact I can usually tell if a woman is deficient in testosterone by giving her a comprehensive 10 second visual evaluation—with her clothes on! Even though it is a skill I initially learned in medical school, I further perfected my diagnostic observations by evaluating thousands of women who had symptoms of testosterone deficiency who also gave me their lab values to confirm my diagnosis of testosterone deficiency. This process further confirmed the physical signs of testosterone deficiency that accompanies aging and these physical signs are what we will discuss today. My purpose is not to teach you to be a doctor, but to help you understand yourself and your friends who are suffering because of lack of testosterone.

You may have heard of the author Malcom Gladwell who proved, that becoming an expert requires 10,000 hours of practice, so this is not a shortcut to becoming a hormone expert. My goal is to wake up your mind to the visual signs of testosterone deficiency, every time you see someone you know who complains of her low testosterone symptoms.

So here is the process I go through when visually examining women with TDS. The first thing I look at is skin. With or without sun damage, testosterone starved skin becomes fragile, thin, saggy, dry and old.


If someone has had major plastic surgery on their face, then I look at their hands and they always tell the story.


The second clue is seen in a full length mirror shows the loss of a waistline, with accumulated belly fat and elongated breasts.


Testosterone provided the collagen and connective tissue that held our skin tight to our bodies and built muscles in our abdomen and oblique muscles that make our waists slim. But when women who have deficient testosterone turn around and look at their backs in a mirror…the lack of musculature and abundant back fat is unmistakable, and is an obvious tell tale sign of low T.

back fat

Next thing on my checklist of TDS in women are the presence of sagging arms that look like flabby wings. In contrast when we are young we have plenty of muscle mass and connective tissue that holds the skin tight to the upper arms. Without testosterone, our muscles atrophy and connective tissue gets saggy and pulls away from the muscle until it stretches well away from the muscle of the upper arm.


This one clue is a tell tale sign of aging, and the loss of muscle mass that goes along with it. No amount of exercise and weight lifting can reverse this process without the replacement of testosterone in high enough dose to reverse the process that robs of our muscles.

Next characteristic is loss of hair on our head…as testosterone decreases, our quantity of hair on our head decreases, it becomes flat and loses the glossy healthy look of youth. It is testosterone that stimulates the growth of hair on our head, the oil that is produced from our sebaceous glands that makes our scalp healthy and hair shiny, and it is testosterone that makes our eyebrows and eyelashes thick.


I bet you thought testosterone was the hormone that makes us bald when we are old, but it isn’t! We lose hair because our free T becomes low and our DHT increases making the ratio of one to the other out of balance. When pure testosterone is reinstated and rises above DHT, the hair follicles begin to grow and oil glands recover and make dry hair, normal. All of our testosterone decreases 10 years before our ovaries fail so loss of hair and poor hair quality begins before we even know something is happening to our hormones! After menopause, loss of estradiol contributes to the hair loss in the frontal area, and many women who also have low thyroid hormone as they age, contributes to our hair loss as well.

The mechanism of testosterone’s effect on all of our youthful physical qualities occurs through the stimulation of Growth Hormone by testosterone, conversion of testosterone into Dihydrotestosterone (DHT), and DHEA which is a precursor to testosterone. Those women who never had to diet all of a sudden gain weight by looking at food!

The last characteristic that is obvious to only the most intimate observer is our loss of pubic hair, underarm hair, and hair on our legs.


Because I was a gynecologist I could tell very easily that testosterone was declining when I was doing a pelvic partially because of sparse pubic hair, shrunken labia and a very small clitoris as well as a dry and thin skin around the vaginal opening.

Remember that when you see these one or two of these signs in a woman, some of them may be attributable to other hormones that are lacking, that either stimulate testosterone production or are stimulated by testosterone. However when all of these are present, or at least most of them in one person, you can rightly predict their low testosterone levels!

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.

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