Do You Really Need Testosterone Therapy?

Many midlife women are being told to “just ask your doctor for testosterone” when they’re dealing with fatigue, weight gain, or low libido. And while testosterone is an important hormone for women, the conversation online is missing some critical context.

The Problem With the Current Advice

Testosterone therapy might sound like an easy fix, but there are two big issues:

How are they testing?
Most doctors run bloodwork, but testosterone is a pulsatile hormone and levels can look “normal” in blood while symptoms still persist. Functional testing, like the DUTCH test, gives a more complete picture of free and metabolized hormones.
Why is it low?
Low testosterone is usually a symptom, not the root problem. Band-aiding with a prescription won’t fix the underlying causes that led to the dip in the first place.

Common Symptoms of Low Testosterone

Low libido and impaired sexual function
Decreased muscle mass and strength
Fatigue and weight gain
Aches, pains, wrinkled or sagging skin, thinning hair
Hot flashes or incontinence
Mood changes: depression, anxiety, low drive, brain fog

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Root Causes That Lower Testosterone

From what I see in my practice, the #1 driver is chronic stress, whether mental/emotional or physical stressors like mold toxicity, Lyme disease, or chronic infections. Other common culprits include:

Nutrient deficiencies
Low-fat diets (cholesterol is the raw material for hormones)
Too much estrogen from the environment or diet
Blood sugar imbalances or obesity
Hypothyroidism
Postpartum hormone shifts

Hormone metabolism imbalances — Sometimes testosterone looks “low” in bloodwork, but the real issue is how quickly your body is breaking it down or converting it into other hormones.

Why I Often Recommend DHEA First

Before jumping to testosterone prescriptions, I prefer to consider DHEA, which is a natural precursor to testosterone. Supporting the body with precursors and addressing stress, nutrition, and lifestyle first can often bring testosterone levels back online without needing a prescription.

That said, DHEA isn’t a one-size-fits-all solution. For some women, it can be really helpful. But for others, it may stir up unwanted side effects, like new breakouts, more hair growth in places you don’t want it, or mood changes. That’s why I don’t recommend trying it blindly.

–> This is where functional testing (like the DUTCH test) becomes so valuable. It doesn’t just tell us how much testosterone you have, but also how your body is using and breaking it down. That’s the missing piece most women never get from standard bloodwork and why one woman may thrive with a little DHEA while another feels worse.

How to Support Healthy Testosterone Naturally

Dietary Shifts

Eat healthy fats daily (avocado, olive oil, nuts, seeds, grass-fed meat, wild fish).
Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) support estrogen metabolism, freeing up testosterone.
Pomegranate juice and tiger nuts may give an extra boost.
Avoid processed soy (stick to small amounts of fermented soy, like miso or tempeh).

Key Nutrients

Zinc, magnesium, B-vitamins, vitamin C, vitamin D, vitamin E, boron all play critical roles in hormone production.

Lifestyle Factors

Resistance training.
Consistent, quality sleep (8+ hours).
Sunlight or light-box therapy to support circadian rhythm and hormone production.
Stress release and nervous system regulation (non-negotiable if you want lasting hormone balance).

Bottom Line

You don’t need to rush to a testosterone prescription just because it’s trending. The smarter question is: why is your testosterone low in the first place?

By addressing root causes — stress, nutrient gaps, gut and thyroid health, toxins — and, in some cases, supporting your body with precursors like DHEA, many women see their energy, strength, libido, and vitality return naturally. The key is knowing what’s really driving your imbalance before deciding whether DHEA or testosterone therapy makes sense.

Next Step

Want to know what your body’s hormones are really doing? Take my free Decode Your Midlife Body Quiz. It’s the fastest way to uncover where your system is most out of balance.

And if you want a deeper look, my Decode Your Midlife Body Lab Package uses advanced functional labs (like DUTCH and GI-MAP) to reveal the true root causes behind your symptoms, so you can finally reclaim your energy, clarity, and confidence.