Testosterone: Not So Manly After All?

Last week’s primer on testosterone garnered a ton of responses, mostly positive, but there appeared to be a bit of confusion regarding testosterone’s role in the female body. Namely, folks seemed to think I was suggesting it played almost no role at all! I tried to be as clear as possible – testosterone is an absolutely vital hormone for women – but I’ll try to be clearer. There’s just that niggling, pervasive stigma of testosterone as the sole hormonal realm of big burly men with bulging muscles, and I guess it’s hard to shake, even for my enlightened readership. Perhaps it’s because we’ve been subject to years of simplistic, substandard health and nutrition advice, black-and-white proclamations that attempt to describe the complex inner workings of the human body with a few sentences.

Fat is bad! Whole grains good! Men make testosterone! Women make estrogen!

The reality is confusing and complex, sure, but when it’s reduced down to simple declarations, it’s made even more difficult to comprehend. As a result, there’s a ton of misinformation regarding women and testosterone. Some have the idea that women are unable to produce the stuff – that it’s only produced in the testicles (as if women and men are of different species or something). Others seem to fear testosterone, as if a bit of weight lifting and meat eating is going to flood their bodies with pure, unadulterated testosterone whose sole goal is to synthesize puffy muscles, convert lilting squeaks to husky baritones, and implode breasts to make way for muscular mounds. We have the notion that estrogen and testosterone are mortal enemies, waging bitter hormonal war as each tries to gain a foothold.

The reality, of course, is that testosterone is vitally important in the female body. It plays a huge role, and it does a few really important things. Women (and men) may consider testosterone to be the masculine hormone, but they’d definitely notice if it suddenly went missing from their lives.

Young women produce most of their testosterone in the ovaries. The rest is actually produced in body fat and skin tissue in response to the hormones DHEA and DHEAS, from the adrenal glands, and androstenedione, from the ovaries. That’s also where estrogen is produced.

Sexual Desire

Female libido is inextricably linked to testosterone. A common side effect of hormonal birth control is elevated levels of sex hormone-binding globulin, or SHBG. Its function is right there in the name – it binds to the sex hormones, especially testosterone and estradiol, and inhibits their function. Reduced bioavailability of testosterone means less desire for sex. You can want it all you want, but without the right hormonal balance, which includes plenty of testosterone for men and women, you’re not going to want it.

As women approach menopause, they produce far less testosterone (and they weren’t producing a huge amount to begin with) and experience far less sexual desire. Causation? Definitely. Female testosterone therapy can increase libido and restore sexual relations to a relationship (which, unfortunately, are often bereft of sex – I wonder why…). I’m not suggesting hormonal replacement therapy; I’m just pointing out that increasing testosterone in women does increase libido. So that’s one function.

Estrogen Production

Estrogen is made from testosterone. Yes, you heard me correctly. Without testosterone, women would be unable to produce estrogen.

Wait – let me back up a second and provide some detail. Testosterone is responsible for the production of estradiol, which is the primary estrogen in non-pregnant women, up until menopause hits. After menopause, estrone is produced, and in pregnant women, estriol is produced. For our intents and purposes, I’ll continue using “estrogen” when referring to the “feminine” hormone produced from testosterone.

We can all agree that estrogen plays an important role in female (and male) function – a post is probably in order, in fact – and it’s all made possible by the presence of testosterone.

Muscle Building

Just as in men, testosterone is responsible for the acquisition of lean muscle mass in women. We’re all human, remember, and hormones play similar roles in our bodies, regardless of gender. But because women have far less testosterone, packing on serious amounts of muscle simply isn’t going to happen naturally. The internal wiring necessary for muscle building is in all of us, though, as shown by the results of female exogenous testosterone usage.

Bone Health

Birth control pills have another unintended, unwelcome side effect: they lower bone density in females. The article doesn’t mention it, but I figure increased binding of testosterone by SHBG is probably to blame. After all, we know that testosterone and libido are linked in both sexes, and that anything that decreases the bioavailability of serum testosterone – like birth control pills – also decreases libido. Last time I mentioned that testosterone is responsible for proper bone mineralization, in both men and women, and this BC study seems to bolster that claim.

It’s true that women produce far less testosterone than males – roughly 1/10th as much, by most accounts – but their sensitivity to testosterone is far greater. Quite simply, women don’t need as much raw hormone to handle business. It’s no less important for women, and it plays the same roles and enables the same functionality as it does in males.

It’s just a matter of scale.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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108 thoughts on “Testosterone: Not So Manly After All?”

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  1. Thank you for shedding some more light on this issue. Looking at the comments a while back when you posted about testosterone, I too saw the frequent generalizations and misunderstandings that people commented on.

    I’d really like to see how estrogen plays a role in men as well!

  2. Mark I have a question about vegetables, and leafy greens in particular. I know you are a big fan, but is it possible to have too much? Don’t vegetables contains toxins and antinutrients etc to avoid being eaten? Can these irritate the intrstines and cause damage?

    1. Yeah, that’s a great issue I think Mark should discuss.

      I actually stopped eating vegetables and leafy greens (not completely, but I rarely do because I don’t like the taste) and I eat mostly fruits.

      Vegetables cause me bloating, constipation and indigestion but fruits make me regular, energetic and glowy 🙂
      My digestion has gotten a lot better and even losing weight is easier. Maybe it all depends on the individual, but I feel you shouldn’t force yourself to eat something neither you nor your body like.

    2. As long as you are eating a good amount of animal products and not eating too many calories, then you should be fine. Greens do contain toxins which is why it is smart to have a variety. Grok did not eat just spinach for his greens or just swiss chard. He ate them all!

    3. I’ve never seen an elephant or a giraffe irritated from too many greens.

      We only eat a very small number of greens and vegetables out of an impressive number and those that we do eat are not allergenic for most. Yes, plants are potentially toxic and that’s why it’s a very good idea to be sure of what you’re eating and not pick something in the wild.

      1. Actually, most herbivores have a lot of defenses, both physiological and behavioral, specifically to neutralize plant toxins. Elephants do things like eating clay to absorb toxins out of the leaves they eat, and their livers are very well-equipped as well. I don’t think it’s a concern that can be dismissed out of hand, but you can probably avoid most problems by trying for as much variety as possible and not accumulating too much of any one plant toxin in your system at a time.

  3. Yes, it’s too bad for us women that we don’t get the testosterone advantage by strength training as the men do. But I always tell my clients that growth hormone does increase as a result of weights and that is a great fat burning and muscle building hormone as well. Us women CAN get the body we deserve without high levels of testosterone!

  4. This is a fantastic article. I knew birth control pills wrecked sex drive! Most people have no idea how big a role hormones play in everyday life. Insulin and glucagon are especially interesting.

    Heading to the gym to boost my testosterone!

  5. I tried to mention this to my hubby a while back, and he thought I was crazy! He was in the camp that says testosterone is the male hormone meant to build giant muscles…I tried to tell him that, no, women need it too, because we also have musculature that needs support, and that we need testosterone for libido!

    I’ll just have to forward him the article so hopefully he’ll believe me this time 🙂

  6. You say that because “women have far less testosterone, packing on serious amounts of muscle simply isn’t going to happen naturally.” High testosterone levels alone do not account for increased muscle building ability. Rather it is only when there are big changes of testosterone levels in the body, such as those that occur during male puberty, that account for the difference in % of lean muscle mass between men and women. Once puberty is over, men and women put on muscle at the same rate (when measured as % increase of existing muscle), despite their differing levels of testosterone. Male adults in general simply have a higher starting point in terms of amount of muscle mass, giving the illusion that they are able to put on muscle more easily. I don’t mean to correct you but this is my field of study and this issue is one that is addressed frequently. Thanks so much for your awesome blog! The world is healthier because of it 🙂

    1. You say men and women put on muscle at “the same rate” but also say that it’s based on a percentage of lean body mass which is not the same in men and women.

      Same percentage rate does not mean same rate because the original values are different.

      Thus, even if everything you said were true (minus the contradiction), women STILL put on less muscle in response to increases in testosterone (in pounds, not percent).

      That makes a little more sense.

      1. I don’t see a contradiction. Absolute and percentage rates of change are just that.

        In 2009, Australia and Kazakhstan both had real GDP growth rates of 1%. Economists would say they both grew at the same rate. Australia, starting at a higher level, added more real wealth to its economy than Kazakhstan.

  7. On the topic of bone health, I heard an ad on the radio today for some pharmaceutical the helps provide calcium and vitamin D because our bodies “suck calcium from our bones”. I wanted to smack my forehead when I heard it. I wish they had said, “when you consume an improper diet, our bodies suck calcium from our bones.”

    1. Haha, that’s like the Caltrate (or something) commercial that says our body “steals” calcium from our bones…sounds really scary huh??? Quick, the calcium thief is coming! Take your Caltrate!

  8. I have a friend who has AIS (androgen insensitivity syndrome). As a result, she has almost no libido at all. The one time she was treated with some topical T, she was amazed at what a sex drive felt like.

  9. What’s your take on using topical T to deal with low libido issues in post-menopausal women? Any studies showing its affects on bone-density?

  10. Any chance you have some natural remedies for young women with no sex drive? I’ll be 32 next month and have had absolutely zero sex drive for several years. I was on birth control for several years but have been off that for about 2 years, I eat primal most of the time, and I do weight lift twice a week plus walk an hour daily. While I don’t care that I don’t want it (probably sounds bad, but its hard to want it when you just don’t want it), it certainly drives my husband nuts. I’ve always mentioned it to my doctors (I’m now on my 3rd), who have tested my hormones, and no one has any advice or offers help other than saying “that’s unfortunate”. Thanks!

    1. Beef liver. Hands down the best food for libido and really is the best primal source of many nutrients that help regulate hormonal function.

      1. Wow–can you share more on this Kat, or some links? Is it better than say, chicken liver?


        1. I suffered with very low energy and low libido for quite a while. When I finally got the guts to try beef liver, I was amazed at how much more energized I felt the next day. All liver is good, but beef liver has a higher nutrient profile than chicken livers. I have noticed more energy from beef liver than other kinds, but I do eat all types of liver for variety. Beef liver just seems to have ‘something’ maybe that we haven’t identified yet that helps with fatigue.

          Here’s a good review, the Weston Price Liver Files; https://www.westonaprice.org/food-features/509-liver-files.html
          They have a comparison chart about half way down of the nutrient content in each type of liver.

          I have a bunch of links saved up somewhere I’ll be posting on my blog in the next few weeks. The one book I read that convinced me to try it was “Rebuilding From Depression” by Amanada Rose. I posted a bit about what else I ate for energy here (eggs, liver, oysters, bone marrow all often): https://www.scdkat.com/2010/03/scd-and-gaps-foods-for-adrenal-fatigue/

          I’d be interested to hear from anyone who has low libido but very high energy otherwise. They seemed to go together for me.

        2. Oops, I posted a few links and think it got marked as spam. 😉

          I was on the pill 12 years and went off about 8 months ago. I have struggled with fatigue and low libido for a while and the only thing that finally helped was eating more beef liver. I eat about 8 ounces per month, on top of eating other organ meats once a week. Beef liver just seems to have something extra in it that gives a huge energy boost.

          I’ll be posting lots of info and share more of my experiences on my blog later in July. Just trying to organize a bunch of links and other blog posts on it.

        3. Kat, you were probably deficient in B-vitamins, iron or zinc. Liver is a good source for these. Birth control pills deplete mineral stores.

        4. According to blood tests all my b-vitamins and iron were fine. I took b-vitamin supplements, zinc, magnesium, multi-mineral (including iron) for years because I used to be low (probably from the pill yes). Since starting to eat liver none of those levels have changed but I have been able to stop all supplements.

          The supplements did not give me any energy at all. The liver did, and makes me wonder if there’s something in it that we don’t even know about.

        5. BTW, you can get better effects from liver tabs. ‘Tried And True’ makes the best ones in the market. They are made from Argentine cows. It’s dessicated liver tabs, higher potency than eating liver. Cheers!

        6. [QUOTE]BTW, you can get better effects from liver tabs. ‘Tried And True’ makes the best ones in the market. They are made from Argentine cows. It’s dessicated liver tabs, higher potency than eating liver.[/QUOTE]

          I’d be careful w/ any liver from Argentine cows b/c of the possibility of arsenic toxicity:

          [QUOTE] …there are very high levels of arsenic in the groundwater in Argentina.

          In the region of Cordoba, Argentina, Arguello et al. (1938) reported maximum levels of arsenic of between 0.9 and 3.4 mg/litre.

          “In his presentation, Professor Smith cast some doubt on the role of nutrition in combating poisoning. His study in Argentina showed that Argentinians of European origin, on high protein diet (beef steak), have also been suffering from Arsenic poisoning since the 1930s.”

          In Argentina, groundwater arsenic concentration in some places ranges from 100 to 2000 microgram/l. Reports from epidemiological studies in Argentina indicated that 0.3mg/l arsenic in drinking water resulted in increased incidences of hyperkeratosis and skin cancer with an increased consumption of water [/QUOTE]

          I think it’s just really important to look into your sources.

          And Kat, is the liver not a fatty organ? I thought it was important to get high quality organ meats as well. (Of course in an ideal world, we’d get all of our meat high quality/grass fed/pastured, but I’m wondering if it’s as important to get high quality organ meats as it is fat…)

          Thanks for all the good info! Will be picking up some grassfed beef liver tomorrow–yum! (Joking–I’m not a fan, but am pretty good at hiding it in various meals…;)

        7. FairyRae thanks for posting that link about the arsenic issue. I did try taking liver tabs once but I think I never took enough to make any difference. I prefer just buying beef from a farmer I trust and eating it.

          Liver is actually quite low in fat, but yes it’s best to get it from pastured healthy animals. I only started eating liver after getting it as part of my 1/4 pastured cow order, so I’m really not sure the difference in taste/texture/look of regular beef liver. I do know that many farmers are quick to throw in extra organ meats with large order. For my 1/4 cow I got about 7lbs of liver extra because my farmers gets a lot of orders from people who only want muscle meat.

          Good luck hiding that liver taste!

        8. Kat, thank you for those links. I’ll be checking your blog for upcoming posts!

          And I’d love to hear more about this:

          I took b-vitamin supplements, zinc, magnesium, multi-mineral (including iron) for years because I used to be low (probably from the pill yes). Since starting to eat liver none of those levels have changed but I have been able to stop all supplements.

          I’ve actually been trying to create a superfoods/supplements list for myself, and the only synthetic/mega-dose type vites I was thinking to continue were the B vites and the minerals. I’d LOVE to hear more about this! The link to my continually evolving ‘plan’ is here, if you want to come on by and check it out!! https://www.mothering.com/discussions/showthread.php?t=1241375

          I’m getting grassfed beef liver tomorrow and planning to do the ‘liver pill’ thing…Wish me luck!!

          1. A good addition to the vitamins you are taking is Vitex Chastberry, its the premier herb for females

            It balances hormones in women, if you have high testo levels it will bring it down by allowing you excrete it through your liver

            You can get it in pill forms. Try it and be glad

      2. I used to eat a lot of liver, and then it occurred to me that its primary function is to filter toxins, ergo, wouldn’t that suggest it’s riddled with toxins? Am I totally wrong?

        1. That’s why it’s so important to get grass fed/pastured liver. I wouldn’t touch CAFO liver at all…

        2. The liver filters toxins, it does not store them. In fact, liver is high in nutrients like vitamin C because it requires vitamins to be able to bind to toxins to remove them. Fat is more likely to store toxins so it’s very important to get animal fats from pastured/organic animals.

        3. Cool Kat, makes sense. I just checked out your blog. I live in Montreal, so I’ll look into your links for organic farms in the OTT valley. Can’t seem to find much here.

      3. Yes I agree about the beef liver I’m a guy but I also had anemia 2 years ago my iron levels are normal except my ferritin so I will feel weak no energy no sex drive. But now that I’ve started taking liver pills I feel a lot better I’m also going to eat fresh beef liver also so yes I’m starting to understand the importance of liver

    2. What was your libido to begin with before the birth control pills? I know some women who’ve really never been much into sex.

      The natural remedy that I would recommend first is have your husband stop initiating( as in never making any advances) and give you time to become interested. You should also wait to want it and not give in because you feel horrible. This may help finding your libido and seeing how big it is.

      1. I’d say my libido was pretty high for the first few years before birth control. Yea, I do notice I become less interested the more he bugs me, but he won’t stop. Always slappin my butt, pulling out his deal, etc.

        1. @Midgy

          Just to provide the male perspective on this, most men want it (or are willing, at least) almost all the time, don’t have to be in any special mood or state of mind to want it, don’t understand that you dont’t want it, and don’t understand that touching you, slapping your butt, and generally trying to ‘get your motor running’ just feels pushy to women rather than sexy. I had to learn this with my girlfriend, but I only understood it after we had several conversations about it and she spelled it out for me clearly. Have you really talked to your husband about it (as in said something to the effect of ‘you are only making me want sex less by being pushy, so you are better off leaving me alone and letting me come to you. It’s not that I don’t love you, it’s that what you are doing is turning me further off of sex, and that’s not something I can change.’) and made sure he understands, or are you just suffering silently, which does neither of you any good?

        2. The sex life is most intense the first two-three years of a relationship because of the newness and the excitement so it may be that you couldn’t get to those levels anyway , but somewhere to 50-75% of that.

          Try to talk to him in very descriptive terms and very directly as the comment above said. As in “you pulling it out is turning me on as your mother showing up right this moment unannounced at the door”.

          And another thing: don’t do it because you feel guilty( out of love as one comment below said). I’d say limit the sacrifice sex to once a month. Men in the same position do not feel guilty. If they’re too tired they say no and move on.

    3. Have you heard of “The Orgasmic Diet”? (google it) Very in line w/ primal, and she discusses ways of raising testosterone along w/ other good stuff, naturally (w/ vits, supps, and food, along w/ exercises). It’s basically a low carb diet, w/ lots of fish oil, a multi, extra mag/zinc, and she also includes a small amount of dark chocolate. I just think it’s a great read and would be helpful/information to any woman looking to increase libido. Another major focus of the book is on achieving vaginal orgasms (or any orgasms if that is an issue.)

      Just thought it might help!

    4. LEF.org

      You can order your own tests, and those doctors will, I believe, review it with you keeping in mind “optimal” vs. “normal” levels.

      Quite helpful, actually.

    5. There is some research to suggest that sometimes hormonal BC can permanently effect your libido. I’d be interested if there is anything you can do to reverse that, because the same thing has happened to me. But I just thought I’d put that out there.

  11. Thanks for the much needed infos.

    It seems I always have a hard time to convince women to lift heavy. May be this will help them.

  12. Hormones have such a massive effect on mood. For example since my wife stopped using birth control she is much more even tempered and experiences virtually no PMS symptoms. Thank God for that!

  13. My wife’s doc put her on bioidentical testosterone earlier this year. She’s a different person. She’s just happy all the time now. It’s made a huge difference. I got back the girl I married 22 years ago.

    1. I second the birth control article. It has become such the norm that women are totally ignorant to what it is, what it does, and what the risks are- immediate and long term.

      1. A fourth! I’d like to get off BC pills too, as I have colitis and a gluten intolerance, and I hear they mess with your gut flora as well.

    2. Still anxiously waiting that article on birth control… 😉

      1. Same. I don’t want to get preggers and have been on the pill for 15 years. I love to hear if there are any primal options out there or how to mitigate the pill’s effects. Family planning is just too risky for me and 11/100 preggers with a condom is still too high of a probability for me.

        It scares me to think that my body has been hormonally been fooled since I was 15. My mom put me on it before I even kissed a boy “just in case”. I don’t even know what my body is like sans pill + know you’re telling me the damage is quasi permanent!?

        ugh. all this for a little worry-free booty. 😉 Can’t tell you if it affects my libido since I’ve never been off the pill but currently I definitely have the stronger drive between the boy and I. So I’d be even less satified without it!

        1. I switched from BC to a non-hormonal IUD because of just these concerns. While my period is a little heavier, life is so much better without having to take a pill every day or worry about pregnancy! I’d do some of your own research and talk about it as an option with your doctor. I’m a big fan!

  14. I puffy heart lifting weights! Heavy weights! And I can’t tell you how many times my girlfriends tell me I am going to get all bulky by doing so. I have given up telling them that is impossible and, of course, looking at my serious LACK of bulk is not enough to convince them.


    1. I have seen several of my females friends bulk up from heavy lifting. Not only did they bulk up, their faces took on a more masculine appearance. Also, I know they definitely do not take any form of steroids.

  15. I am very excited to see the role(s) that estrogen plays. I’m a victim of the belief that estrogen is bad for men (look at the number of products made to inrease the T:E ratio!).

  16. What would happen if women had high sex drive and would constantly be busy trying to satisfy that?

    Would that hurt the baby? The future of the baby? What if after birth she’d be up and looking for another male to mate with? Forget the baby, where the hell are the guys!!!

    Also what if women carried an insane amount of muscle + boobs + the baby?

    As far as I’m concerned now Estrogen + Testosterone are both for bone density and it doesn’t matter which one of the 2 you have.

    And besides, I’ve seen a ton of women have bigger bi-and tri-ceps than men.
    During my prime I ran 100 metre in 13.8 seconds. No guy in my entire school could catch me 🙂

    Estrogen is the magical hormone that puts women in control of manipulation. We b****h and men find a solution…take for example the Dishwasher!
    In history, behind every powerful leader was usually a woman.

    1. Yes, the woman that’s paid 87% as the man for the same job. Or that’s left for the young new wife in her 50’s. And the woman who can’t really get maternity leave. And all of these because she’s so good at manipulating. If you’re selling pink colored glasses I’m getting a pair!

      1. Ok, maybe you are right about that…but only in America.
        In Europe women get 1 year paid maternity + longer if needed and cannot be let go by law.
        A woman also has the right by law to make the same money as a man with the same college degree, in european countries.

        And when I worked for the united states army I was paid above average (as a woman), more than all the men equal to my position and was offered the promotion to a even higher paid job. I also was paid more than a man in his early 50’s for the exact same position for the same company. After 3 months he was fired, I was promoted.

        It isn’t unfair everywhere, ya know.

        And being left for a younger woman?
        I married a man 10 years older than myself, I already knew this back in my 20’s. He barely keeps up with me and always wants me to ‘settle’ down.
        I don’t fear him ever leaving me for someone younger.

        Also, when men hit male “menopause” (not sure what their term is – andropause?) they tend to do wacky things, have great fear of getting older, more so than women, but just don’t talk about it.

        I’ve always felt sorry or bad for women and when I was younger felt like we’re getting the bad end of the deal.
        But living in America now men really have it tough. They work themselves to death to support a woman sitting at home wanting to have 5 kids to outdo the neighbors. The obsession with kids in this country is making it really tough on the guys while the ladies stay home and play dress-up.

        1. What??? I don’t know one single woman who fits this description! What country are you referring to? Certainly not the USA.

          I do, however, know a few women who have 5 kids, but they did not have them as an excuse to not work, nor did they have the kids to outdo the neighbors.

          I’m sorry, but your statements seem a tad silly.

        2. Women in the US earn the same pay for the same work in almost all cases. However women generally choose jobs that earn less. Men who take those jobs earn less as well, but more men go for high paying jobs.

          Women are also more likely to take time off for the kids (the year you get legally there – but often 5-10 years), and that means when they go back to work they are 5-10 years behind in promotions (or more – often they end up starting all over). Once again this factor also applies to men – however in most families men don’t make the choice to take time off for the kids.

          The above factors allow someone to claim the 87% and be technically correct – but this statistic is completely useless for discussion purposes.

        3. You obviously never had 5 kids…..there is no sitting involved.

    2. Ew. I am really turned off by all your babycentric arguments. I am not just a vehicle to make babies. I am entitled to a high sex drive. I refused to be defined by the fact that have a uterus.

      “Estrogen is the magical hormone that puts women in control of manipulation (…) take for example the dishwasher!” Wow. I just puked in my mouth right there. 1. I don’t manipulate a man for HIM to find me a solution. I can solve things myself. I don’t have a passive-aggressive desire to manipulate ppl because I don’t give them my power. I take it. 2. You are implying that washing dishes is a “woman problem” but it is my bf that does all the cleaning and washing of dishes in my home. and 3. I’d rather be that powerful leader than be behind him.

  17. wow thanks for posting this! I have been wondering for awhile now whether I should come off the contraceptive pill.. I am now!!

  18. Thanks Mark for this post. I have polycystic ovary syndrome and it plays havoc with my hormone levels…plus leads to insulin resistance. Carrying extra weight is a trigger for the vicious cycle of gaining weight and hormone imbalance. Knowing that estrogen comes from testosterone helps me understand this delicate balance and the chaos it creates when that balance is thrown out of wack. I am 3.5 weeks into being Primal and I am loving it! It has been great to get off the insulin roller coaster and I look forward to the great effects it will have in balancing out my hormones.

    1. Something else you should know about estrogen is that excess fat can create it leading to estrogen dominance.

      PCOS can pretty much be “cured” by a low-carb diet… but it’s a lifelong thing.

  19. Great article! I too would like to see an article on birth control. I’ve read bc pills can limit muscle gains from strength training and want to know more.

  20. Thanks for the article. I am new to the site (been following it for a couple of weeks and just recently finished the book) and while I have not yet commented, I couldn’t help but second all of the requests for an article on birth control. Unfortunately, too many women are just given “the pill” and without realizing it begin playing “Russian Roulette” with their bodies. Having an adequate sex drive is not only a lot of fun but imperative to a healthy marriage, high self worth, and overall good health. I think living Primal can get you the healthiest anyone can ever be: I have suffered from endometriosis and elevated fsh levels, er-visit strength uterine cramps, and a perforated uterus all before being diagnosed celiac, lacotse intolerant with extremely low vit D levels and suffering from osteopenia. Being gluten free and Primal has SAVED me…but I’m still continually sacked with the hormonal imbalance served even with the mini-pill. Doctors say a hysterectomy followed by hormones…but I’m only 31. Now Mark, what’s a girl to do? Thank you for helping me, I hope I can encourge others to become Primal.

    1. My sister had her uterus taken out because of problems like you described.
      They left the ovaries for her hormone production.

      She told me that the uterus isn’t needed at all to regulate any hormones…not sure if it’s true, but she feels great now.

  21. I’m guessing that bio-identical hormone replacement = non-primal = bad?

    1. I looked it up last night, apparently although it’s called bio-identical it’s still a hormone replacement therapy?

      And it’s still created in a Lab.
      On top of that no long term studies have been made to see the outcome of it.

      So for now I’d have to agree = bad.

      1. “Bad” is relative right? It’s “bad” to be depressed all the time and have zero libido.

        Is it “bad” to then take a drug to remedy this situation?

        I think the choice is up to each individual and shouldn’t be labeled “good or bad”.

        If a person has made an informed choice, weighing all options, then that is their choice and should not be labeled “bad”. For them it very well may be “good”.

  22. I noticed someone else mentioned PCOS and I suffer from this also. I was under the impression that the undesireable symptoms are from increased testosterone. Would you mind addressing this? PB works wonderfully for me at maintaining my blood sugar which was formerly quite wonky I believe related to PCOS. But I don’t want my testosterone to go increase even more, right?

    1. PCOS is the result of blood sugar dysregulation (too many refined carbs). Keep eating low carb, get to your ideal weight, and the pcos symptoms should diminish.

    2. For those who wanted more information about PCOS, one of my favourite bloggers had a doctor explain PCOS on her site on Friday: https://tinyurl.com/285r7rg.

      These three paragraphs stuck out to me:

      “It’s a hormonal disorder characterised by three main features – high levels of androgens (male hormones), irregular ovulation and polycystic ovaries. You only need to exhibit two of these three features to be diagnosed with PCOS.

      “We don’t know what causes PCOS. It’s most likely due to a combination of genetics and lifestyle factors. PCOS seems to often run in families and close female relatives (e.g. sisters, daughters) of a woman with PCOS have up to a 50 per cent chance of also developing the condition.

      “Women with PCOS are more likely to be overweight and have insulin resistance … People with insulin resistance have a high level of insulin circulating in their bloodstreams. This increases their androgen levels, which makes their PCOS symptoms even worse.”

      Testosterone is a type of androgen. The way I understand it, though, it’s “free” testosterone that’s the problem, and insulin resistance contributes to this by decreasing the levels of the sex hormone-binding globulin (SHBG). So it’s not the overall levels of testosterone you need to worry about per se, it’s the levels of SHBG – i.e. more testosterone is fine, as long as SHBG also rises. Can anyone with more expertise confirm this?

      Hope it helps!

    3. I have PCOS too. In PCOS, women have testosterone levels more than what a woman’s body can normally deal with. PCOSers probably need not worry about low testosterone because they are on the other end of the spectrum.

      But I would like to point that there is no one solution to PCOS as in low carb diet isn’t a solution for everyone.

      e.g., my symptoms don’t reduce by any significant amount when I’m on low GI diet. and I don’t do well on low carb at all… I end up losing too much body weight and even getting me too too underweight

      PCOS is typically tied to overweight women having too much estrogen and blood sugar/insulin issues but it isn’t always the case. PCOS women come in all sizes, with low to high estrogen, normal to unhealthy BS/insulin.

  23. Just to add a little bit on BC, Wouldnt it be better to just not have sex, well until marriage or atleast involved in a strong relationship.

    That way you dont need the pill and i’m sure not having sex with your boyfriend or girlfriend cant be that bad, i’m mean, remember that post on affection?

    I’m not catholic or anything but i think they might have been right with this one lol

    1. Andy, that’s ridiculous. Just because you’re married doesn’t mean you want a bucketful of kids. You still need to have a choice, love and commitment with someone doesn’t automatically infer an incessant need to procreate. Not to mention birth control is far more affordable than too many kids, and that kind of stress really would be hell on the relationship.

    2. not to mention, sex is essential for healthy relationships, kids aren’t. birth control allows women to be human beings and not slaves.

      even ancient humans could control their fertility. we need to regain some of their secrets. hormones work for some but it would be nice if others had more options.

    3. Read Taking Charge of Your Fertility. No BC necessary, sex when you want it, other than your fertile time. It’s not rocket science, it’s just knowing your body!

    4. That’s just silly. I actually didn’t have sex until I was married and I’m very dependent on BC (not the Pill right now, but barrier forms along with the fertility awareness method) because I do not want to be pregnant. Just because a woman is married doesn’t mean she wants to be knocked up all the time. And likewise, just because someone is just dating doesn’t mean they shouldn’t be able to have sex. To each their own, but if BC is available, why not use it regardless of your relationship status?

    5. By “sex” do the commenters here mean only penis-in-vagina sex? Because let’s not forget another good form of contraceptive is, well, not having vaginal intercourse… there are many, many different ways to share pleasure, intimacy and orgasms…

  24. From what I understand with PCOS, when we carry extra weight, our bodies make too much estrogen. Plus, one of the symptoms is too much testosterone. It’s all related back to the insulin response. Once that is balanced and we are able to lose weight then the hormones are in balance…. Which means the right amount of testosterone….so no worries. I think going Primal is what we are looking for.

  25. Thank you so much for these hormone posts Mark!!! It really is amazing and something we generally don’t think about as much as we should.

    I too have been cursed with no libido for about 5 years now. It only occurred to me recently that that may have been around the same time that I changed my birth control pill. Consequently I recently went to the doc and am starting a new one this week. If that doesn’t work then I’ll probably go off them. I’m sure my wonderful hubby (who tries very hard to understand my lack of interest) won’t mind wearing condoms if it means more sex.

    Ladies, if you do nave no libido, make sure you discuss it with your man so he realises it isn’t his fault. When I initiated the conversation I found that my hubby was thinking I just wasn’t finding him attractive any more, and nothing could be further from the truth. It truly hits hard on their self esteem. Also, try to make the effort to do it at least some times, simply as an act of love. Besides, even though I don’t WANT it I still enjoy it when we do do it! I hope this change works because my husband is wonderful, 6 years younger than me and has a truly hot bod. I honestly MISS my libido and I WANT to want it.

    Great info Mark, many people out there don’t understand this stuff and getting the word out can truly change lives!

  26. I just had my testosterone tested after having an extremely high 8am cortisol reading. My testerone numbers were fine, but my SHBG was through the roof! One more reason to get off the pill (which I will be by the end of the year – woohoo!).

  27. Mark, I feel for you man. You take the time to research and post excellent articles and then I read the comments and see a cavalcade of misinformation and off topic posts and irrelevant questions and just plain voodoo heresy and it must make you want to give the whole thing up at times. 🙂

  28. “I’m guessing that bio-identical hormone replacement = non-primal = bad?”

    Bio-identical Hormone Replacement is a proven therapy for people whose hormone levels are low for reasons other than diet and exercise. Hormone levels for men and women decline with age. It’s a natural progression. Some or all of this may be mitigated by a primal lifestyle and for others not. Hormone replacement therapy may be the answer to abnormally low levels of Testosterone and or estrogen (in women). If you can do it naturally, great but not everyone can.

    1. Thanks for that comment. I was producing virtually NO testosterone on my own and had to go on bio-idnetical. Now I am losing fat and gaining muscle and have a libido again.

  29. What about us women with PCOS.I Hate what the testosterone has done to me.Although my testosterone is high by a blood test I have NO SEX DRIVE!!!!!!

  30. One amazing pill I have found that helps manage insulin resistance which is associated with PCOS is Chromium. Try it out. This, along with the Primal Diet helps out.

  31. This is a very detailed article on testosterone from a woman’s perspective. I guess no matter how clear one tries to be, one subconsciously sees testosterone = man.

  32. yea i hope Mark could do an article on PCOS, Birth Control Pills (which are often given to women with PCOS). My gf has been diagnosed with PCOS, even though her hormone levels came back fine. In the last year, she went to the gym every other day but yet gained 30 pounds.

    i got her on the PB and things have gotten better but somehow on the second month of her starting the pill, the effects of PCOS seemed to have come back again – putting on weight, acne, mood swings, depression, low libido, etc.

    I personally don’t like how docs simply prescribe BC pills for PCOS. I know there’s a better simpler solution to PCOS. It would be great if Mark could help shed some light on this, cos i sure as hell believe that women weren’t meant to go thru so much.

  33. Good topic…my husband has been taking injectable testosterone for a couple of months now, and I’ve been using topical, bio-identical progesterone cream for about 5 months. He’s 45, I’m 50. We did saliva testing before deciding what to do, and in both our cases, our hormone levels were far off what they should be. Menopausal women usually end up in an estrogen-dominant situation, due to waning progesterone. As our hormone levels creep back to where they should be, we’re both experiencing better sleep, more energy, better muscle tone and an improved sex life.

    With aging, our hormone levels naturally start to wane, SAD hustles that along more than in a lot of other parts of the world. We can suffer along, waiting for things to get better (they won’t) or we can opt to do what feels right. Hormone levels are important for every single body function and cannot be ignored.

    1. Hi there,
      We have the same stats, my husband is 45, I am 51. Where did you get the saliva testing done?
      I think I need some of that big T.!

  34. If both testosterone and estrogen are present (and needed?) in both males and females, then WHY are they still considered male and female hormones. I’m a woman and don’t care to have one thing of ‘male’ in me!! So until the hormones are just that.. hormones.. not sex-linked I will NOT believe that we females have testosterone. ZILCH. It’s all false with pharma trying to get more money. And all the medical society to lock into another medical profit industry!!
    I don’t believe one bit estrogen is derived from testosterone.
    GET REAL!! The mechanics of men needing testosterone for erections is false too. Why else would the boys get erections and play around with erect penises???????? I was raised with brothers, had sons (they were taught they could only touch themselves when they were alone of course) played with brothers friends and regardless of age would get erections!! Even my husband told me what he did as a boy!!

  35. Right on Mark. As a woman I never once questioned my levels of testosterone until things were WAY off. With healthy eating and hardcore workouts, my weight gain was swift and uncomfortable.

    I was left scratching my head. Huh? What is heck is going on?!?!!?

    After 2k worth of blood tests and changing doctors like people change undies I finally got answers. No DHEA and VERY low Testosterone. No libido and increased weight. It sucks. I’m not back to normal yet but at least I have a most positive pathway to follow.

    Above all…I understand WHY!!!

    Hormones control all. Baby them.


  36. Thanks for the post. I have constantly observed that a lot of people are desirous to lose weight simply because wish to show up slim plus attractive. Having said that, they do not always realize that there are more benefits just for losing weight as well. Doctors declare that over weight people experience a variety of health conditions that can be instantly attributed to their excess weight. The great thing is that people who definitely are overweight as well as suffering from diverse diseases can help to eliminate the severity of the illnesses by losing weight. You possibly can see a steady but marked improvement in health as soon as even a bit of a amount of weight loss is obtained.

  37. When my husband uses Androgel, he becomes the asshole from hell.

  38. I’m female and lately I’ve experienced tiredness, acne all over my body, shrinking breasts, weight gain around thighs, hips and stomach, and now I hairloss with slight receding hair line ( not sure if it’s from hair dye ) now I have receding eyebrows and suffer with severe headaches and dry skin! Had all the blood work done and everything comes back normal. I feel like I’m losing my mind, I need to lower testosterone as I think adult acne and hairloss is an indication of high testosterone!

  39. Does anyone in the MDA community have advice for a 24-year-old female who thinks she may have too much testosterone? Thanks for your help!

  40. Estrogen levels fall at menopause. This is a natural transition for all women between ages 40 and 55. The decline in estrogen can happen abruptly in younger women whose ovaries are removed, resulting in so-called surgical menopause.

    Perimenopause is the period of transition before menopause. The first natural decline in estrogen levels starts during this phase. Other physiological changes also start. Women going through perimenopause may experience weight gain along with other menopause symptoms. For instance, there may be irregular menstrual periods, hot flashes, and vaginal dryness.

  41. Testosterone and estrogen are present in both men and women, the only difference is that

    In men, testosterone is dominant while in women estrogen is dominant

    An imbalance can occur which means a man can experience estrogen dominance which symptoms like man boobs occur