In women, testosterone tests are used primarily in cases of infertility, absence of menstruation, abnormal uterine bleeding, or if there is a suspicion of polycystic ovary syndrome or other cause of virilization (hoarse voice and hirsutism (abundance of body hair)). The mass spectrometry (LC-MS/MS) technique provides a more accurate measurement of the low testosterone levels found in women. Depending on the clinical situation, the interpretation of testosterone levels is based on levels of LH, estradiol, SHBG and sometimes free and bioavailable testosterone.
In women, high testosterone levels are caused by ovarian tumours and polycystic ovary syndrome or by adrenal tumours or overactive adrenal glands. Sometimes, this overactivity is caused by pituitary gland or hypothalamus disorders.
In women, a clinically relevant decrease in testosterone combined with decreased libido can result from bilateral oophorectomy, adrenal gland insufficiency, or poor pituitary function.