Testosterone vs Estrogen Levels

It’s not what you thought!

If you’re new to my Substack I’m a prostate cancer survivor that has been receiving treatment with drugs that cause side effects that mimic those of perimenopause, menopause and sometimes post menopause. I’m in the unique position of being a biological man who understands the life challenges that many women experience in their menopause journey. I have experienced nearly every symptom of menopause, including hot flashes, memory loss, anxiety, brain fog, fatigue, loss of sleep, muscle wasting, weight gain, depression, and low libido. In an effort to learn how to cope with my symptoms, I educated myself on menopause to see how women work through them. I’ve taken the time to learn about how changes in estrogen, progesterone, and testosterone levels affect women. In the process I have come to realize that women get treated like second class citizens even when it comes to women’s specific health issues.

My main mission with my posts is to educate men on menopause issues from the perspective of a man who has suffered with the same issues and can relate to to being the person experiencing the issues, and also being the husband to a woman who has gone through menopause. I hope to inform men how and why they can and should support their female partners from peri-menopause through post-menopause. If you’re a woman on a journey through menopause, I hope you consider printing out this post and sharing it with your male partner. Please consider sharing this post with a friend or re-Stacking it. I would be honored if you would do so. Also please consider subscribing. It’s free and I have no plans to monetize my content!

Estrogen versus testosterone. Which one is more important?

There’s a common misconception that estrogen is a “female hormone” and testosterone is a “male hormone”. The truth is that both hormones are actually human hormones, not exclusively female or male hormones. In fact for much of a woman’s life, her body will have more testosterone than estrogen, and that amount of testosterone is important for maintaining a woman’s physical health. I hope to clear up some of this confusion by relating how testosterone and estrogen levels mathematically relate to one another.

I believe the confusion arises because testosterone levels are substantially higher in men than women, and women have substantially higher levels of estrogen than men. Generally speaking, a man will have about 10 times the testosterone of a woman so it’s importance to women gets downplayed. Conversely a pre-menopausal woman will have about 10 times the estrogen of a man so the importance of estrogen to a man is minimized unless certain health problems arise that point to an estrogen deficiency. Adding to the confusion is the fact that testosterone and estrogen are measured differently, and the relative levels are almost never compared directly to each other. Until now that is. That’s what I hope to demonstrate in this post with the hope of educating men that their partners may benefit from both estrogen and testosterone replacement.

Testosterone is produced by the testes and adrenal glands in males. Testosterone is produced by the ovaries and adrenal glands in females. Estrogen is produced by the ovaries, adrenal glands and body fat in females. Estrogen is not produced by any organs or glands in males, however, estrogen is converted from testosterone in males by the enzyme aromatase. Testosterone levels peak typically in a woman’s 20s and decline steadily over the years often with a further precipitous drop in perimenopause.

Let’s get technical

Testosterone levels are measured in nanograms per deciliter. This is a very small amount. Let me explain just how small this is. A nanogram is one billionth of a gram. A deciliter is only 1/10 of a liter so think of a 1 liter bottle of water that is only filled 10%. So in that 1/10th full 1 liter bottle, there are these little molecules that are almost on a subatomic scale. We’re talking absolutely teeny tiny!

Estrogen is measured in picograms per milliliter. This is even a smaller amount than the measurement that is used for testosterone. A picogram is one trillionth of a gram or put another way, a picogram is 1/1000th of a nanogram. Measuring using picograms is a much more sensitive measurement method than using nanograms. A milliliter is 1/1000th of a liter and this is a more sensitive measurement of volume than a deciliter which is 100 times more in volume!

Let’s compare expected typical estrogen and testosterone levels to get an idea of where things start out when a woman is in her mid 20’s to early 30’s. During a woman’s menstrual cycle, her estrogen may vary from as high as 400 pg/mL just before ovulation, to as low as below 50 pg/mL during menstruation. Testosterone varies too from a reported mean of 35 ng/dL during most of the month, rising to as much as 70 ng/dL around the time of ovulation. So what does that look like when we convert the scale for testosterone to the scale used for estrogen? Rather than go through the detailed and painful math let me just state that the two scales of measurement are an order of magnitude apart so it’s as easy as taking the nanograms per deciliter of testosterone and multiplying them by 10 to convert them to picograms per milliliter.

Just before ovulation when both estrogen and testosterone are at their highest values, it would not be unheard of for testosterone to measure 700 pg/mL while estrogen has peaked at 400 pg/mL. What this means is that at the time of ovulation, a woman may have almost twice as much testosterone as she has estrogen. At the time of menstruation when her estrogen is as low as 50 pg/mL, her testosterone level may reduce to 350 pg/mL, and that’s seven times more testosterone then estrogen!

During perimenopause, estrogen levels can fluctuate wildly so I’m not even going to try and attempt to compare estrogen and testosterone levels during perimenopause. That would be a fools errand. Suffice it to say that the ratio of testosterone to estrogen may remain the same, may increase, or may decrease but most likely testosterone levels will be greater than estrogen levels during perimenopause.

Lastly let’s take a look at estrogen and testosterone levels post menopause, and see how that shakes out. It is reported that a typical serum estradiol range for most postmenopausal women often have an estradiol level of less than 10 picograms per milliliter. Testosterone levels for both women fall steadily over time but it’s reported that a target testosterone range for a post menopausal woman is 20 to 70 ng/dL. Assuming that a woman has 10 pg/mL of estrogen and 20 ng/dL of testosterone and converting the 20 ng to pg we get 200 pg/mL of testosterone. In this case, a post menopausal woman with a low normal limit of testosterone, she has 20 times as much testosterone as she does estrogen! Clearly, testosterone is an important hormone for women at all ages.

To summarize, both testosterone and estrogen are important hormones for women before menopause, during perimenopause, and post menopause. A clinician skilled in the treatment of a woman’s hormonal balance can be very valuable in helping women meet their goal of living their best lives.