Testosterone & Libido: Why It Works Differently in Men and Women
Testosterone gets talked about a lot, usually as “the hormone for libido.” And while testosterone absolutely plays a role in sexual desire, the truth is more nuanced. Both men and women produce testosterone, and it does influence libido — just not in the same way or with the same intensity. Understanding testosterone and libido is especially important during perimenopause, menopause, and phases of hormone imbalance, when many people begin searching for answers about low libido and hormone balance.
How Testosterone Works in the Brain
Testosterone affects libido mostly through the brain, not just the reproductive system.
It interacts with receptors involved in:
desire and motivation
reward
mood
energy
Testosterone also plays a role in dopamine and nitric oxide, which support both mental and physical arousal. In everyday language, testosterone doesn’t just affect sex — it affects how alive, connected, and responsive we feel. This applies to both men’s health and women’s hormones, even though the effects show up differently.
Men: Big Rises Make Big Changes
Men naturally have 10–20 times more testosterone than women. Because the baseline is so much higher, changes in testosterone levels are easier to notice. When testosterone drops too low for that man, he may experience:
fewer sexual thoughts
reduced morning erections
lower initiation or interest
less physical and mental “drive”
This is why low testosterone in men often shows up as low libido, low energy, and lower mood. When levels improve in a man who is truly low, desire often improves too. But — and this is the part most people forget — testosterone is still not the only factor. Stress, sleep, emotional health, relationship dynamics, and chronic health conditions all influence men’s libido just as much as hormones do.
Women: Smaller Amounts, Subtle but Important Effects
Women make far smaller amounts of testosterone, but their brains are still sensitive to it. Research shows that testosterone in women can support:
interest in intimacy
responsiveness
overall sexual satisfaction
However, in women, blood levels of testosterone do not always predict how someone feels. Many women with “normal” levels still struggle with low libido, especially during perimenopause and menopause, when estrogen, progesterone, and androgens fluctuate. This is why female libido is often more complex than simply “testosterone is low.” For women, testosterone is one ingredient in a much bigger hormonal picture — not the main driver.
Why Libido Is Multifactorial (For Everyone)
Libido is never controlled by one hormone. Desire is shaped by:
stress or mental load
sleep
medications
mood and energy
relationship connection
body image and confidence
nervous system activation
overall health
This is why simply “fixing testosterone” doesn’t automatically fix low libido in women or low libido in men. Desire improves most when hormones, lifestyle, mental health, and stress are all addressed together — something we consider in any conversation about hormone optimization, HRT, or hormone balance.
Men vs. Women: Why Desire Often Feels Different
Men often experience spontaneous desire (they feel ready for intimacy without needing much buildup).
Women more often experience responsive desire (“Once I feel safe, relaxed, and connected, desire builds”). Neither pattern is wrong. They’re simply different ways the brain and hormones express desire, influenced by sex differences, stress, life context, and overall hormone balance.
The Bottom Line
Testosterone matters for sexual desire in both men and women — just not in the same way, and not with the same intensity. Libido is complex, deeply human, and influenced by far more than a single hormone.
If you’re feeling “not like yourself” in midlife — whether physically or emotionally — hormones can be one piece of the puzzle, but they’re never the whole picture. Understanding the role of testosterone, women’s hormones, perimenopause, men’s health, and overall hormone balance can help you make sense of why libido changes and what factors might be involved.
If you’re in Florida and want support understanding your hormones in a clear, compassionate way, you can explore my approach to hormone health and wellness here.