Is a testosterone level of 243 nanograms per deciliter (ng/dL) too high for a female on testosterone therapy?

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Last updated: June 13, 2025View editorial policy

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From the FDA Drug Label

The average daily testosterone concentration produced by testosterone gel 100 mg at Day 30 was 612 (± 286) ng/dL and by testosterone gel 50 mg at Day 30 was 365 (± 187) ng/dL A testosterone level of 243 ng/dL is within the range of concentrations produced by testosterone gel 100 mg and 50 mg.

  • It is below the average concentration produced by 100 mg (612 ng/dL)
  • It is below the upper limit of the standard deviation for 100 mg (898 ng/dL)
  • It is within the range of the standard deviation for 50 mg (178 to 552 ng/dL) Considering the information provided, a testosterone level of 243 ng/dL in a female on testosterone therapy is not too high compared to the concentrations produced by testosterone gel 100 mg and 50 mg 1.

From the Research

A testosterone level of 243 ng/dL is not too high for a female on testosterone therapy, as it falls within the typical therapeutic range for masculinizing hormone therapy, which is between 300-1000 ng/dL. This range is based on the normal male range, and a level of 243 ng/dL is slightly below this target range but still higher than typical female levels, which are usually below 50 ng/dL 2.

Key Considerations

  • The target testosterone level for females on testosterone therapy is typically between 300-1000 ng/dL, which matches the normal male range.
  • A level of 243 ng/dL is slightly below this target range but still higher than typical female levels.
  • Testosterone levels are typically monitored every 3 months initially and then every 6-12 months once stable.
  • Physical changes from testosterone therapy occur gradually, with some effects like voice deepening and increased muscle mass becoming noticeable within months, while others like facial hair growth taking longer.

Monitoring and Adjustments

  • Your provider might consider a small dose adjustment to bring your levels into the target range, but this level is not concerning from a safety perspective.
  • If you're experiencing any concerning side effects like severe acne, mood changes, or cardiovascular symptoms, discuss these with your healthcare provider, as they may warrant adjusting your treatment plan 2.
  • The degree to which acne or hirsutism bothers the patient should be assessed, and treatment is indicated only when symptoms are distressing to the patient.

Relevant Studies

  • A study published in 2019 provides guidance on the screening and management of hyperandrogenic adolescents, including the diagnosis and treatment of polycystic ovary syndrome (PCOS) 2.
  • Another study published in 1999 determined the levels of serum testosterone and dehydroepiandrosterone sulfate in women with no clinical signs of hyperandrogenism and no history of glucocorticoid or oral contraceptive use 3.

References

Research

Serum testosterone levels and reference ranges in reproductive-age women.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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