Normal Testosterone Levels for a 44-Year-Old Woman
Normal total testosterone for a 44-year-old woman ranges from approximately 15-46 ng/dL (520-1595 pmol/L), with free testosterone ranging from 1.2-6.4 pg/mL (4.16-22.2 pmol/L). 1
Reference Ranges for Women in Their 40s
The most reliable reference ranges come from studies of healthy, normally cycling premenopausal women without signs of hyperandrogenism:
- Total testosterone: The 5th to 95th percentile range for a typical woman around age 30-40 is 15-46 ng/dL (520-1595 pmol/L) 1
- Free testosterone: 1.2-6.4 pg/mL (4.16-22.2 pmol/L) using direct measurement 1
- Calculated free testosterone: 1.3-5.6 pg/mL (4.5-19.4 pmol/L) 1
- Bioavailable testosterone: 1.12-7.62 ng/dL (38.8-264.21 pmol/L) 1
Age-Related Considerations
Testosterone levels decline with age in women, similar to men, so age-specific reference ranges are important 1:
- Women in their 40s typically have lower testosterone levels than women in their 20s and 30s 1
- Sex hormone-binding globulin (SHBG) remains relatively stable across reproductive years, with a reference range of 18-86 nmol/L 1
Alternative Reference Ranges from Other Studies
A second high-quality study of young healthy women (18-40 years) without hyperandrogenism found slightly different ranges 2:
- Total testosterone: 0.54-2.72 nmol/L (approximately 15.6-78.4 ng/dL when converted) 2
- Calculated free testosterone: 3-39 pmol/L 2
- Bioavailable testosterone: 0.06-0.81 nmol/L 2
Critical Pitfalls in Testosterone Testing for Women
Commercial laboratory reference ranges are often inappropriately wide and fail to detect hyperandrogenemia in women. 3 Many commercial labs report upper limits as high as 95 ng/dL, which would miss the vast majority of women with elevated testosterone 3:
- In one study, the upper limit of normal (mean + 2 SD) in healthy women was only 28 ng/dL, providing 84% sensitivity for detecting hyperandrogenemia 3
- Women with mild hirsutism had mean testosterone of 38.4 ng/dL, and those with moderate-to-severe hirsutism had 49.0 ng/dL—both within "normal" ranges provided by most commercial laboratories 3
Menstrual Cycle Variations
Testosterone levels show minimal variation across the menstrual cycle, so timing of blood draw is not critical 1:
- A small mid-cycle increase occurs, but it is relatively minor compared to overall variability 1
- Reference ranges can be applied regardless of menstrual cycle phase 1
Practical Application
For a 44-year-old woman, testosterone levels should be interpreted as follows:
- Below 15 ng/dL: Potentially low, consider clinical context and symptoms
- 15-46 ng/dL: Normal range for age 1
- Above 46 ng/dL: Elevated, warrants evaluation for hyperandrogenism if accompanied by clinical signs (hirsutism, acne, menstrual irregularity) 3, 1
Morning blood samples are preferred for consistency, though the diurnal variation in women is less pronounced than in men 1.