SubQ Testosterone for Women: Boosting Spine Health Naturally

SubQ Testosterone for Women: Hormone and Spine Health

Abstract

Testosterone is often labeled a “male hormone,” but it is also a normal and biologically active hormone in women. Women generally have much lower testosterone levels than men, yet androgens help regulate sexual function and participate in muscle, bone, reproductive, metabolic, and nervous-system physiology. Tissues can also convert testosterone into estradiol. This article explains how female androgens are produced, why blood testing can be difficult to interpret, what is known about subcutaneous testosterone injections, and why testosterone treatment requires individualized medical oversight. It also explains how integrative chiropractic care, rehabilitation, functional medicine, and medical management can work together to help patients improve mobility, reduce pain, sleep more comfortably, and maintain overall function without confusing chiropractic care with hormone replacement.

Testosterone Is a Normal Female Hormone

Androgens include testosterone, dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEAS). Although these hormones are often associated with men, every healthy woman produces and uses androgens. Testosterone is actually present at higher concentrations than estradiol during much of a woman’s adult life (Davis & Wahlin-Jacobsen, 2015).

Women’s testosterone concentrations are much lower than men’s. Research commonly describes female levels as roughly one-tenth to one-fifteenth of typical adult male levels, fitting the broader concept that women generally have about 10 to 20 times less circulating testosterone than men (Hunter, 2025). Lower does not mean unimportant. Androgen receptors are found in many tissues, and testosterone plays a role in normal female physiology.

Cleveland Clinic notes that androgens contribute to muscle development, bone density, red blood cell production, sexual desire, and reproductive health in people of both sexes (Cleveland Clinic, 2024). Newer research also continues to examine testosterone’s relationships with female muscle, bone, cardiovascular, reproductive, and brain physiology (Faucett et al., 2026).

Where Do Androgens Come From in Women?

Female androgen physiology is more complex than simply measuring testosterone in a blood sample. The ovaries and adrenal glands both produce testosterone and androgen precursors. Peripheral tissues can also produce additional testosterone from compounds such as DHEA and androstenedione (Davis & Wahlin-Jacobsen, 2015; Thomas, 2022).

The process becomes even more interesting at the tissue level. DHEA and other precursor hormones can enter tissues where enzymes convert them into testosterone, DHT, or estradiol. The whitepaper’s intracrine model on page 3 illustrates this pathway: the adrenal glands and ovaries supply precursors, peripheral tissues process them, and the final hormones can act locally before being inactivated.

This means a woman’s blood testosterone concentration is not the only factor to consider. Hormone activity also depends on local enzyme activity, androgen receptors, precursor availability, and sex hormone-binding globulin, or SHBG.

Testosterone Changes With Age

Female androgen levels generally decline gradually with age rather than suddenly falling at menopause. DHEA and DHEAS begin declining years before the final menstrual period. Natural menopause, therefore, should not automatically be interpreted as testosterone deficiency.

A different situation may occur after surgical removal of both ovaries. Because the ovarian source of androgen production disappears abruptly, testosterone and androstenedione can decrease more sharply than during normal aging (Davis & Wahlin-Jacobsen, 2015).

Research on aging also shows that sex hormones interact with muscle and bone physiology, but hormone replacement should not automatically be assumed to prevent age-related muscle loss or improve longevity. Those broader outcomes still require stronger clinical evidence, especially in women (Horstman et al., 2012).

Why Female Testosterone Testing Can Be Complicated

Measuring testosterone in women is challenging because concentrations are near the lower detection limits of many routine laboratory tests. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is generally more reliable at these low concentrations.

SHBG must also be considered. SHBG binds much of the circulating testosterone. A woman can therefore have a seemingly acceptable total testosterone level while the amount available to tissues differs because of SHBG.

For example, oral estrogen can increase SHBG and reduce the free fraction of testosterone, while obesity and insulin resistance may lower SHBG. This is one reason that a single testosterone result should not be used alone to diagnose a female androgen-deficiency syndrome. The uploaded whitepaper emphasizes looking at laboratory trends and the patient’s clinical picture rather than treating one number as a diagnosis.

What Does Testosterone Actually Do in Women?

The best-established therapeutic evidence involves sexual health. Randomized studies show that appropriately selected postmenopausal women with hypoactive sexual desire disorder, or HSDD, can experience improvements in sexual desire and related sexual-function measures with physiologic testosterone treatment (Davis et al., 2019).

The body’s biology suggests wider roles because androgen receptors are found in skeletal muscle, bone, the brain, adipose tissue, and other organs. However, biological plausibility does not equal proven treatment benefit. Studies have not established testosterone therapy as a general treatment for improving memory, mood, body composition, bone health, fatigue, or overall wellness in women.

Current international guidance therefore remains narrow: the strongest evidence-based indication is HSDD in appropriately evaluated postmenopausal women after other contributing factors have been considered (Davis et al., 2019; Parish et al., 2021).

What Are Subcutaneous Testosterone Injections?

A subcutaneous, or SubQ, testosterone injection places testosterone in fatty tissue beneath the skin rather than deeply into a muscle. The medication is then gradually absorbed into the circulation.

SubQ administration can seem attractive because it does not require deep intramuscular delivery and may allow clinicians to use relatively small amounts of medication. However, clinicians must distinguish between physiologic reasoning and proven clinical outcomes in women.

The strongest randomized evidence for testosterone therapy in women involves transdermal treatment, such as gels, creams, or patches. Dedicated randomized efficacy trials establishing SubQ testosterone injections as a preferred treatment for women are lacking. The uploaded whitepaper specifically notes that evidence supporting the injectable subcutaneous route has largely been extrapolated from male testosterone treatment, while randomized female evidence remains primarily transdermal.

There is also currently no FDA-approved testosterone medication specifically indicated for women in the United States. FDA-approved testosterone products are approved for specific forms of male hypogonadism, so testosterone treatment in women is off-label (FDA, 2026).

When testosterone is considered for a woman, a careful medical plan may include:

• A full symptom and medical-history assessment rather than treating a laboratory number alone.
• Evaluation for other causes of symptoms, including thyroid disease, anemia, sleep problems, medication effects, depression, pain, relationship factors, and menopausal symptoms.
• Baseline total testosterone and SHBG when appropriate.
• Selection of therapy designed to remain within the physiologic female range.
• Follow-up laboratory testing and clinical monitoring.
• Monitoring for androgen excess, including acne, unwanted facial or body hair, scalp-hair changes, or other signs of excessive exposure.
• Ongoing discussion of benefits, limitations, side effects, and the still-limited long-term cardiovascular and breast-safety data in women.

Guidelines also caution against testosterone preparations that produce supraphysiologic concentrations. Long-term safety information remains incomplete (Davis et al., 2019; Parish et al., 2021).

Integrative Chiropractic Care: Treating the Person, Not Just the Hormone

Testosterone therapy and chiropractic treatment have different jobs. Chiropractic care should not be presented as a way to raise testosterone levels or replace medical hormone management.

Instead, integrative chiropractic care can address musculoskeletal problems that occur alongside hormonal concerns. For a patient experiencing back pain, joint stiffness, poor mobility, muscle weakness, or difficulty exercising, conservative musculoskeletal care may help the patient move more comfortably and participate more consistently in rehabilitation.

From the patient’s perspective, goals may include less pain, improved mobility, greater physical confidence, easier exercise, improved strength and function, and better sleep when musculoskeletal discomfort interferes with rest.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, describes his clinical approach as integrating musculoskeletal evaluation, chiropractic care, rehabilitation, functional medicine, nutrition, and medical collaboration rather than treating each problem in isolation. His published clinical discussions emphasize restoring movement and function while appropriately referring or coordinating medical concerns.

This approach also supports a basic principle of safe healthcare: avoid unnecessary harm. When appropriate, non-invasive and drug-free options for mechanical pain can reduce the need to immediately escalate treatment to additional medications or invasive procedures. That can limit unnecessary exposure to medication side effects, dependency risks associated with certain drugs, or surgical complications. Conservative treatment, however, should never delay medication, injections, surgery, or specialist treatment when those options are medically necessary.

Medical and Chiropractic Collaboration in El Paso

At Injury Medical Clinic PA in El Paso, Texas, the treatment model combines chiropractic care with functional medicine, personal injury care, rehabilitation, medical evaluation, and related services. The goal is coordinated care rather than having one discipline attempt to manage every part of a patient’s condition.

Dr. Jimenez works with Dr. Maria Guadalupe Cardenas, MD, an internal medicine physician in El Paso with Texas medical license J2933 and NPI #1164426749. Clinic materials identify her as board-certified in internal medicine and as Medical Director and Collaborative Physician. Dr. Cardenas provides internal-medicine oversight for medical assessment, laboratory interpretation, medication safety, contraindications, and complex health concerns. Dr. Jimenez contributes chiropractic, family nurse practitioner, functional medicine, biomechanical, and rehabilitation perspectives.

For a woman considering testosterone therapy, this type of coordinated model allows medical professionals to manage hormone-related decisions while chiropractic and rehabilitation services focus on movement, pain, strength, physical function, and recovery. It also allows the patient’s existing physicians and specialists to remain part of the treatment plan.

Bringing Female Androgen Physiology Into Perspective

Testosterone should be understood as both a female and a male hormone. Women require much smaller amounts, but androgen physiology remains important throughout life.

At the same time, recognizing testosterone’s biological importance does not mean that every symptom in a woman with a lower laboratory value should be treated with testosterone. No single blood level establishes a female testosterone-deficiency syndrome, and current evidence does not support testosterone as a universal treatment for fatigue, weight gain, muscle loss, cognitive complaints, or menopause itself.

Subcutaneous testosterone injections are an emerging off-label option used by some clinicians, but female-specific evidence for this route remains limited compared with transdermal therapy. Safe treatment requires appropriate patient selection, realistic expectations, physiologic-range exposure, laboratory monitoring, informed consent, and collaboration among qualified healthcare professionals.

Integrative care can then address something broader than a hormone result: helping the patient move better, hurt less, sleep more comfortably, regain physical function, and participate actively in her overall health plan.

“Understanding the link between female hormones and spinal longevity is a vital step toward reclaiming your pain-free mobility. Jot down any questions this guide raised about your symptoms or lab monitoring so we can address them at your next visit and ensure your path to healing is perfectly targeted, safe, and balanced.”

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References

Cleveland Clinic. (2024). Androgens: Function, levels & related disorders.

Davis, S. R., Baber, R., Panay, N., et al. (2019). Global consensus position statement on the use of testosterone therapy for women. Journal of Clinical Endocrinology & Metabolism, 104(10), 4660-4666.

Davis, S. R., & Wahlin-Jacobsen, S. (2015). Testosterone in women—the clinical significance. The Lancet Diabetes & Endocrinology, 3(12), 980-992.

Faucett, K., Giles, L. A., & Sing, E. (2026). Testosterone: Vital to female physiology. Women’s Health.

Hatzilabrou, T. A. (n.d.). Testosterone and androgen physiology in women. Worldborne Medical/Medivant Healthcare.

Horstman, A. M., Dillon, E. L., & Urban, R. J. (2012). The role of androgens and estrogens on healthy aging and longevity. Journal of Gerontology: Series A, 67(11), 1140-1152.

Hunter, S. K. (2025). Testosterone and androgen receptors in females: What is possible with resistance training?. The Journal of Physiology, 603(18), 5227-5228.

Jimenez, A. (2026). SubQ testosterone therapy for women and health insights. DrAlexJimenez.com.

Parish, S. J., Simon, J. A., Davis, S. R., et al. (2021). International Society for the Study of Women’s Sexual Health clinical practice guideline for the use of systemic testosterone for hypoactive sexual desire disorder in women. The Journal of Sexual Medicine, 18(5), 849-867.

Thomas, L. (2022). The role of testosterone in women’s health. News-Medical.