ArticleJournal of endocrinological investigation2026
Redefining testosterone reference ranges for adult females.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo define an age-continuous reference range for testosterone (T) in females.
methodsA large-scale retrospective analysis of anonymised serum T collected via capillary sampling from a private healthcare service. 5,323 female individuals (19-59 years) with no history of reproductive conditions, normal BMI and regular cycles were analysed to establish a robust, age-continuous reference range for T, including probability density distributions and specific quantiles. Competing models of log T values as a function of age were statistically assessed, and the best model selected. Additionally, a cohort with self-reported hirsutism was compared.
resultsA weakly skew-Normal distribution describes the best-fit distribution of log T values at any specific age, such that the mean decreases and the variance increases linearly with age. Analysis of the hirsutism cohort showed significantly higher T levels compared to the reference cohort.
conclusionEstablishing a reliable reference range for female T enables clinicians to differentiate between physiological and pathological states (e.g. hyperandrogenism). Here, we establish a robust, age-continuous reference range for T in a large female population under strict inclusion criteria. The findings underscore the importance of age-specific reference ranges and highlight a substantial decrease in T over adult life. This study provides a valuable tool for clinicians and researchers seeking to compare patient hormone levels to a reliable reference distribution of T levels in women.
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