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Purpose <p>To define an age-continuous reference range for testosterone (T) in females.</p> Methods <p>A large-scale retrospective analysis of anonymised serum T collected via capillary sampling from a private healthcare service. 5,323 female individuals (19–59&#xa0;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.</p> Results <p>A 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.</p> Conclusion <p>Establishing 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.</p>

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Redefining testosterone reference ranges for adult females

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月24日

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  • Esther Wainwright,
  • Natalie Getreu,
  • Lauren Crawford,
  • Adrian Timpson,
  • Sofia Vaz,
  • George Adams,
  • Lucinda Lawrie,
  • Timothy Woolley,
  • Lorna Brightmore,
  • Ali Abbara,
  • Helen C. O’Neill

摘要

Purpose

To define an age-continuous reference range for testosterone (T) in females.

Methods

A 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.

Results

A 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.

Conclusion

Establishing 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.