Determinants of serum total and free testosterone levels in women over the age of 65 years

Anne R. Cappola, Sarah J. Ratcliffe, Shalender Bhasin, Marc R. Blackman, Jane Cauley, John A Robbins, Joseph M. Zmuda, Tamara Harris, Linda P. Fried

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Context: Little is known about testosterone (T) levels and their determinants in women of late postmenopausal age. Objective: We describe levels of total and free T and selected factors that influence these levels in a random sample of older women. Design: Levels of serum total T and free T by microdialysis were measured using ultrasensitive assays in 347 community-dwelling women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to define factors associated with total and free T levels. Results: In adjusted models: 1) total T levels declined with age until 80, whereas free T levels did not vary by age; 2) women with bilateral oophorectomy had 23% lower total T and 16% lower free T levels than those with at least one intact ovary; 3) oral estrogen users had total and free T levels that were 47% lower than never users; 4) obese women had 47% higher total T and 20% higher free T levels, and overweight women had 24% higher total T and 14% higher free T levels, than normal weight women; and 5) free T levels were 51% higher in black women. Corticosteroid users had 75% lower total T and 43% lower free T levels than nonusers. Conclusions: Bilateral oophorectomy, estrogen use, corticosteroid use, and low body mass index are independent risk factors for lower T levels in women aged 65 yr and over. Although highly prevalent in women of this age, the physiological significance of low T levels in late postmenopausal women requires further investigation.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number2
StatePublished - Feb 2007

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism


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