Most people have heard of testosterone. But fewer people understand that testosterone is only one part of a larger hormone system—or that androgens are essential to the health of both women and men.

Androgens are often casually described as “male hormones.” That label is incomplete. Women produce and use androgens as well, and these hormones influence far more than libido or reproductive health.

They help support energy, cognitive function, mood, motivation, muscle maintenance, bone health, body composition, sexual well-being, and physical resilience. As androgen activity changes with age, the effects can be felt across many systems of the body.

For people experiencing persistent fatigue, brain fog, reduced strength, slower recovery, changes in body composition, or a general loss of vitality, androgen health may be an important part of the conversation.

What Are Androgens?

Androgens are a group of steroid hormones that includes testosterone, DHEA, DHEA-S, DHT, and related hormone metabolites.

Each has a different role:

• Testosterone is a key androgen involved in muscle, bone, mood, sexual health, energy, and many other functions.

• DHEA and its storage form, DHEA-S, are produced largely by the adrenal glands and can serve as precursors for downstream androgens and estrogens.

• DHT, or dihydrotestosterone, is a more potent androgen formed when testosterone is converted by the enzyme 5α-reductase.

• Androgen metabolites can provide additional clues about how hormones are being converted and processed throughout the body.

Androgens also matter for estrogen production. In many tissues, androgens can be converted into estrogens through a process called aromatization. This is one reason a broader hormone assessment can be more useful than viewing testosterone—or any single hormone—in isolation. DHEA is a recognized precursor for both androgens and estrogens.

Why Androgens Matter For Women

Women naturally have lower androgen levels than men, but lower does not mean unimportant.

Androgens contribute to women’s energy, sexual function, mood, cognitive health, muscle mass, and bone maintenance. During the menopausal transition and afterward, shifts in ovarian and adrenal hormone production can change the hormonal environment significantly.

For some women, this transition may coincide with concerns such as:

• Lower energy or motivation

• Brain fog or reduced mental sharpness

• Changes in libido or sexual comfort

• Loss of lean muscle mass

• Changes in body composition

• Reduced exercise tolerance or slower recovery

• Declining bone density over time

These symptoms do not automatically mean that androgen levels are the cause. Sleep, thyroid function, nutrition, medications, inflammation, metabolic health, menopause, and many other factors can contribute. However, androgen patterns should not be overlooked simply because the patient is female.

Why Androgens Matter For Men

In men, testosterone and other androgen-related hormones generally decline more gradually with age. The rate and clinical significance of that change vary widely from person to person.

A lower androgen state may be associated with changes in body composition, strength, bone health, energy, sexual function, mood, and cognitive performance. Research supports the importance of androgen signaling for maintaining muscle and bone, although symptoms and laboratory results must always be interpreted in the context of the individual.

The key point is not that every change in energy or performance is caused by low testosterone. Rather, it is that hormones are one meaningful piece of a much larger health picture.

Hormones do not remain static. Testosterone, DHEA, DHEA-S, estrogen, cortisol, and other endocrine signals shift across the lifespan.

One notable feature of aging is the substantial decline in adrenal androgens, including DHEA and DHEA-S. Cortisol, in contrast, often remains relatively stable in circulating levels with age, although its daily rhythm and stress regulation can become less adaptive for some individuals.

This creates an important clinical context: the body may have less anabolic hormonal support from DHEA and androgen activity while continuing to experience the metabolic demands of stress.

That does not mean cortisol is “bad.” Cortisol is essential for survival. It helps regulate blood pressure, blood sugar, immune signaling, alertness, and the body’s response to stress. The problem is not cortisol itself; it is prolonged, poorly timed, or dysregulated cortisol signaling in a body already experiencing lower androgen and DHEA activity.

The Stress-Recovery Balance

A useful way to think about this relationship is through the balance between anabolic and catabolic activity.

Anabolic activity refers to the processes that support building, maintenance, and repair. This includes preserving lean tissue, supporting bone, recovering after exercise, and rebuilding after physical or emotional stress.

Catabolic activity refers to processes that mobilize energy and break down stored resources. Cortisol plays an essential role in this response, especially during short-term stress.

DHEA is an adrenal prohormone and precursor to downstream sex hormones. Alongside androgen activity, it is often discussed in the context of anabolic support, tissue maintenance, and resilience. Cortisol helps the body meet immediate demands; however, when stress signaling stays elevated or poorly regulated over time, the balance may shift toward more catabolic activity.

In practical terms, that imbalance may be relevant when someone is experiencing poor recovery, loss of muscle, declining bone health, low energy, or a diminished capacity to adapt to ongoing stress.

Cortisol, DHEA, and Cardiovascular Context

The relationship between cortisol and DHEA-S can offer another lens through which to view stress physiology and aging.

A higher cortisol:DHEA-S ratio can occur as DHEA-S declines with age while cortisol remains relatively stable. Studies have associated low DHEA-S and certain cortisol/DHEA-S patterns with cardiovascular and metabolic risk markers, as well as poorer outcomes in people who already have cardiovascular disease. These are associations—not proof that one hormone pattern causes cardiovascular disease—and the ratio is not a diagnostic test for heart disease.

Still, cortisol and DHEA-S patterns can add useful context when they are evaluated alongside blood pressure, glucose regulation, lipids, inflammation, body composition, family history, lifestyle, symptoms, and other clinically relevant information.

A thoughtful assessment should use these markers to inform the broader picture, not to make conclusions based on one result.

Why a Testosterone Test Isn’t Enough

A single testosterone result can be useful, but it does not show the entire hormone landscape.

Hormone function depends on more than how much of one hormone is present in the blood at a given moment. It also involves:

• Hormone production

• Conversion into downstream hormones

• Metabolism and clearance

• Daily cortisol patterns

• The balance between cortisol and DHEA-S

• Tissue sensitivity and receptor activity

• Sleep, nutrition, stress, exercise, medications, and underlying health conditions

The enzyme 5α-reductase, for example, converts testosterone into DHT. Looking at androgen metabolites can help provide context about how that conversion is occurring. The goal is not to label one pathway as inherently “good” or “bad,” but to understand the pattern in relation to the individual’s symptoms, goals, and health history.

Comprehensive Hormone Testing

At Therapeutic Health, comprehensive hormone testing may help assess patterns involving:

• Testosterone and other androgen-related hormones

• DHEA and DHEA-S

• Hormone metabolites

• Cortisol levels and daily cortisol patterns

• The relationship between cortisol and DHEA

• Androgen metabolism, including the 5α-reductase pathway

• Other relevant biomarkers that may help place results in context

Testing is not about chasing a single “ideal” number. It is about using meaningful data to ask better questions.

Could changing hormone patterns be contributing to fatigue or brain fog? Is there evidence of altered androgen metabolism? Is stress physiology affecting recovery? Are there nutrition, sleep, exercise, medical, or lifestyle factors that need to be addressed first?

Those answers are never found in one lab value alone.

Turning Results Into a Plan

A comprehensive assessment should lead to a thoughtful, individualized plan—not a one-size-fits-all protocol.

Depending on a patient’s symptoms, goals, medical history, and test findings, a care plan may include:

• Targeted nutrition strategies

• Sleep and circadian-rhythm support

• Exercise programming focused on strength, recovery, or body composition

• Stress-management and lifestyle interventions

• Evaluation of cardiometabolic, thyroid, inflammatory, or nutrient-related contributors

• Appropriate medical treatment or hormone-based therapies when clinically indicated

The goal is to identify the factors that may be affecting how you feel and function, then create an evidence-informed plan that supports energy, strength, recovery, resilience, and long-term health.

When to Consider an Evaluation

Consider discussing a comprehensive evaluation with a qualified clinician if you have ongoing concerns such as fatigue, brain fog, reduced strength, loss of muscle, poor exercise recovery, lower motivation, changes in body composition, sexual-health concerns, or a noticeable decline in vitality.

These symptoms are common, but they are not always something to simply accept as part of aging.

Schedule a consultation with Therapeutic Health to explore comprehensive hormone testing and a personalized plan for your health, performance, and longevity.