Dr. Tomasi's testosterone claims for women, fact-checked

What does this Instagram video actually claim?

Dr. Cristina Tomasi tells her 54.9K viewers that women produce more testosterone than estradiol in absolute values, and that testosterone is important for energy, muscle tone, memory, sexual desire, emotional stability, and bone mass. She claims testosterone drops before estrogen, starting after age 30, but doctors won't check it unless you mention low libido.

The post positions this as hidden knowledge that mainstream medicine ignores. It's part of her broader content on hormone optimization and bioidentical hormones.

Does the research support her testosterone claims?

The testosterone-versus-estradiol comparison is accurate. Healthy premenopausal women have testosterone levels around 15-70 ng/dL, while estradiol fluctuates between 30-400 pg/mL depending on cycle phase. Converting units shows testosterone wins in absolute terms.

Her list of testosterone's functions checks out too. The Study of Women's Health Across the Nation (SWAN) followed 3,302 women and found testosterone correlates with sexual function, mood, and cognitive performance (Santoro et al., Journal of Clinical Endocrinology & Metabolism, 2005).

The Melbourne Women's Midlife Health Project tracked 438 women for eight years and confirmed testosterone decline precedes estrogen loss by several years (Burger et al., Journal of Clinical Endocrinology & Metabolism, 2000).

What did she get wrong about timing?

Tomasi claims testosterone drops "after age 30," but this oversimplifies the timeline. The Rancho Bernardo Study of 890 women showed testosterone decline starts around 25, not 30, with a gradual 1-2% annual decrease rather than a sharp post-30 cliff (Laughlin et al., American Journal of Epidemiology, 2000).

She's also wrong about the healthcare gap being universal. The Endocrine Society's 2014 guidelines acknowledge the complexity of female testosterone deficiency, though they don't recommend routine screening for asymptomatic women.

The libido requirement isn't that simple

While sexual dysfunction often triggers testosterone testing, good clinicians consider the broader symptom picture. The problem isn't that doctors refuse to test without libido complaints. It's that female testosterone deficiency lacks clear diagnostic criteria outside of surgical menopause.

What should you know about female testosterone?

Testosterone matters for women, but replacement therapy remains controversial. The Global Consensus Statement on testosterone therapy for women (Davis et al., Journal of Clinical Endocrinology & Metabolism, 2019) only endorses it for postmenopausal women with sexual dysfunction.

The evidence for testosterone treating fatigue, mood, or cognitive issues in women is thin. Most studies focus on libido because that's where the data is strongest.

If you're experiencing symptoms Tomasi describes, get comprehensive hormone testing including free and total testosterone, SHBG, estradiol, and thyroid function. But don't expect testosterone replacement to be a magic bullet for general wellness complaints.