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Similar to other hormones, the onset of perimenopause and menopause cause the decline in production of testosterone (by at least 50%) in women. Again, hysterectomy with or without removal of the ovaries will cause a more significant decline in testosterone levels . Also, high levels of stress can divert the precursors for testosterone hormone production in women over to cortisol production and create a further reduction. High stress levels can also contribute to symptoms earlier in the perimenopause when a woman is in her late thirties or early forties. This means less energy, brittle hair, less bone and muscle strength, and a diminished sexual drive. A hysterectomy and some prescription drugs can also result in lower levels of testosterone for women .