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Testosterone Therapy Is Trending—for Women. Here’s What to Know

Enter testosterone replacement therapy. More than 30 different testosterone products are approved for men by the U.S. Food and Drug Administration (FDA), but the agency has never approved testosterone for women. However, doctors can still prescribe it off-label to women they feel would benefit. Historically, testosterone was used in combination with estrogen and progesterone, hormones that decline with age. But these days, it’s also prescribed as a standalone treatment, says Dr. Traci A. Kurtzer, a gynecologist at the Northwestern Medicine Center for Sexual Medicine and Menopause, opening the door to people who can’t or don’t want to take other hormones for various reasons.

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Featured

 Attention women: Low sex drive? Testosterone won’t help

For women seeking treatment for low sex drive, the idea of a “quick fix” probably sounds appealing. Testosterone therapy and boosting supplements are among those widely marketed options that might seem too good to be true – because for most women, they are. Low testosterone (low-T) products for women such as pills, injections, or supplements like dehydroepiandrosterone (DHEA) claim to boost energy, mood, and sexual desire. However, low-T as the root cause for low sex drive is rare in women, especially before menopause.

 Why Use Testosterone for Women’s Hormone Replacement Therapy?

As women enter menopause or perimenopause, hormone replacement therapy (HRT) becomes a consideration to address symptoms and mitigate long-term health risks. While estrogen and progesterone are the most well-known options, testosterone is increasingly being used for women’s HRT. But why is this the case, and what are the benefits compared to traditional estrogen-based therapies?

 Women are turning to testosterone to feel younger. Here’s what the science really says.

Testosterone is being hailed as the secret to better energy, mood, and sex drive. Here’s what experts say about when it actually does help—and when it doesn’t.

Articles of Interest

Testosterone therapy in women: Myths and misconceptions

Abandoning myths, misconceptions and unfounded concerns about T and T therapy in women will enable physicians to provide evidenced based recommendations and appropriate therapy.

Testosterone use in women

With increasing interest in the use of testosterone for women, fuelled by anecdotal reports on social media, patients may present requesting prescriptions for testosterone for a range of reasons. It is timely to reconsider the evidence base for efficacy of testosterone, and the guidelines for safe use.

A Personal Prospective on Testosterone Therapy in Women—What We Know in 2022

The safety of testosterone use in women has been evaluated for the past 80 years. A recent publication on the complications of subcutaneous hormone-pellet therapy, looking at a large cohort of patients over 7 years, demonstrated long-term safety. In addition, there have been two large long-term peer-reviewed studies showing a significant reduction in the incidence of invasive breast cancer in women on testosterone therapy. Perhaps it is time for the FDA to consider approving products that would benefit testosterone-deficient women.

Don’t believe the hype. Menopausal women don’t all need to check – or increase – their testosterone levels

Ever heard “low testosterone” blamed for low mood, brain fog and loss of vitality? Despite all evidence to the contrary, social media influencers are increasingly promoting testosterone therapy as an elixir for women experiencing troubling symptoms of menopause.

Effects of testosterone therapy for women: a systematic review and meta-analysis protocol

Testosterone therapy for women is in widespread use, primarily in the form of compounded preparations and off-label use of formulations for men. The benefits and risks of such therapy remain uncertain. This review will identify and evaluate studies that have examined the effects of testosterone therapy for women on a range of outcomes including sexual function, cardiovascular events, metabolic parameters, musculoskeletal health, wellbeing, cancer events, androgenic effects and withdrawal rates.

First testosterone patch for menopausal women to begin clinical trials this year

UK study will look at patch’s effect on boosting libido associated with hormone level drop, which could transform lives globally

Global Consensus Position Statement on the Use of Testosterone Therapy for Women

The only evidence-based indication for testosterone for women is for HSDD. There are insufficient data for using testosterone for any other symptom/condition or for disease prevention. There are no clearly established indications for testosterone therapy for women. Nonetheless, clinicians have treated women with testosterone for decades, with the intention of alleviating a variety of symptoms, with uncertain benefits and risks.

Midlife Women Are Clamoring for Testosterone. Does It Work?

Demand for the hormone is surging, and not just to treat libido. Here’s what we know about its benefits, and potential risks.

Prescribing of testosterone for middle-aged women ’out of control’

Experts warn of long-term health implications amid concerns over advice from social media ‘evangelists’

Prescribing testosterone and DHEA: The role of androgens in women

When treatment is offered, transdermal preparations are preferred, and testosterone levels should be checked before and during treatment to ensure physiologic dosing. Decisions to continue treatment are based on clinical response; hormone levels do not correlate with symptom burden, and testing is intended only to ensure safe delivery of treatment.

Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care

Numerous studies have shown that adding testosterone to hormonal therapy can improve sexual function and general wellbeing among women during their menopause. A recent systematic review and meta-analysis of testosterone treatment in women has provided robust support for a trial of testosterone in women when clinically indicated. In postmenopausal women, testosterone supplementation improved several domains of sexual response, including sexual desire, pleasure, arousal, orgasm, and self-image.

Testosterone Replacement Therapy (TRT): Benefits and Risks for Women

Estrogen and progesterone are the primary sex hormones in women, whereas testosterone is the primary sex hormone in men. However, the female body also produces testosterone, which plays a vital role in women’s health and well-being. Supplementing testosterone can be an important part of hormone replacement therapy (HRT) for some women. However, there is no FDA-approved testosterone replacement therapy (TRT) treatment for menopause symptom relief. In some cases, the hormone may be prescribed off-label with dose modifications or, more commonly, in combination with estrogen for postmenopausal women experiencing decreased libido.

The clinical management of testosterone replacement therapy in postmenopausal women with hypoactive sexual desire disorder: a review

As women age, there is an overall decrease in androgen production due to decline of ovarian and adrenal function during menopause. Androgens have been demonstrated to play an important role in sexual motivation in women. As a result, many postmenopausal women experience Female Sexual Dysfunction (FSD) which are a group of disorders that pertain to sexual arousal, desire, orgasm, and pain. A prevalent manifestation of FSD is Hypoactive Sexual Desire Disorder (HSDD) or the absence of sexual fantasies, thoughts, and/or desire for or receptivity to sexual activity. There is gaining interest in the use of Testosterone Replacement Therapy (TRT) for the treatment of HSDD in postmenopausal women.

The Safety of Testosterone Therapy in Women

The evidence we have reviewed here suggests that transdermal testosterone, at a dose of 150 μg or 300 μg per day, appears to be the safest method of administration. More long-term studies investigating the safety of testosterone therapy in women are needed.

Women Are Turning to Testosterone Therapy in Search of ‘Miracle-Drug’

On the advice of influencers, middle aged women are turning to testosterone therapy to combat symptoms of menopause.

‘Frightening’ how easily women can get hold of testosterone, say doctors

Experts are worried that women are not being properly advised about the hormone and that it is too readily obtainable – as I found out for myself.

Resources

6 Myths About Testosterone Therapy in Women

One of the most widespread myths is that testosterone is solely a male hormone. While men do produce more testosterone than women, it is crucial for both men’s and women’s health. Women produce testosterone in their ovaries and adrenal glands, and it plays a key role in various physiological processes, including libido, energy levels, mood regulation, and muscle mass maintenance.