Testosterone Therapy for Women: What the Evidence Shows

Testosterone therapy for women has one evidence-based use: treating distressing low sexual desire, called hypoactive sexual desire disorder (HSDD), in postmenopausal women, according to a 2019 global consensus statement. No testosterone product is FDA-approved for women in the United States, so it is prescribed off-label, at low doses, with regular monitoring.

Do women make testosterone?

Yes. Women naturally make testosterone, in much smaller amounts than men, and levels decline gradually through the reproductive years. That decline alone isn't a diagnosis, and it doesn't mean a woman needs treatment.

The Global Consensus Position Statement on the Use of Testosterone Therapy for Women, endorsed by the Endocrine Society, the North American Menopause Society and other international groups, notes that testosterone concentrations decline during the reproductive years. The Endocrine Society recommends against diagnosing 'androgen deficiency' in healthy women, because no well-defined syndrome links low levels to specific symptoms.

What is hypoactive sexual desire disorder (HSDD)?

HSDD is a persistent lack of sexual desire that causes a woman distress. It's diagnosed through a full assessment of physical, psychological and relationship factors, not with a blood test.

The consensus statement says a blood testosterone level should not be used to diagnose HSDD, and that low desire has many possible causes, including physical illness, relationship difficulties and psychological distress. The Endocrine Society adds that a woman's own testosterone level did not predict whether she responded to treatment. That's why the conversation with your provider matters as much as the labs.

What can testosterone do for women, and what can't it do?

For postmenopausal women with HSDD, testosterone at doses that keep levels in the normal premenopausal range modestly improves sexual function. The evidence does not support it for energy, mood, weight, muscle, bone, heart health or memory.

In the trials reviewed by the consensus panel, testosterone added, on average, about one satisfying sexual event a month compared with placebo, along with improvements in desire, arousal and pleasure. There wasn't enough evidence to recommend it for women before menopause, and it showed no significant effect on lean mass, body fat or muscle strength. The Endocrine Society recommends against using testosterone for general well-being.

Is there an FDA-approved testosterone product for women?

No. In the United States, no testosterone product is approved for women, so providers who prescribe it use a product approved for men, off-label, at a much lower dose.

The consensus statement considers off-label use of an approved male product reasonable when blood levels are kept in the normal female range, and it doesn't recommend any form or dose that pushes levels above that range. The FDA held a public meeting in September 2026 on testosterone use in menopausal women, noting growing off-label use and critical knowledge gaps.

What are the risks and side effects?

At doses that keep levels in the female range, the most common side effects are mild acne and extra body or facial hair. Long-term safety data are limited, and testosterone must not be used during pregnancy.

The consensus panel found female-range doses were not linked to scalp hair loss, clitoral enlargement or voice changes, but safety data don't extend beyond 24 months. It doesn't recommend oral testosterone, because of its effects on cholesterol, and it urges caution in women with hormone-sensitive breast cancer. The testosterone prescribing information lists a deeper voice, male-pattern hair loss and clitoral enlargement among effects reported in women, which is why dose and monitoring matter.

How is testosterone therapy monitored in women?

A baseline testosterone level is checked before starting and again a few weeks later, then about every six months to make sure levels stay in the female range. If there's no benefit by six months, treatment should stop.

That schedule comes from the consensus statement: a baseline total testosterone, a repeat level 3 to 6 weeks after starting, and checks every 6 months for signs of too much testosterone. Tell your provider about new acne, hair growth or any other change between visits.

How does Padgett approach testosterone for women?

At Padgett Medical Center in Tampa, hormone therapy for women is lab-guided and medically supervised, and lab testing comes first. Testosterone is something you discuss with your provider as part of that conversation; it isn't right for every woman.

Come ready to talk about what has changed: your desire, your sleep, your mood, your relationship and any menopause symptoms. Bring a list of your medications, including any estrogen or progesterone you already take, and mention any history of breast cancer or blood clots. That fuller picture helps your provider decide whether testosterone belongs in your plan at all, or whether something else is the better place to start.

Morgan Colee, PA, reviews your labs, symptoms and health history with you, and your plan and its cost depend on those results. Visits are in person at 6904 W. Linebaugh Ave, Tampa, FL 33625, or by telehealth anywhere in Florida with a valid Florida driver's license or ID shown on camera. Learn about bio-identical hormone replacement for women and menopause hormone therapy, or book your visit.

This article is educational and is not medical advice. Talk with a licensed provider about your own health, medications and treatment options.