Testosterone Therapy for Women: Benefits And Considerations

Introduction

Many women don’t realize that testosterone is just as important for them as it is for men. In fact, women have more testosterone than estrogen throughout their lives! It plays a crucial role in sexual function, energy levels, mood, and overall well-being. But as we age, testosterone levels naturally decline—and just like men, we can’t make more.

At my menopause clinic, I often meet women struggling with low libido, fatigue, and brain fog—symptoms that testosterone therapy could help. Yet, unlike men, women don’t have an FDA-approved testosterone option in the U.S. In this post, I’ll discuss why testosterone therapy is an option worth considering and the challenges many women face when trying to access it.

Frustrations with Access: Why is Testosterone for Women So Hard to Get?

Recently, I’ve had some frustrating encounters with pharmacists who refuse to fill testosterone prescriptions for women. Some have been outright rude, and one even hung up on me. It’s unacceptable and highlights a bigger issue: why is it so difficult for women to access a hormone that is beneficial to their health?

What’s even more frustrating? Australia is the only country that has a testosterone product specifically made for women. Why hasn’t the U.S. caught up? It raises the question—do only men matter? Testosterone isn’t just a “male hormone.” Women need it too, and the fact that we don’t have an approved option here is a major gap in healthcare.

Women should not be forced to opt for the more expensive compounded formulation simply because a pharmacist is out of his or her comfort zone. Especially when the same pharmacist has likely filled prescriptions for narcotics, blood thinners, blood pressure medications, NSAIDs, benzodiazepines, diuretics, and other medications that carry significantly higher risks—many of which I see causing complications in the ER. I have never seen a testosterone complication lead a patient to the ER. It just doesn’t happen.

Many medications used in women are primarily studied in men, yet they are still prescribed with the assumption that the risks and benefits are similar. Why can’t the same logic apply to testosterone? When I used to prescribe testosterone for men back in my family medicine days, I never had a pharmacist question it—ever. Yet, a transitioning female-to-male patient can get testosterone more easily than a woman who needs it for menopausal symptoms. This is yet another example of an anti-woman health disparity.

Why Would a Woman Take Testosterone?

Testosterone is commonly associated with men, but it plays a major role in women’s health as well. Research shows it can help with:

• Sexual health – increasing libido, improving arousal, and enhancing overall satisfaction.

• Energy levels – reducing fatigue and boosting vitality.

• Mental clarity – improving focus and reducing brain fog.

• Mood stabilization – helping with motivation and emotional balance.

• Bone and muscle strength – supporting overall physical health and fitness.

  
  

Currently, testosterone is not FDA-approved for women, but research supports its benefits, particularly for postmenopausal women with hypoactive sexual desire disorder (HSDD). Studies show that using it at appropriate doses can be safe, with manageable side effects like mild acne or increased body hair in some cases. However, side effects are not ignored or tolerated, and I take proactive steps to minimize them.

Testosterone is frequently used off-label for women by many menopause and sexual medicine specialists all over the country. This means that even though there isn’t an FDA-approved option, countless doctors recognize its benefits and prescribe it based on strong evidence and clinical experience.

The Double Standard: Testosterone for Men vs. Women

Men often receive testosterone therapy—even for off-label reasons like age-related declines—despite limited long-term studies for those uses. So why is there hesitation when women seek the same treatment?

The FDA has approved more than 30 testosterone products for men but zero for women. Yet, testosterone levels naturally decline with age in both sexes. If men are routinely prescribed testosterone despite limited long-term safety data, why are women denied the same option?

Cost & Accessibility: Why Do Women Pay More?

Women seeking testosterone therapy often turn to compounded medications, which are expensive and rarely covered by insurance. However, a little-known alternative exists: using standard male testosterone products at lower doses.

Formulation Type	Typical Cost (Monthly)	Insurance Coverage	Notes
Compounded Testosterone	$30+	Rarely covered	Custom-made; varies by pharmacy
Standard Male Formulation	$10–$15 with GoodRx	May be covered for men, rarely for women	Lower doses last longer, making it affordable

Since male testosterone gels and injections are already FDA-approved, adjusting the dose for women can provide an effective and much cheaper alternative to costly compounded versions.

Is It Safe?

Understandably, women often worry about potential side effects. Research suggests that testosterone is safe when used at appropriate doses. The most common side effects are mild and reversible, such as acne or slight increases in body hair. The risk of more serious issues, such as voice deepening, is extremely low when proper dosing is followed. Many studies also show no significant negative impact on cardiovascular health or liver function when used correctly, particularly the transdermal formulations I prescribe.

I caution women to watch for side effects because they are not at all acceptable, and we want to avoid them at all costs. If any hint of side effects such as greasy skin begins to occur, I stop your medication for a while and would potentially resume later at a lower dose. My goal is to find the right balance where you receive the benefits of testosterone without unwanted side effects.

If a woman already has symptoms of elevated testosterone, such as facial hair or acne, I recommend against initiating testosterone supplementation. It is important to start with a careful evaluation to determine if it is the right option.

Out of an abundance of caution, testosterone is the only prescription in my clinic that requires baseline lab work. While many medications do not necessitate initial testing, I believe in ensuring a strong foundation for safe and effective therapy.

What Needs to Change?

Women deserve access to safe, effective testosterone therapy. The lack of an FDA-approved female-specific option in the U.S. is unacceptable. Meanwhile, off-label prescribing remains a safe, practical, and evidence-based option for those who need it.

At my clinic, I advocate for personalized treatment plans based on symptoms, with lab testing included out of an abundance of caution.  I want women to feel empowered to discuss testosterone therapy as a valid option for their health and well-being.

Final Thoughts

Testosterone therapy isn’t just for men. It’s a crucial hormone for women too, and its decline can significantly affect quality of life. Despite the challenges in accessing it, research supports its benefits, and affordable options exist.

If you’re experiencing symptoms that could be related to low testosterone and want to explore your options, I encourage you to take the next step. You deserve access to effective, evidence-based care, and I am here to guide you through that journey.