Testosterone therapy for women: what the evidence shows

Testosterone is often thought of as a male hormone, but women produce — and depend on — testosterone throughout their lives. Levels peak in the mid-20s and decline gradually thereafter, with a steeper drop after natural or surgical menopause. For some women that decline meaningfully affects libido, energy, mood, and a sense of vitality. Carefully prescribed low-dose testosterone can restore it.

What the evidence supports

The strongest evidence — including the 2019 Global Consensus Position Statement on the Use of Testosterone Therapy for Women — supports testosterone for one specific indication: hypoactive sexual desire disorder in postmenopausal women. Multiple randomized controlled trials have shown meaningful improvements in sexual desire, arousal, orgasm, and overall sexual satisfaction. Many clinicians, including ours, also see substantial benefit for energy, mood, and cognitive sharpness in selected patients, though the evidence base for those uses is more limited.

Who is a candidate

• Postmenopausal women with low libido that bothers them
• Women already on stable estrogen therapy who still feel "flat"
• Women who have had their ovaries surgically removed
• Carefully selected perimenopausal women, on a case-by-case basis

How it is dosed

Female-physiologic dosing is critical. The goal is to restore testosterone to the upper end of the normal premenopausal range — not above it. We typically prescribe a compounded transdermal cream applied daily, with a follow-up level drawn at 6 to 8 weeks to confirm dosing. Side effects in correctly dosed women are uncommon. At supraphysiologic doses, testosterone can cause acne, hair changes, and voice deepening — which is why dosing accuracy and monitoring matter.

What it is not

Testosterone is not a weight loss drug, not a "biohacking" supplement, and not appropriate for every woman. A clinician trained in this area should evaluate whether testosterone is a fit for your specific picture before prescribing.

Medically reviewed by Dr. Ana Lisa Carr, MD, MBA
Board-Certified Family Medicine Physician · Lead Provider / Medical Reviewer
NPI 1689841744 · Last reviewed: May 10, 2026