Testosterone prescriptions for women are up 146% — and so are pharmacy denials and delays

By Kevin Wolfe, Founder & CEO

Reviewed by Kindr Health Clinical Team

Published September 15, 2026 · Updated September 15, 2026

On September 15, 2026, Reuters reported that women turning to testosterone therapy for menopause symptoms are increasingly running into prescription denials, dose-splitting workarounds, and pharmacy delays. A data analysis by the healthcare analytics firm Truveta found the rate of women receiving a testosterone prescription rose 146% — nearly tripling — between January 2023 and July 2026. No testosterone product is FDA-approved for women in the U.S. At a public workshop on September 17, 2026, FDA highlighted gaps in long-term safety and efficacy evidence.

The story is not really about a drug shortage. It is about a treatment that has outgrown its regulatory paperwork, and about women being sent home from the pharmacy counter with no plan. Here is the honest version.

Why there is no approved testosterone product for women in the United States

Every testosterone gel, cream, patch, pellet, and injection sold in the U.S. is approved for men. There is no FDA-approved female testosterone product. That single fact drives almost everything women experience downstream: prescriptions written off-label, doses that must be measured out of a male-sized container, pharmacy software that flags the sex and dose as an error, insurers that deny coverage because the indication is not on the label, and compounding pharmacies filling the gap with products that vary in quality and oversight.

What the evidence actually supports

The Menopause Society and several other medical organizations endorse testosterone in menopausal women for one indication: hypoactive sexual desire disorder — persistent, distressing low sexual desire that is not explained by relationship factors, depression, medication effects, or untreated genitourinary symptoms. That is where randomized evidence exists, and the effect in trials is real but modest.

Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society, told Reuters that there is no evidence in women that testosterone improves muscle mass, bone density, mood, or well-being, and that what testosterone is promoted for on social media is not what the data support. That gap between marketing and evidence is worth taking seriously, because it is the same gap that produces the denials.

Where the delays actually come from

• Off-label indication: no approved female product means no on-label diagnosis code for an insurer to match, so coverage is often denied outright.
• Dose mismatch: female dosing is a fraction of male dosing, so patients are asked to split or micro-measure a male product — which pharmacy systems and some pharmacists reasonably question.
• Controlled-substance rules: testosterone is a Schedule III controlled substance, which adds identity checks, quantity limits, refill restrictions, and state-level variation.
• Compounded products: when a commercial product will not work, prescribers turn to compounding, which introduces its own waiting times, sourcing issues, and quality variability.
• Prescriber unfamiliarity: many clinicians have never dosed or monitored testosterone in a woman, and understandably decline rather than improvise.

How Kindr approaches testosterone requests

We will not promise you a testosterone prescription, and no telehealth service honestly can — it is a controlled substance, prescribed off-label, and appropriate for a specific clinical picture rather than for everyone who asks. What we can do is remove the part of the process that wastes the most time: guessing.

• You get a clear answer about candidacy rather than an open-ended wait, including when the answer is that testosterone is not the right tool for what you are describing.
• We start with what has stronger evidence for your actual symptom. Low desire is frequently driven by untreated genitourinary syndrome of menopause, sleep loss, vasomotor symptoms, thyroid disease, medication effects, or relationship and mood factors — and treating those often works better than adding a hormone.
• If testosterone is clinically appropriate, the plan includes the intended indication, dosing route, baseline and follow-up labs, and what to do if a pharmacy will not fill it — written down before you are standing at the counter.
• We tell you plainly when a product is compounded, when coverage is unlikely, and when the honest recommendation is to wait for clearer guidance.

Care is delivered by licensed clinicians in the states where we operate, and prescribing decisions always depend on your individual history. Availability of any specific medication or formulation depends on your pharmacy and your state.

What to bring to the visit

• Your specific symptom, in your words — low desire, fatigue, loss of strength, brain fog — because they lead to different treatments.
• How long it has been present and whether it is distressing to you, which is part of the actual diagnostic criteria for HSDD.
• Your full medication list, including antidepressants, hormonal contraception, and any current hormone therapy.
• Your menopause status and the date of your final period, if you have had it.
• Any prior testosterone use, including compounded creams, pellets, and anything obtained without a prescription.
• Recent labs if you have them, and any history of clot, breast cancer, liver disease, or cardiovascular events.

What to be cautious about

• Pellets. Implanted testosterone pellets often produce supraphysiologic levels that cannot be reversed once inserted, and they are not recommended by major menopause guidelines.
• Testosterone marketed for muscle, weight loss, energy, or anti-aging in women. That is precisely the use the evidence does not support.
• Any provider who guarantees approval before taking a history, or who dispenses without baseline and follow-up testing.
• Unmonitored dose escalation. Acne, unwanted hair growth, scalp hair loss, and voice change are the signals that a dose has gone too high, and some are not fully reversible.

The bottom line

A 146% rise in prescribing with no approved product for women is a regulatory failure, not a patient failure. Women are not wrong to ask about testosterone, and clinicians are not wrong to be careful with it. The fix is a clear, evidence-based conversation early — one that names the specific symptom, treats the causes with better evidence first, and reserves testosterone for the indication it was actually studied for. The FDA’s September 2026 review may eventually change the labeling picture. Until it does, the difference between months of frustration and a workable plan is usually the quality of the first appointment.

This article is education, not a substitute for individual medical advice. Testosterone is a controlled substance and its use in women is off-label in the United States. Talk with a licensed clinician about your own history before starting or stopping any treatment.

Medically reviewed by Kindr Health Clinical Team
Last updated: September 15, 2026