HRT · Libido · Energy
Testosterone for women: the missing hormone in menopause care
A young woman produces roughly three times more testosterone than estradiol on a molar basis. By age 40 her testosterone is already halved. In menopause, testosterone loss compounds the sexual, cognitive, and body-composition changes attributed to estrogen loss — but it is almost never treated in conventional care.
What the evidence supports (strong)
- Hypoactive sexual desire disorder in postmenopausal women — 20+ RCTs consistently show benefit
- Muscle mass preservation during resistance training
What the evidence suggests (moderate)
- Mood and cognitive clarity
- Bone density (mechanistically strong, RCTs limited)
- Energy and motivation
Delivery methods
Compounded transdermal cream is the most-used option in the US. Subcutaneous injections (5–10 mg testosterone cypionate weekly) give more predictable levels. Pellets are common but produce supraphysiologic peaks and are harder to titrate.
Monitoring
Baseline total and free testosterone, SHBG, DHEA-S, hematocrit, lipids. Recheck at 6 weeks and 3 months, then every 6 months. Target: mid-to-high female physiologic range.
Frequently asked questions
Is testosterone therapy FDA-approved for women?
No. All testosterone prescribing for women in the US is off-label. The ISSWSH and Endocrine Society have published guidelines supporting off-label use for hypoactive sexual desire disorder in postmenopausal women.
What does testosterone do for women?
Improves libido, orgasm intensity, energy, mood, muscle mass, bone density, and cognitive clarity. The libido effect has the strongest RCT evidence.
How is testosterone dosed for women?
Typical doses: 1–2 mg/day transdermal cream (compounded) or 5–10 mg weekly subcutaneous injection. Male doses are 10–20x higher and cause virilization in women.
What are the side effects?
Acne, oily skin, and mild hair changes at appropriate doses. Overdosing causes clitoral enlargement, voice deepening, and unwanted facial hair — reversible in early stages, not fully reversible if prolonged.
Does testosterone cause hair loss in women?
It can — in genetically susceptible women. Monitor DHT levels and consider adjunctive treatment (topical minoxidil) if scalp thinning appears.
Considering a physician-supervised longevity protocol? Kindr Health evaluates peptide therapy as part of personalized perimenopause and menopause care.
Request your Longevity Consult →Related: FDA peptide review July 2026 briefing · Peptide therapy hub · Longevity service
Medically reviewed by Kindr Health Clinical Team · Last reviewed 2026-06-19. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.