When we talk about hormones in women, estrogen and progesterone tend to get most of the attention. But women make testosterone too—and it plays an important role throughout a woman’s life.
Testosterone is produced primarily by the ovaries and adrenal glands, and levels generally decline with age. By midlife and after menopause, some women may experience symptoms that overlap with declining androgen levels, including changes in sexual desire, energy, strength, mood, and overall sense of well-being.
At Living Wellness Medical Center, we believe testosterone deserves a thoughtful place in the conversation about women’s hormone health. Testosterone isn’t appropriate for every woman, and it isn’t a cure-all. But for the right patient, carefully prescribed and monitored testosterone can be an important part of an individualized hormone replacement plan.
Testosterone Isn’t Just a “Male Hormone”
One of the biggest misconceptions about testosterone is that it belongs exclusively to men.
Women naturally produce testosterone throughout their lives. Although circulating levels are much lower than they are in men, testosterone interacts with receptors throughout the female body, including the brain, muscles, bones, reproductive tissues, and cardiovascular system.
As with estrogen and progesterone, the goal of hormone therapy isn’t simply to chase a laboratory number. We consider symptoms, medical history, other hormones, medications, health risks, and laboratory findings together.
Sex hormone-binding globulin (SHBG) can also be important. SHBG binds testosterone in the bloodstream, meaning that two women with similar total testosterone levels may have different amounts of testosterone available to their tissues.
What Does the Research Say About Testosterone for Women?
The strongest evidence for testosterone therapy in women is for the treatment of hypoactive sexual desire disorder (HSDD) in appropriately selected postmenopausal women.
Large reviews and international consensus guidelines have found that physiologic-dose testosterone can improve sexual desire and other measures of sexual function in women with HSDD. Research has demonstrated improvements in desire, arousal, orgasm, pleasure and sexual responsiveness, along with reductions in sexual distress.
But sexual health isn’t the only reason testosterone has attracted interest.
Women frequently tell us that changes around menopause extend far beyond hot flashes. Fatigue, decreased motivation, changes in muscle strength, difficulty concentrating, mood changes and a general feeling of “not being myself” can all become part of the picture.
A recent study discussed in the material that inspired this article followed 279 women who were already receiving conventional hormone replacement therapy and then added transdermal testosterone. After at least three months, statistically significant improvements were reported in 15 of 24 measured symptoms, including symptoms involving energy, mood, cognition, genitourinary health and musculoskeletal complaints.
This is encouraging, but there is an important distinction: an association in a study like this does not prove that testosterone should be prescribed to every woman for these symptoms. Current international consensus guidelines consider HSDD the indication with the strongest evidence. Research into testosterone’s effects on mood, cognition, musculoskeletal health, energy and overall well-being is evolving, and we need larger, longer-term controlled trials before making definitive claims about these benefits.
What Benefits Might Women Notice?
Depending on the individual and the reason testosterone is prescribed, potential benefits may include:
- Improved sexual desire, arousal and sexual satisfaction
- Improved ability to reach orgasm or increased sexual responsiveness
- Improved sense of sexual well-being
- Possible improvements in energy, motivation and general well-being
- Possible improvements in mood and cognitive symptoms
- Possible musculoskeletal benefits, including effects on muscle and physical function
The first three have substantially stronger clinical evidence than the latter benefits. We think it’s important for patients to understand that distinction rather than treating every proposed benefit of testosterone as equally established.
Why Isn’t There an FDA-Approved Testosterone for Women?
This is one of the most frustrating aspects of women’s hormone care.
As of 2026, there is still no FDA-approved testosterone formulation specifically for women in the United States.FDA-approved testosterone products in the U.S. are approved for men with certain forms of hypogonadism. Testosterone use in women is therefore considered off-label.
That does not mean testosterone itself is experimental. It means the FDA has not approved a testosterone product specifically formulated and labeled for women.
Other countries have taken a different approach. For example, Australia has an approved testosterone cream specifically formulated for postmenopausal women with HSDD.
Here in the United States, physicians who prescribe testosterone for women have historically had to work with either carefully adjusted doses of testosterone products manufactured for men or custom-compounded testosterone preparations.
At Living Wellness Medical Center, Dr. Turner has been prescribing compounded testosterone for appropriately selected women for approximately 20 years. Compounding allows us to prescribe doses and formulations designed for the much lower amounts typically used in women.
It’s important to be transparent, however, that compounded testosterone products are not FDA-approved, and major consensus guidelines generally prefer an approved standardized product when one is available because compounded preparations do not undergo the same FDA review for consistency, safety and efficacy. Unfortunately, the United States still does not have an FDA-approved female testosterone product.
Is Testosterone Safe for Women?
This is where appropriate dosing and monitoring matter.
At doses that maintain testosterone within the normal physiologic range for women, clinical trials have generally found testosterone to be well tolerated in the short term. However, we do not yet have the same quality of long-term safety data that we would like to have, particularly regarding cardiovascular outcomes and breast health.
Potential side effects can include:
- Acne or oily skin
- Increased facial or body hair
- Scalp hair thinning in susceptible women
- Changes in mood in some individuals
- Increased red blood cell production with excessive systemic exposure
- Voice deepening, which may be irreversible
- Clitoral enlargement, particularly with excessive dosing
- Testosterone levels rising above the normal female physiologic range
Many androgenic side effects are dose-related, which is one reason we believe testosterone therapy should be individualized rather than approached with a “more is better” philosophy.
Long-term cardiovascular and breast safety remain areas of active research. Current evidence has not established that physiologic-dose transdermal testosterone causes cardiovascular disease in women, but the available trials aren’t large or long enough to declare long-term cardiovascular or breast safety with certainty. That’s an important difference.
In fact, the FDA held a public workshop on testosterone use in menopausal women in September 2026, specifically recognizing both the growing use of testosterone in women and the need for additional research into sexual function, cognition, mood, musculoskeletal health, measurement and long-term cardiovascular and breast safety.
Not Every Woman Needs Testosterone
Hormones aren’t one-size-fits-all.
Low libido, fatigue, decreased strength, brain fog or changes in mood can have many causes. Thyroid dysfunction, iron deficiency, sleep problems, medications, chronic stress, insulin resistance, relationship factors, depression and other medical conditions may produce similar symptoms.
That’s why we don’t believe testosterone should be prescribed simply because someone has a particular laboratory value.
Instead, we look at the whole picture: your symptoms, medical history, menopausal status, other hormone therapies, medications, laboratory testing, testosterone levels, SHBG and individual risk factors.
The goal isn’t to create unusually high testosterone levels. The goal is to determine whether testosterone may be an appropriate part of restoring healthy physiologic hormone balance for that particular woman.
There Is More Than One Way to Use Testosterone
Testosterone can be delivered in several different ways, and the best route depends on the individual.
Depending on your situation and treatment goals, your Living Wellness physician may discuss options such as topical creams or gels, sublingual preparations, injections or testosterone pellets. Different routes have different advantages, disadvantages, dosing characteristics and monitoring considerations.
Published international guidelines have the strongest evidence for transdermal testosterone delivered at physiologic female doses, and some guidelines caution against preparations that can produce testosterone concentrations above the normal female range.
This is exactly why testosterone therapy should be individualized rather than chosen simply because one delivery method is popular or convenient.
The Bottom Line
Women need testosterone too.
For decades, testosterone has received far less attention in women’s hormone therapy than estrogen and progesterone. Today, research increasingly supports its importance—particularly for sexual desire and sexual function in appropriately selected women—and researchers continue to investigate its potential effects on other aspects of women’s health.
At the same time, good hormone medicine requires balance. Testosterone has potential benefits and potential risks. Appropriate patient selection, conservative dosing, and ongoing monitoring matter.
If you’ve noticed changes in libido, sexual function, energy, strength, mood, or overall well-being during perimenopause or menopause, testosterone may be worth including in your hormone conversation.
Talk with your Living Wellness physician about whether testosterone is appropriate for you and which route of administration may best fit your symptoms, goals and medical history.
This article is for educational purposes only and is not intended to diagnose or treat any medical condition. Hormone therapy should be prescribed and monitored by a qualified healthcare professional.
