Testosterone for Women: Evidence, Side Effects and Status
Testosterone can modestly improve low desire in some postmenopausal women, according to a 2019 global consensus, but there is no FDA-approved testosterone product for women in the US. Golden Glow does not currently offer testosterone.
Testosterone can help some women, but its proven use is narrow. The 2019 Global Consensus Position Statement, endorsed by major menopause and endocrine societies, found that testosterone can modestly improve low sexual desire that causes distress in postmenopausal women, using doses aimed at premenopausal levels. It does not support testosterone for energy, mood, bone or heart health. There is no FDA-approved testosterone product for women in the US, so prescriptions are off-label, and Golden Glow does not currently offer testosterone.
Key takeaways
- The best evidence is for low desire with distress in postmenopausal women.
- Evidence does not support testosterone for fatigue, mood, cognition or bone health in women.
- No US testosterone product is FDA-approved for women; men's products are sometimes used at small doses off-label.
- Side effects include acne and unwanted hair growth; high levels can cause voice deepening and clitoral enlargement.
- Golden Glow does not prescribe testosterone. Other desire options include PT-141 and treating menopause symptoms.
What the evidence shows
Women make testosterone in the ovaries and adrenal glands, and levels fall gradually with age. The Global Consensus Position Statement reviewed randomized trials and concluded that testosterone, given through the skin at doses that keep blood levels in the premenopausal range, can modestly increase satisfying sexual events, desire, arousal and pleasure in postmenopausal women with hypoactive sexual desire disorder.
The statement found insufficient evidence for using testosterone to treat other symptoms or conditions, and it recommends against routine use for those. NAMS reaches similar conclusions in its 2022 hormone therapy position statement.
Why it is not FDA-approved for women
Testosterone products for women have been studied, but none has been approved by FDA. In the US, some clinicians prescribe a small fraction of a men's product or a compounded cream. ACOG cautions that compounded hormone products are not FDA-approved and may vary in dose.
Side effects
| Effect | What to know |
|---|---|
| Acne and oily skin | Most common |
| Unwanted hair growth | Face or body, usually mild at appropriate doses |
| Scalp hair thinning | Possible |
| Voice deepening, clitoral enlargement | Signs of too much; may not fully reverse |
| Effects on cholesterol | Oral forms can worsen cholesterol; skin forms are preferred |
Long-term safety data, including breast and heart safety beyond a few years, are limited. Testosterone is not for use in pregnancy.
How long it takes
In trials, benefits for desire were typically assessed after about three to six months. The consensus statement suggests checking blood levels before and during treatment and stopping if there is no benefit by six months.
Why blood tests are used carefully
There is no testosterone level that defines low desire, and the consensus statement advises against using a blood test to diagnose it. Blood tests are used instead to check a starting level and to make sure treatment does not push levels above the normal premenopausal range. Labs ordered by your provider or primary care clinician can give a baseline for other hormones, such as estradiol, FSH and thyroid.
Other options for low desire
If low desire bothers you, a provider can review contributors such as sleep, stress, pain with sex and medications. For premenopausal women, bremelanotide (PT-141) and flibanserin are FDA-approved for low desire. For peri and postmenopausal women, treating hot flashes, poor sleep and vaginal dryness can help.
Frequently asked questions
Can women take testosterone for low libido? Is it FDA approved for women?
Testosterone has evidence for low desire with distress in postmenopausal women, but no testosterone product is FDA-approved for women in the US, so any prescription is off-label.
What are the side effects of testosterone cream for women?
Acne and unwanted hair growth are the most common. Too much can cause scalp hair thinning, voice deepening and clitoral enlargement, which may not fully reverse.
How long does testosterone take to work for libido?
In studies, benefit was usually judged after three to six months. If there is no benefit by about six months, guidance suggests stopping.
Do you offer testosterone for women?
No. Golden Glow does not currently offer testosterone. Our licensed providers can discuss other options, such as PT-141, menopause hormone therapy and vaginal estrogen.
Talk to a licensed provider
A licensed provider can help sort out what is behind low desire and which options fit. Explore PT-141 for women or menopause hormone therapy. This article is educational and does not determine eligibility for any treatment.
Sources
- Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019)
- The 2022 hormone therapy position statement of The North American Menopause Society
- ACOG Practice Bulletin No. 213, Female Sexual Dysfunction (2019)
- ACOG Clinical Consensus No. 6, Compounded Bioidentical Menopausal Hormone Therapy (2023)
- FDA, Drug Trials Snapshots: Vyleesi (bremelanotide)
This article is educational and is not medical advice. Golden Glow content is written to be accurate and is reviewed against the sources above. Rx programs require an online visit with a licensed provider. Results vary.