Women’s Testosterone Therapy: Benefits, Risks, and What to Know
Testosterone is thought to be the male hormone only. However, women make it, too, but in smaller amounts.
In women, testosterone is produced in the ovaries and adrenal glands, and it plays a role in sexual desire, sexual function, muscle and bone health, and other bodily functions still under study.
Testosterone levels in women gradually decline with age. They decrease by roughly 25% between ages 18 and 39 and by another 25% between ages 40 and 59.
And when this happens, testosterone therapy may help increase libido in women with low sexual desire. This guide explores the benefits of testosterone therapy in women and its risks, and answers questions frequently asked about testosterone therapy and women.
What Is Testosterone Therapy for Women?
Testosterone therapy for women is an off-label medical treatment used primarily to improve low sexual desire or hypoactive sexual desire disorder (HSDD) during or after menopause. Low sexual drive is the only sign of low testosterone in women when there is sufficient evidence to support the use of testosterone therapy.
While it is still far less than that of men, women produce three times as much testosterone as estrogen before menopause. Average testosterone levels for women are usually between 15 and 70 ng/dL (nanograms per deciliter), whereas men's average levels are between 300 and 1000 ng/dL.
However, testosterone levels can drop either gradually or suddenly as women age or have surgeries like oophorectomy (removal of the ovaries). When a woman’s testosterone levels decline, her desire for sex also declines.
Studies suggest that testosterone therapy can help improve sexual function and general well-being in postmenopausal women.
It’s important to note that testosterone treatment for women is not approved by the U.S. Food and Drug Administration (FDA). However, the off-label use is backed by studies.
Other countries like England and Australia have used testosterone for over 60 years to relieve symptoms of perimenopause and menopause. The United Kingdom, New Zealand, and South Africa have approved testosterone treatment for women.
What does testosterone do in a woman's body?
In the female body, testosterone helps to support:
Sexual desire/libido
Arousal and sexual response
energy levels,
Memory and mood
Bone and muscle health
What Are the Symptoms of Low Testosterone In Women?
The only way to determine if your testosterone levels are low is through a blood test. Nonetheless, there are a few common signs of low testosterone to be aware of, such as:
Low sex drive (hypogonadism).
Fatigue and a lack of energy.
Loss of muscle tone and strength.
Infertility or difficulty becoming pregnant.
Irregular menstrual cycle.
Vaginal dryness.
Anxiety or depression.
Thinning hair.
Dry skin.
Difficulty falling asleep.
Potential Benefits of Testosterone Therapy for Women
Testosterone therapy, when prescribed for an appropriate medical indication and used at carefully monitored doses, can offer potential benefits for women with hormonal imbalances. It aims to restore a healthy balance and support overall health.
1. Increased libido and sexual satisfaction
Testosterone is a proven treatment for Hypoactive Sexual Desire Disorder (HSDD) and has been shown to increase libido, arousal, and orgasm in women. It is most likely to be beneficial for women with extremely low libido and those who have decreased sexual desire after menopause but are already receiving hormone replacement therapy (progesterone and estrogen).
According to one research review, TRT improved the frequency of sexually satisfying events, arousal, and orgasm in surgically and naturally postmenopausal women.
2. Mood, mental health, and cognitive clarity
Testosterone also has other positive effects on mood and mental health. Women who take testosterone report feeling calmer, less depressed, more confident, and more in control. Additionally, testosterone might reduce fatigue, which many women experience after menopause.
3. Bone and muscle health
Studies show that testosterone helps maintain bone mineral density in women, and some research notes that combining testosterone with estrogen may improve bone density better than estrogen alone.
In addition to these benefits, several smaller studies suggest that testosterone may preserve cardiovascular health and provide further metabolic benefits. Some research also suggests a decreased risk of breast cancer in women with low-dose testosterone.
Who May Be a Candidate for Testosterone Therapy?
Testosterone therapy for women may not be suitable for everyone. Women who experience persistent low sexual desire or Hypoactive Sexual Desire Disorder (HSDD) that does not improve with estrogen therapy or other treatments may be candidates for testosterone therapy.
A testosterone blood test alone does not determine whether a woman needs testosterone therapy. There is no single testosterone level that can diagnose HSDD or predict who will benefit from treatment.
Instead, your provider will consider the whole clinical picture, including symptoms, medical history, medications, menopause status, and potential alternative causes.
They will then determine exact dosages and treatment methods based on the results.
Women who are pregnant or breastfeeding, or those with active liver disease, hormone-sensitive disorders, uncontrolled hyperlipidemia, or severe acne, should avoid testosterone replacement therapy. Those with hormone-sensitive cancers should have a conversation with the healthcare team about the risks and benefits.
How Is Testosterone Therapy Given to Women?
Testosterone therapy for women is given using injections, low-dose transdermal creams, gels, or skin patches that absorb directly into the bloodstream:
1. Testosterone injections for women
Of the existing methods, injections provide the most control. Dosage can be carefully adjusted; optimization occurs more quickly since absorption is predictable.
A common starting dose for women is a low-dose testosterone regimen of 5–10 mg given once a week, either subcutaneously or intramuscularly. The dose can be divided into two smaller injections if needed.
At NP2GO, we take into account your age, baseline hormone levels, symptoms, and your response to treatment when determining the precise dosage. We monitor clinical outcomes (energy, mood, libido, and any side effects) and serum testosterone levels every four to six weeks after starting therapy to inform dose adjustments.
At NP2GO, we follow a "start low, go slow" strategy, increasing the dosage in 2 mg increments only when needed and if the results remain within the physiological range for females. We recommend ongoing follow-up to ensure safe, effective treatment while reducing the risk of masculinizing side effects.
You can receive weekly in-clinic testosterone shots at our clinic or have pre-filled testosterone syringes delivered right to your door.
Cream or gel
Testosterone is also administered as a cream or gel that you apply to your skin like a moisturizer. It's then absorbed directly into your bloodstream.
Your healthcare provider will advise you on the right dosage of testosterone. It should be applied to clean, dry skin on your buttocks or upper outer thigh; it normally takes 30 seconds to dry.
After using it, you should thoroughly wash your hands to avoid transferring the hormone to your partner or children. The best results will come from applying the cream or gel at the same time every day, which will also help you remember to apply.
Avoid applying perfume, deodorant, or moisturizing lotions to the area, and wait about half an hour after application before swimming or showering.
Testosterone pellets
A testosterone pellet is a longer-term solution that is surgically implanted in the office. Our healthcare provider will insert small, compounded testosterone pellets under your skin, where they slowly release the hormone over several months. This method is convenient and doesn't require weekly injections or daily application.
As you begin your journey back to yourself, the best option will depend on your lifestyle, comfort level, and desired flexibility in dosage. Each approach (all accessible at NP2GO) has benefits and drawbacks.
What Are the Risks and Side Effects of Testosterone Therapy for Women?
There are typically no negative side effects with testosterone therapy, since it replaces the testosterone you're otherwise lacking.
When testosterone is used at a lower dosage, it often does not raise your chance of acquiring facial hair, voice deepening, or skin changes.
And when side effects occur, they are usually mild and improve as your body adjusts or your provider fine-tunes your dose.
Common side effects may include:
Acne
Increased facial/body hair
Oily skin
Changes in hair growth
After around three months of beginning treatment, you should undergo a blood test to measure your testosterone levels. After that, you should have a regular (usually annual) blood check to minimize the risk of side effects developing.
What happens if testosterone levels become too high?
When testosterone therapy is prescribed, the goal is not to raise testosterone levels as high as possible. Instead, treatment should aim for an appropriate dose based on the individual’s symptoms and clinical needs while avoiding excessive hormone exposure.
Testosterone levels that become too high may lead to side effects such as:
Acne and oily skin
Increased facial and body hair growth
Menstrual changes
Deepening of the voice
Body odor
Shrinking of breast tissue
Clitoral enlargement
Headaches
Changes in skin color or texture
Mood changes
When done properly, testosterone therapy should just restore levels to where they function best. Regular check-ups with your healthcare provider will ensure that the blood level does not exceed the normal range for a woman.
How Long Does Testosterone Take to Work in Women?
Testosterone therapy does not produce an immediate change in symptoms. When it is appropriate for a woman, its effects may develop gradually, and individual responses can vary.
Rather than expecting a dramatic change within days, treatment should be evaluated over time based on symptom improvement, side effects, and appropriate follow-up.
Increasing the dose simply to achieve faster results is not recommended, as higher testosterone exposure can increase the risk of unwanted effects.
While responses can vary from woman to woman, the general timeline looks like this:
Weeks 1–2: Early changes may be subtle
During the first few weeks of treatment, some women may notice little or no change in their symptoms. This does not necessarily mean that treatment will be ineffective. Common early changes include:
Mild improvements in mental clarity
Slight changes in motivation
Weeks 3–5: Improvements in energy and motivation
Many start to notice changes in weeks 3 to 5. Common changes include:
Improved energy
Reduced mental fatigue
Increased motivation
Weeks 6–8: Changes in sexual desire
Potential changes may include:
Increased interest in sexual activity
More frequent sexual thoughts
Improved sexual desire or responsiveness
Greater satisfaction with sexual activity
Months 3–4: Benefits stabilize
After 3 months, the benefits are stabilizing. You should be able to determine whether testosterone therapy is working. Stay the course if you're seeing steady progress. If nothing has changed, discuss with your provider whether to proceed. While some women are slow to respond, you should at least have noticed a pattern by now.
It’s important to note that it usually takes several months for your body to adjust to the medication fully. Once you achieve your ideal dosage, your body will experience a type of "new normal" with all the benefits of testosterone replacement therapy. As you get used to it, this will continue and become less noticeable.
FAQs About Women’s Testosterone Therapy
Do women naturally produce testosterone?
Yes. Women naturally produce testosterone, primarily from the ovaries and adrenal glands, although they produce much less than men do. Testosterone contributes to several aspects of women’s health, including sexual desire and function, muscle and bone health, and overall well-being. Testosterone levels generally change with age, but a lower level does not automatically require treatment.
How does a woman know if she needs testosterone therapy?
A woman should not determine the need for testosterone therapy based on a blood test alone. A healthcare provider can evaluate symptoms, medical history, medications, menopause status, and other potential causes. Testosterone therapy may be considered for appropriately evaluated postmenopausal women with persistent, distressing low sexual desire when other causes have been considered.
Can women get testosterone injections?
Yes, some women may receive testosterone through injections when a healthcare provider determines that testosterone therapy is appropriate. Injectable testosterone requires individualized dosing and medical monitoring to help maintain appropriate hormone levels and minimize side effects.
Can testosterone help women after menopause?
Testosterone may help some postmenopausal women, particularly those experiencing persistent, distressing low sexual desire after other potential causes have been evaluated. Research supports its use for appropriately diagnosed low sexual desire, but testosterone is not a general treatment for all menopause symptoms. Other symptoms, such as hot flashes or vaginal dryness, may require different treatment approaches.
Does testosterone increase sex drive in women?
Yes. Studies suggest that carefully dosed, low-level testosterone therapy may increase sexual desire in women, particularly postmenopausal women with persistent, distressing low sexual desire. However, low libido can have many contributing factors, including medications, stress, relationship concerns, vaginal symptoms, and other health conditions. Testosterone is therefore not appropriate for every woman experiencing a change in sexual desire.
What happens when a woman takes testosterone?
When appropriately prescribed, testosterone may improve sexual desire and certain aspects of sexual function in some women. However, excessive testosterone exposure can cause side effects such as acne, oily skin, increased facial or body hair, scalp hair thinning, and voice changes. Treatment should be individualized and monitored to help balance potential benefits with possible risks.
How long does testosterone take to work in women?
Most women experience the first noticeable changes between weeks 6 and 8, and the benefits usually peak between months 3 and 6. While some women pick up on some changes sooner, others don't see anything until the fourth month. Both are common. No matter how it is administered, testosterone doesn't take effect right away, so a quiet first few weeks doesn't necessarily imply it isn't working.
Does testosterone cause weight gain in women?
Usually not. When beginning therapy, some women temporarily have water retention, but this normally goes away in a few weeks. Proper testosterone levels may eventually promote lean muscle mass and enhance body composition when paired with a balanced diet and regular exercise.
What happens if a woman's testosterone is too high?
High testosterone levels can cause acne, oily skin, increased facial or body hair, hair thinning, menstrual changes, and masculinizing effects such as voice deepening. Some changes can be irreversible, which is why testosterone therapy should be prescribed at an appropriate dose and monitored by a healthcare professional.
Talk With a Provider About Women's Testosterone Therapy
While testosterone is generally thought of as a male hormone, women also need it. Low testosterone may cause several symptoms. If your levels are low, it may affect other hormones in your body, lowering your libido and leaving you feeling weak and exhausted.
If you are experiencing persistent changes in sexual desire or other hormone-related concerns, talking with a qualified healthcare provider can help you understand what may be causing your symptoms and whether testosterone therapy is appropriate for you.
At NP2GO, hormone therapy begins with an individualized evaluation designed to look at your symptoms, health history, treatment goals, and laboratory results—not just a single hormone level.
If testosterone therapy is appropriate for you, your provider will develop a personalized treatment plan based on your individual needs. Injectable testosterone is available for eligible women in Oklahoma, Texas, Florida, New York, Washington, and Kansas. Your provider will also explain what to expect from treatment and the importance of ongoing follow-up and monitoring.
NP2GO's Individual Initial Program is $149 and includes the first and second consultations and the initial set of laboratory testing. After the initial labs, you may use your insurance or choose cash-pay options for additional laboratory testing, depending on your individual needs and coverage.
NP2GO also offers a Couples Initial Program for $199, which allows couples to have their hormone appointments at the same time. The specific evaluation and laboratory testing recommended will depend on each patient's individual needs.
If you're considering women's testosterone therapy, schedule an evaluation with NP2GO to discuss your symptoms and treatment options with a provider.
