By Jordan Stachel, MS, RDN, CPT

Benefits of Testosterone for Women: What You Need to Know

When people think of testosterone, they often associate it with men. But testosterone is also an essential hormone for women. Though women produce it in smaller amounts, testosterone plays a significant role in women’s sex drive, bone health, muscle mass, and mood. [Cleveland Clinic]

The internet and social media feeds are filled with news of hormone therapy for midlife women. In order to make informed decisions about their health, women are wondering, what are the benefits of testosterone for women?

In this article, we’ll break down what the science says about testosterone’s role in the female body, who might benefit from testosterone therapy, and what to consider before starting treatment.

What Is Testosterone?

Testosterone is an androgen. Androgens are a type of hormone produced by both men and women. In women, the ovaries and tiny bean-shaped glands above the kidneys, called the adrenal glands, make testosterone. While it may incorrectly be labeled a “male hormone,” women actually produce three times as much testosterone as estrogen during and after menopause.

Menopause is the point in time when a woman goes a full year (365 days) without having a period. The time before menopause is called perimenopause. Perimenopause is a time with unpredictable and extreme shifts in the hormones produced by the ovaries – estrogen, progesterone, and to a lesser degree, testosterone.

It is normal testosterone levels fall gradually in most women, beginning at age 30. [Cleveland Clinic] Testosterone can drop steeply to very low levels in women who go through menopause early (before age 40) or in women who have their ovaries surgically removed. [Cleveland Clinic]. This quick change can cause more severe symptoms.

Why Do Women Need Testosterone?

From the experience of women who have had their ovaries removed and those going through early menopause, we have learned more about testosterone’s role in women’s health and how replacing testosterone has benefits. Researchers now recognize that changes in testosterone levels can influence women’s:

• Libido, sexual arousal, and ability to orgasm. [2,3]

• Bone strength and prevention of bone thinning, called osteoporosis. [5,6]

• Muscle strength and tone. [Cleveland Clinic]

• Mood and cognitive health. [Zito, Davis, should]

• Energy and stamina. [Cleveland Clinic, Davis, should]

Key Benefits of Testosterone for Women

Improved Sexual Function and Libido

Perhaps the most well-documented benefit of testosterone therapy for women is its treatment of a condition called hypoactive sexual desire disorder (HSDD). Healthcare providers diagnose HSDD in women who report a lack of sexual desire that is severe enough to cause them distress. About 1 in every women aged 45 to 64 in the U.S. has HSDD. [NAMS, practice pearl] HSDD has been shown to be related to pain with sex, difficulty becoming aroused, problems orgasming, depression, and anxiety. [NAMS, practice pearl]

Multiple clinical trials and meta-analyses show that testosterone therapy can improve sexual desire, arousal, and satisfaction in postmenopausal women, particularly those not responding to estrogen therapy. [Islam, Davis, Panay]. One major review found that testosterone treatment resulted in significant improvements in sexual function compared to people not taking any testosterone. The same study did not show any negative side effects of the testosterone treatment when used at recommended doses. [Islam]

Energy and Mood Support

Anecdotal evidence suggests that some women feel an energy boost, improved motivation, and better focus with testosterone replacement therapy. [Cleveland Clinic] More research is needed to prove that testosterone plays a role in women’s moods, energy levels, and their ability to focus, called cognition. Some small studies suggest that testosterone may improve well-being and reduce fatigue, particularly in women with lower testosterone levels below normal before testosterone treatment. [Panay]

Increased Muscle Mass and Strength

Sometimes called a “muscle hormone,” testosterone helps support how big and strong your muscles are and helps keep a healthy balance between how much body fat and muscle you have. As both men and women age and testosterone levels fall, they lose muscle mass. This is called sarcopenia. This happens naturally, even if you exercise and lift weights. Testosterone therapy has been shown to preserve or slightly increase muscle strength and lean body mass, though results vary depending on the dosage, sex, and population studied. [Davis, clinical significance]

Bone Strength and Osteoporosis Prevention

While not approved to prevent or treat osteoporosis or osteopenia (the stage of bone thinning before osteoporosis), researchers are studying a link between testosterone levels and bone density or thickness. The thicker (or more dense) your bones are, the less likely you are to break them if you fall.

Estrogen and testosterone both help protect bone mineral density (BMD). This protection is especially important during and after menopause, when bone loss accelerates. Studies indicate that testosterone may enhance bone health, either on its own or in combination with estrogen therapy. [Watts]

Who Might Benefit from Testosterone Therapy?

Testosterone therapy is not for everyone, but certain women may see benefits, including:

• Peri- and postmenopausal women with hypoactive sexual desire disorder (HSDD). [Panay]

• Perimenopausal women with fatigue, decreased muscle tone, and mood changes not improved by estrogen and progesterone therapy or antidepressants. [Davis, should]

• Women who have had their ovaries removed in a surgery, or those women who have chemotherapy and/or radiation that decreases the ability of their ovaries to release the right amount of testosterone. [Cleveland Clinic]

• Women who experience premature menopause (younger than age 40) or early menopause (before age 45). [Parish]

• Midlife women with bothersome symptoms who don’t get relief with treatment with estrogen or combination estrogen and progesterone therapy.

Importantly, testosterone therapy for women is off-label in the U.S., meaning the U.S. Food and Drug Administration has not approved any medicines with testosterone specifically for women. However, many medical organizations support using testosterone in specific cases, such as women with diagnosed HSDD.

What Does Testosterone Therapy Involve?

Beginning testosterone therapy should involve:

• Talking with a licensed healthcare provider about your symptoms, your medical history, and the medications you currently take.

• Some baseline blood tests to make sure giving you additional testosterone would not harm your health or increase your testosterone levels above normal ranges. [Cleveland Clinic]. Unnaturally high levels of testosterone are called supra-physiological levels. Having supraphysiological levels puts you at risk for side effects, some of which can be permanent. [NAMS, Parish]

In the U.S. there are several forms of testosterone available, all off-label. These medicines can either be purchased at a pharmacy (gels and creams) or obtained through a compounding pharmacy. The forms of testosterone available are:

• Transdermal gels or creams (most common).

• Patches, injections, or implants (sometimes called pellets).

• Compounded formulations prescribed by healthcare professionals in gel, cream, patch, or pellet form.

According to the Menopause Society, when an approved formulation for women is not available (as it is not currently in the U.S.), it is reasonable to prescribe off-label an FDA-approved formulation for men at approximately one-tenth of the dose for men. [NAMS] The experts at the Menopause Society do not recommend using compounded products they have not been tested enough to know that they are effective and safe.

Testosterone absorbed through the skin (called transdermal) in a patch, gel, or cream provides the closest match for normal testosterone in your body. Experts suggest avoiding injections or pellets because they can cause supraphysiologic levels which are not easily reversed once you have the shot or pellet. [NAMS] Taking testosterone in pill form is not as safe for women because it can have negative effects on your cholesterol levels by: , Braunstein[NAMS]

1. Lowering high-density lipoprotein cholesterol

2. Raising low-density lipoprotein cholesterol

Current Medical Guidelines for Women and Testosterone Therapy

The Global Consensus Position Statement on Testosterone Therapy for Women, endorsed by more than 20 medical organizations, supports its use for postmenopausal women with HSDD as the sole evidence-based indication[7].

The statement emphasizes:

• Use the lowest effective dose

• Monitor regularly for efficacy and side effects

• Avoid therapy in women with active or past hormone-sensitive cancers

The North American Menopause Society (NAMS) also supports testosterone therapy as a treatment option for HSDD in midlife women, usually after first treating with estrogen and progesterone. [10]

Monitoring and Safety

Once you start testosterone therapy, you should have your testosterone levels checked regularly, at least in the first 6 to 8 weeks. [NAMS]

Because testosterone can impact your liver and cholesterol levels, you should also have these checked with a blood test. Blood levels should be kept within the normal premenopausal female range to minimize the risk of side effects.

Potential Side Effects of Testosterone Therapy

Although generally safe when prescribed appropriately, testosterone therapy can have side effects, especially if levels become too high:

• Acne or oily skin

• Unwanted hair growth (hirsutism)

• Voice deepening

• Increased aggression or mood changes

• Clitoral enlargement (rare)

There’s no evidence that testosterone therapy causes cancer or serious cardiovascular events when used in low doses under clinical supervision[9].

Common Myths and Misconceptions

“Testosterone therapy will make me masculine.”

At medically appropriate doses, testosterone does not cause masculinization. Side effects like hair growth or voice changes are rare when hormone levels are properly monitored.

“Only men need testosterone.”

Women produce and need testosterone too. It contributes to sexual health, mood, and musculoskeletal strength—all of which impact overall well-being.

“There’s no scientific support for testosterone use in women.”

On the contrary, decades of research support its use for sexual dysfunction in menopausal women[2,3,7].

FAQs: Common Questions About Testosterone for Women

What are the benefits of testosterone therapy for women?
It may help improve libido, energy, muscle mass, and bone density—particularly in menopausal women experiencing HSDD[2,7].

Is testosterone safe for women?
Yes, when used under medical supervision and kept within physiological female ranges, testosterone therapy is considered safe[9].

Are there any FDA-approved testosterone therapies for women?
No, but clinicians often prescribe testosterone off-label using custom-compounded formulations or lower-dose male products[8].

Can testosterone therapy help with vaginal dryness or sexual pain?
Indirectly. Testosterone may help restore libido and arousal, which can support better vaginal health. Estrogen therapy may be combined for vaginal symptoms[7].

How can I check my testosterone levels?
Everlywell offers at-home hormone tests that include testosterone, or you can ask your provider for a blood test.

How Everlywell Can Help

If you’re curious about your hormone levels or wondering whether testosterone might be playing a role in your symptoms, Everlywell offers an at-home Testosterone Test. This simple, physician-reviewed test lets you check your testosterone level from the comfort of your home. Having this information can set you up to have an empowering conversation with your healthcare provider. Looking for a healthcare provider experienced in prescribing hormone therapy? Everlywell has licensed healthcare providers available to consult with you one-on-one.