Physician-led menopause care in Jupiter, Florida

Progesterone Therapy for Women

Progesterone can be an important part of a thoughtful menopause plan—especially when estrogen is prescribed and the uterus is still present. The right choice depends on your symptoms, health history, and goals.

A clear starting point: progesterone is not a universal answer for sleep, mood, or every midlife symptom. NovaGenix uses a physician-led evaluation to decide whether it belongs in your care plan and how it should be used safely.
Dr. Timothy Mackey, D.O., Medical Director of NovaGenix in Jupiter, Florida
Quick answers

What women usually want to know first

Why is it prescribed?

For a woman with a uterus who uses systemic estrogen, an appropriate progestogen is generally used to help protect the uterine lining. It may also be considered in other carefully selected situations.

Is it the same as progestin?

No. Progesterone is chemically identical to the hormone the body makes. “Progestin” is a broader term that includes synthetic medicines with progesterone-like effects.

Will it fix every symptom?

No. Benefits depend on why it is prescribed. Claims about weight loss, anti-aging, or guaranteed better sleep are not responsible substitutes for an individual medical assessment.

How is it taken?

Prescription options may include oral or vaginal routes. Route, dose, and schedule should be chosen by a clinician; over-the-counter creams should not be assumed to protect the uterine lining.

Progesterone’s role in a menopause plan

When systemic estrogen is used by someone who still has a uterus, estrogen can stimulate the endometrium. Progesterone or another suitable progestogen may be added to reduce the risk of endometrial overgrowth. This is different from using progesterone as a stand-alone wellness product.

Evidence supports

  • Endometrial protection when paired appropriately with systemic estrogen
  • Individualized continuous or cyclic prescribing
  • Monitoring symptoms, bleeding patterns, tolerability, and treatment goals

What this will not do

  • Guarantee weight loss or reverse aging
  • Replace evaluation of thyroid, sleep, mood, or other medical concerns
  • Make unexplained vaginal bleeding safe to ignore

Micronized progesterone and other progestogens

Micronized progesterone is one prescription option. Other progestogens may be appropriate depending on a woman’s needs, response, contraception requirements, and medical history. “Bioidentical” does not automatically mean safer, and compounded products are not the first choice when an FDA-approved option meets the clinical need.

Side effects can include sleepiness, dizziness, breast tenderness, mood changes, or bleeding changes. Because oral progesterone may cause drowsiness, timing and safety precautions matter.

Who needs extra caution?

A clinician should review unexplained vaginal bleeding, a history of hormone-sensitive cancer, blood-clot or stroke history, significant liver disease, pregnancy possibility, medication interactions, and other individualized risks before treatment. New or heavy bleeding, chest pain, sudden shortness of breath, severe headache, weakness, or vision changes warrant prompt medical attention.

This page is educational and does not diagnose a condition or establish a physician-patient relationship.

What care at NovaGenix looks like

Listen first

We begin with your symptoms, menstrual and menopause history, uterus status, medications, priorities, and what has or has not helped.

Review the whole picture

Your physician reviews relevant health history, screening, and labs when clinically useful. Hormone numbers are interpreted in context, not treated in isolation.

Build and monitor a plan

If therapy is appropriate, the plan explains the purpose of each medication, options, risks, follow-up, and what changes should prompt a call.

Frequently asked questions

Do I need progesterone if I have had a hysterectomy?

Often it is not required for uterine protection after the uterus has been removed, but individual circumstances differ. Your physician can review the reason for surgery and your full history.

Is progesterone cream enough with estrogen?

Nonprescription transdermal creams should not be assumed to provide reliable endometrial protection. Discuss any product you use with your clinician.

Can progesterone help with sleep?

Some women report sleep-related effects, and oral micronized progesterone can be sedating. That does not make it an appropriate sleep treatment for everyone; other causes of poor sleep still deserve evaluation.

What if I notice bleeding?

Bleeding patterns depend on menopause stage and regimen. Unexpected, persistent, or heavy bleeding should be reported and may need evaluation.

A plan designed around you

Talk with a NovaGenix physician about whether progesterone, estrogen, another approach, or no hormone therapy is the responsible next step for you.

Schedule a consultation

Serving women in Jupiter and Palm Beach County. Treatment is offered only when clinically appropriate.

Schedule a Consultation

Learn what you want to know about hormone therapy by scheduling a free consultation.

Contact Us Today
Location pin icon

609 N Hepburn Ave Ste 106, Jupiter, FL 33458

Physician-led women's hormone care in Jupiter, Florida

Testosterone Therapy for Women in Jupiter, Florida

You may have read that testosterone will give you your energy back, your focus back, your body back. Some of that was tested in randomized trials and did not hold up. One thing did. This page tells you which is which, because a therapy aimed at the wrong target does not work — and you are the one who spends the months finding that out.

There is no FDA-approved testosterone product indicated just for women in the United States. That does not make the therapy improper. It makes the evaluation, the dose and the monitoring the physician's responsibility rather than the label's.

In short: testosterone therapy for women is physician-prescribed treatment using carefully controlled doses of testosterone. Randomized-trial evidence supports it primarily for postmenopausal women with diagnosed hypoactive sexual desire disorder (HSDD). No testosterone product is FDA approved just for women in the United States, so treatment is prescribed off-label and requires individualized dosing and monitoring.

Physician-led careFlorida licensedGuideline-basedIndividual risk reviewReassessed, not assumed
Start here

Quick answers before you read further

Can women take testosterone?

Yes. Women produce testosterone throughout their lives, and it can be prescribed. As a therapy, the one use supported by randomized trial evidence is treatment of hypoactive sexual desire disorder (HSDD) in postmenopausal women, diagnosed through a full sexual-health assessment rather than a blood level. The 2019 Global Consensus Position Statement put it directly: “The only evidence-based indication for the use of testosterone in women is for the treatment of postmenopausal women who have been diagnosed as having HSDD.”

Is testosterone therapy for women FDA approved?

No. As of August 2026 there is no FDA-approved testosterone product indicated just for women in the United States. The FDA restated this on 18 August 2026: “Unlike estrogen-containing products, there are no FDA approved indications for testosterone therapy for menopausal women.” Prescribing is therefore off-label, which is lawful and ordinary in American medicine.

Who is a candidate for testosterone therapy?

A postmenopausal woman with low sexual desire that distresses her and that she wants treated, after the other causes have been genuinely considered: pain, medication side effects, sleep, thyroid disease, depression and relationship factors. Candidacy is not settled by a lab result. If low desire is what brought you here, our page on low libido in women covers the non-hormonal causes in more depth.

Key distinction: HSDD is defined by the distress, not by a number. Low desire that does not trouble you is not a disorder and does not need treating. And there is no blood level that says a woman needs testosterone — the guidelines are explicit that no such threshold exists.
Normal female physiology

What testosterone does in a woman's body

Testosterone is not a male hormone that women happen to have. It is a normal part of female physiology — produced in two places, converted in a third, and circulating at roughly a tenth to a twentieth of male concentrations.

Ovaries

The main source. Specialised theca cells produce testosterone in response to luteinizing hormone (LH) released by the pituitary gland, and production is influenced by where you are in your menstrual cycle.

Adrenal glands

The adrenal glands, which sit just above the kidneys, produce a smaller amount. Because female levels overall are low, this smaller source still matters to the total.

Peripheral conversion

Some testosterone is produced in peripheral tissues, where other hormones — dehydroepiandrosterone (DHEA) among them — are converted into testosterone.

Levels vary across the menstrual cycle, running higher in the mid-follicular phase and lower in the luteal phase, and they decline gradually with age. Surgical removal of both ovaries causes a more abrupt fall. Chronic illness and certain medications can lower levels as well.

The section most pages skip

What the evidence supports, and what it does not

The Global Consensus reviewed the trial evidence domain by domain and reached three different kinds of answer: this was tested and it worked, this was tested and it did not, and this has not been tested well enough to say. Those are not the same answer, and a page that blurs them is not helping you decide anything.

What you may be hoping forWhat the randomized trial evidence showsStrength
Low sexual desire with distress (HSDD), after menopauseImproves desire, arousal, orgasm, pleasure and sexual self-image, and reduces sexual distressLevel I, Grade A
General wellbeing“No effect of testosterone therapy on general wellbeing”Tested — no effect
Low mood or depression“Available data do not show an effect of testosterone on depressed mood”Tested — no effect
Bone density and osteoporosis“The available data do not support an effect of testosterone treatment on bone mineral density”Tested — no effect
Muscle, strength, body composition“No statistically significant effect … on lean body mass, total body fat, or muscle strength”Tested — no effect
Memory and concentration“Insufficient evidence to support the use of testosterone to enhance cognitive performance, or to delay cognitive decline”Not enough evidence
Fatigue and energyNot an evidence-based indication. The Endocrine Society recommends against testosterone for wellbeing generallyNot an indication
Hot flashes and night sweatsNo guideline supports testosterone for these. Systemic estrogen therapy is the treatment with the evidence behind itNot an indication
Weight lossTrials found a small increase of about 0.48 kg (95% CI 0.16–0.79)Not a weight therapy

Does testosterone build muscle in women?

Testosterone is anabolic. At high enough doses it builds muscle in anyone. But at the physiologic female doses this page is about, pooled trial data found no statistically significant effect on lean body mass, total body fat, or muscle strength. The dose where you would see real body-composition change is the dose that risks voice deepening and clitoral enlargement — effects the approved product labeling describes as potentially irreversible. That is why it is not the dose we use.

If building strength is the goal, resistance training is the intervention with the evidence behind it. Testosterone at a female dose is not typically high enough to cause significant increases in muscle mass.

What “it works” actually looked like in the trials

The largest analysis of the evidence — 36 randomized controlled trials and 8,480 women, published in The Lancet Diabetes & Endocrinology in 2019 — found that testosterone produced a mean of 0.85 additional satisfying sexual events per month compared with placebo (95% CI 0.52–1.18), alongside improvements in desire, arousal, pleasure, orgasm and sexual self-image, and a reduction in sexual distress.

Roughly one more satisfying sexual encounter a month. That is a real result, statistically solid, and it is a modest one. If a clinic promises you a transformation, they are describing something no trial has measured.

Why a clinic that prescribes testosterone would tell you this

Because the alternative is worse for you. If exhaustion is what brought you here, we would rather look at your thyroid, your sleep, your iron, your medication list and your mood than hand you a cream the trials say will not fix it — and then have you come back in six months no better, having paid for it. Telling you what testosterone does not do is the only honest way to tell you what it does.

Regulatory status, stated plainly

Is there an FDA-approved testosterone for women?

No — and it is worth understanding exactly what that does and does not mean.

The United States

There is no FDA-approved testosterone product indicated just for women. The FDA declined a transdermal testosterone patch for women in 2004 over insufficient long-term safety evidence, and the position has not changed. The agency has scheduled a public workshop for 17 September 2026 to examine the evidence and the gaps — naming limited safety data beyond 24 months, and cardiovascular and breast cancer risk, as the critical unknowns. A workshop is an evidence review, not an approval.

One thing worth separating out, because news coverage ran it together: in February 2026 the FDA approved labeling changes removing boxed warnings from menopausal hormone therapy products. That covered estrogen and progestogen products. Testosterone was not included for women.

Australia, New Zealand and the UK

A female-strength testosterone cream is approved for postmenopausal HSDD in Australia (on the ARTG since February 2021), New Zealand and the United Kingdom. Those approvals do not transfer to the United States, and the product is not available here as an approved medication.

What is FDA-approved for HSDD

Testosterone is not — but two medications are, and neither is a hormone.

Bremelanotide (Vyleesi) is approved for acquired, generalized HSDD in premenopausal women. Its labeling states it is not for women who have gone through menopause.

Flibanserin (Addyi) was approved in 2015 for premenopausal women, and on 15 December 2025 the FDA expanded the indication to women younger than 65 — which now includes postmenopausal women.

Whether either fits you is a separate conversation, and one worth having before testosterone is on the table.

What “off-label” actually means

Off-label prescribing means a physician is prescribing a medication for a use, dose or population the FDA has not formally reviewed. It is lawful, it is ordinary, and it is not a loophole. What it means practically is that the package insert will not tell anyone the right dose for a woman. The physician's judgment, the starting dose and the monitoring schedule carry the whole weight instead — which is the argument for a real evaluation rather than an online questionnaire.

Same word, different medicine

How testosterone therapy for women differs from men's TRT

NovaGenix treats both, and they have less in common than the shared word suggests. If your husband or partner is on testosterone replacement therapy, almost none of his protocol applies to you.

WomenMen
FDA-approved productNoneSeveral
Typical starting doseRoughly one-tenth of a man's starting doseFull labeled dose
Evidence-based indicationPostmenopausal HSDDDiagnosed hypogonadism with symptoms
Can a blood level make the diagnosis?No — “no cutoff blood level can be used”Yes, alongside symptoms, on repeat testing
Target while on treatmentInside the premenopausal female range, not above itMid-normal male range
Routes usedTransdermal cream or gelInjections, gels and pellets all in common use
Stopping ruleGuidelines advise stopping at six months without meaningful benefitOngoing while indicated and monitored

The one-tenth figure is the part people find hardest to believe. It is the reason a woman should never be dosed from a man's tube by eye, and the reason a level gets checked a few weeks in.

It is a starting point, not a prescription. There is no standard female dose. Everyone is different, and the dose that suits one woman is not the dose that suits the next. Where yours lands depends on your history, your symptoms, your other medications, how you respond, and what your laboratory results show once you have started. Whether testosterone is clinically appropriate for you at all — and at what dose — is Dr. Mackey's judgment, made with your labs in front of him.
Route is a safety decision

Cream, injection, or pellet: how testosterone is given to women

Route matters more here than it does for men, because the entire safety argument rests on staying inside a narrow range. The serious androgenic effects described in the literature are associated with levels that went above it.

Transdermal cream — what NovaGenix uses

The route the guidelines name, and the one we use first. It is applied daily, it can be titrated in small increments, and — the point that matters most — if the dose is wrong it can be changed tomorrow.

The cream is compounded: prepared by a compounding pharmacy at a female-strength concentration. Compounded preparations are not FDA-approved. We say that plainly rather than letting words like “bioidentical” or “custom” imply otherwise.

Low-dose subcutaneous injection

Route is not what makes a level supraphysiologic — the measured serum concentration is. The Global Consensus advises against preparations “that result in supraphysiologic concentrations of testosterone, including pellets and injections.” Injections are named there because standard protocols usually overshoot the female range, not because the syringe is the problem.

At NovaGenix, cream is the default. A low-dose subcutaneous protocol is available where it suits a patient, held to the same target: total and free testosterone inside the premenopausal physiologic range, confirmed on labs rather than assumed from the dose. If a level comes back high, the dose comes down.

Worth stating plainly: the randomized trial evidence for testosterone in women was generated almost entirely with transdermal preparations. A low-dose injection kept in range is a clinical judgment made under monitoring, not a trial-supported protocol, and we describe it that way.

Pellets

NovaGenix does not use testosterone pellets in women. ACOG is explicit: “Based on the lack of safety data and inability to remove the pellet, ACOG recommends preparations other than pellet therapy for the delivery of testosterone.” The Global Consensus groups pellets with injections as preparations that produce supraphysiologic concentrations, and states they are not recommended.

The practical objection is the simplest one. Once a pellet is in, it cannot be dialed back. If the dose turns out to be too high, you wait it out.

Oral testosterone and troches

Not recommended. Oral testosterone is associated with adverse effects on lipids and carries a Level I, Grade A recommendation against its use in women.

Where this practice and the consensus statement differ, stated openly. No FDA-approved testosterone product exists for women in the United States, so every option here is off-label. The Global Consensus goes further on compounding: it says compounded testosterone “cannot be recommended” for HSDD because of the lack of efficacy and safety data, and that where no approved female preparation is available, off-label use of an approved male formulation is reasonable provided concentrations stay in the physiologic female range.

We use a compounded cream for flexibility. A woman’s hormones do not sit still — they shift over time, alongside other treatment, and with what the next set of labs shows. A compounded preparation can be adjusted when the clinical picture calls for it, rather than working around whatever strength a product happens to be packaged in. The safeguard is identical either way: the level is measured, and it has to stay inside the female range.

That is a considered clinical choice rather than the option the consensus names first, and you are entitled to know the difference and to ask Dr. Mackey about it.

A fair question to ask any clinic that offers pellets as the standard route for women: what happens if the dose turns out to be too high?
Numbers in context

Testing: what a blood level can and cannot tell you

A blood test cannot tell you whether you need testosterone. There is no level below which a woman is deficient. The Global Consensus states it without hedging: “No cutoff blood level can be used for any measured circulating androgen to differentiate women with and without sexual dysfunction.” The Endocrine Society goes further and recommends against diagnosing an androgen deficiency syndrome in healthy women at all.

So what is the blood test for? A baseline — so that once you start, we can tell whether the dose has taken you outside the physiologic range.

What we measure

Total testosterone, plus sex hormone binding globulin (SHBG) at baseline. Total testosterone — not free testosterone, not the free androgen index — is the measure the guidelines name as the best available.

Why the assay matters

Female testosterone concentrations sit near or below the detection limit of the direct immunoassays most commercial labs run by default. The Global Consensus grades those direct assays as “highly unreliable in the female range” and names liquid or gas chromatography with tandem mass spectrometry (LC-MS/MS) as the accurate method. A number produced by that kind of assay may not be reliable enough to interpret clinically at typical female concentrations.

What we do not use

Salivary hormone testing is not recommended for clinical use, and ACOG advises against using adjunct hormone tests to guide compounded hormone dosing. Dried-urine hormone panels are not validated for this purpose by any major guideline.

Adult female total testosterone generally falls somewhere around 15 to 70 ng/dL depending on age, cycle timing and the assay used. That is a general orientation, not a universal range — the reporting laboratory's own reference interval and method are what your result should be read against. Either way it is context for a monitoring baseline, not a threshold that diagnoses anything.

Not appropriate for everyone

Who should not use testosterone, and who should slow down

These come from the approved product information for the female testosterone cream marketed in Australia and New Zealand — product-specific labeling rather than a United States contraindication list, since no equivalent US product exists. It lists known or suspected breast carcinoma, known or suspected androgen-dependent tumour, pregnancy or breastfeeding, history of thromboembolism, nephrotic syndrome, and hypercalcemia.

If you have a history of breast cancer

There is no blanket answer here, in either direction. We will not tell you testosterone is off the table because of your history, and we will not treat it as a routine prescription. It is decided individually, with your full picture in front of the physician.

What goes into that picture: your tumour type and receptor status, how long ago it was, what treatment you had and what you are still taking, your current oncology follow-up, your other risks, and what the symptom is actually costing you.

What is honestly known: known or suspected breast carcinoma is listed as a contraindication on the approved product information for the female testosterone cream marketed in Australia and New Zealand, and the Global Consensus advises caution in women with hormone-sensitive breast cancer. That recommendation rests on expert opinion rather than trial data — because women with these histories were excluded from the trials. The exclusion is the point: the reassuring short-term findings were produced in a population that did not include you.

If you are under oncology care, that team should be part of the conversation. This is one of the places where a blanket policy would serve you worse than a careful one.

If you are premenopausal or perimenopausal

The evidence base for testosterone is postmenopausal. The Global Consensus says plainly: “There are insufficient data to make any recommendations regarding the use of testosterone in premenopausal women.” That is not the same as saying it is unsafe — the trials that would answer the question have not been done.

It is also not a no. Testosterone may be considered for a carefully selected premenopausal woman with formally diagnosed, distressing HSDD once other contributors have been evaluated. It is not prescribed for low libido alone, and the FDA-approved options above should be discussed as part of the decision.

An off-label trial would be considered only when:

  • your reduced desire is persistent, causes you personal distress, and meets the criteria for HSDD
  • a biopsychosocial evaluation has addressed the more common contributors — relationship factors, stress, depression, sleep, pain with sex, medications such as SSRIs, thyroid or prolactin abnormalities, and perimenopausal symptoms
  • you are not pregnant, breastfeeding, or trying to conceive

If it is prescribed, it is low-dose transdermal testosterone kept within the normal physiologic range for premenopausal women — not supraphysiologic injections or pellets. A baseline level is drawn to guard against overtreatment.

If your main complaint is not sexual desire

Then the evidence points somewhere else, and so should we. Sleep, thyroid function, iron, medication effects and mood are the places to look — and for hot flashes, night sweats, vaginal dryness or painful sex, systemic or local menopausal hormone therapy is the treatment with evidence behind it.

Including the ones other pages leave out

Side effects, including the ones that may not reverse

At doses that keep you inside the premenopausal range, the effects seen in trials are modest. The Global Consensus states that physiologic-dose testosterone in postmenopausal women is “associated with mild increases in acne and body/facial hair growth in some women, but not with alopecia, clitoromegaly, or voice change.”

What the trials measured

  • Acne — risk ratio 1.46 (95% CI 1.11–1.92), affecting up to about one woman in ten
  • Increased facial or body hair — risk ratio 1.69 (95% CI 1.33–2.14)
  • Small weight increase — about 0.48 kg on average
  • Skin reaction at the application site

What is still unknown

Safety data for physiologic-dose testosterone in women do not extend beyond 24 months. Short-term transdermal use has not shown an effect on mammographic breast density or on breast cancer risk, but the consensus is equally clear that “data from RCTs are insufficient to assess long-term breast cancer risk.” A non-significant trend toward deep vein thrombosis has been observed.

Who the trials left out

The trials excluded women at high cardiometabolic risk, and most participants were also taking estrogen. The findings do not automatically transfer to a woman outside that profile. Seven years on, the FDA still lists these as the critical gaps in the evidence.

The part that gets left off other pages. Above the physiologic range, the picture changes. The approved product information for female testosterone cream states: “Signs of virilisation, such as voice deepening, hirsutism or clitoromegaly, may be irreversible and discontinuation of treatment should be considered.” Irreversible means what it says. This is why the route is transdermal, why the dose is small, why a level is checked — and why a level that comes back too high means the dose comes down even if you feel fine.
NovaGenix process

What testosterone therapy looks like at NovaGenix

The conversation, not the lab slip

A full sexual-health assessment comes first: what changed, when, whether it distresses you, and what else could be causing it — pain, medications, sleep, thyroid, mood, relationship factors. A testosterone level is not the starting point, because it cannot answer the question being asked.

Baseline testing

Total testosterone and SHBG, plus whatever else your history calls for. The baseline exists so the dose can be monitored, not to hand you a diagnosis.

A trial you can actually evaluate

If treatment is appropriate, it starts low. A testosterone level is usually repeated at six to eight weeks — sooner if there is a reason to look earlier.

Guidelines advise that a trial without clinically meaningful improvement should not run past six months, and the principle is the right one. If there is no response to treatment, or the protocol is not one you can realistically stick to, that is the point to stop, reevaluate, and consider alternatives — not to push the dose.

Reassessment

Labs are repeated every four to six months, or sooner as needed — some patients are checked more often, because everyone is different. We look at response, side effects, levels, adherence, and whether continuing still makes sense.

If a level comes back above the female range, the dose comes down even in the absence of any side effect.

What to bring: your medication and supplement list, any prior hormone prescriptions, recent labs, your menstrual and surgical history including hysterectomy or oophorectomy, any cancer or clot history, and the one or two things you most want to change.

NovaGenix is located at 609 N. Hepburn Ave., Suite 106, Jupiter, FL 33458, and sees patients from Jupiter, Palm Beach Gardens, North Palm Beach, Tequesta, Juno Beach and across Palm Beach County. Eligible Florida patients may be evaluated by telemedicine where legally and clinically appropriate; laboratory testing and in-person requirements may still apply. We do not prescribe hormones on the basis of an online form. Schedule an evaluation or read more about hormone therapy at NovaGenix.

The question nobody answers

Why insurance usually does not cover testosterone for women

Because of a chain that starts with the FDA and has nothing to do with whether your symptoms are real.

There is no FDA-approved testosterone product indicated just for women in the United States → so the prescription is off-label → so the cream is a compounded preparation rather than an FDA-approved product → and insurers commonly classify that as elective, non-formulary, or not medically necessary.

That is the whole reason. It is a regulatory fact about the product, not a judgment about you. Coverage still varies by plan, product, diagnosis and pharmacy benefit, so the only reliable answer is the one your own plan gives. Ask us directly what your evaluation and therapy would involve before you decide anything — call or text 561-277-8260.

Frequently asked questions

Testosterone therapy for women: common questions

Can women take testosterone?

Yes. Women produce testosterone naturally, and it can be prescribed. The one use supported by randomized trial evidence is treatment of hypoactive sexual desire disorder in postmenopausal women, diagnosed through a full clinical assessment rather than a blood level.

Is testosterone therapy for women FDA approved?

No. As of August 2026 there is no FDA-approved testosterone product indicated just for women in the United States, so prescribing is off-label. Off-label prescribing is lawful and routine, but it means the dose and monitoring are the physician's responsibility rather than the label's.

Is testosterone therapy for women covered by insurance?

Usually not. Because no FDA-approved testosterone product is indicated just for women in the United States, the prescription is off-label and the cream is compounded, and insurers commonly treat compounded off-label preparations as elective or non-formulary.

Does testosterone help women with fatigue, sleep, or anxiety?

The evidence does not support it. Trials found no effect of testosterone on general wellbeing and no effect on depressed mood, and no guideline lists fatigue or sleep as an indication. If exhaustion or anxiety is your main problem, thyroid function, iron, sleep quality, medications and mood are the places to look first.

Does testosterone cause weight gain or weight loss in women?

Neither, meaningfully. Pooled trial data found a small average increase of about 0.48 kg and no significant effect on lean body mass, total body fat or muscle strength. Testosterone is not a weight-loss treatment.

How long does testosterone cream take to work in women?

A testosterone level is usually repeated at six to eight weeks to confirm the dose is in range, sooner if there is a reason to look earlier, and women who respond often notice a change over that same period. Guidelines advise that a trial without clinically meaningful improvement should not continue beyond six months, at which point the useful step is to stop and reevaluate rather than push the dose.

Can women take testosterone without estrogen and progesterone?

It depends on your situation, and the evidence is thinner here than people assume: most women in the testosterone trials were also using estrogen therapy. Whether you need estrogen, progesterone, both, or neither is a separate clinical decision from whether testosterone is appropriate.

Where do you apply testosterone cream?

To clean, dry skin on a site your physician specifies, at the same time each day, and away from anyone else's skin contact until it has absorbed. Application site and dose are prescribed individually rather than by a general rule.

Can premenopausal women take testosterone?

Sometimes, but not routinely. The trial evidence for testosterone in women is postmenopausal, and the Global Consensus states there are insufficient data to make any recommendation in premenopausal women. It may be considered for a carefully selected premenopausal woman with formally diagnosed, distressing HSDD after other contributors have been evaluated, and it is not prescribed for low libido alone. Two FDA-approved non-hormonal HSDD medications exist and should be discussed as part of that decision.

Can I use testosterone if I have had breast cancer?

There is no blanket answer either way — it is decided case by case. Known or suspected breast carcinoma is listed as a contraindication on the approved female testosterone product information, and the Global Consensus advises caution in women with hormone-sensitive breast cancer, a recommendation based on expert opinion because women with these histories were excluded from the trials. Your tumour type and receptor status, time since treatment, current therapy, oncology follow-up and other risks all bear on the decision, and your oncology team should be part of the conversation.

What happens if testosterone does not work for me?

Treatment stops and gets reevaluated. Major consensus guidance — the 2019 Global Consensus Position Statement and the ISSWSH clinical practice guideline — recommends that a trial without clinically meaningful improvement should not continue beyond six months, and the same applies if the protocol is not one you can stick to. From there the useful step is to re-examine the diagnosis rather than the dose: pain, medication effects, sleep, mood and relationship factors all produce the same complaint and none of them respond to testosterone.

Medical references

Primary guidance used for this page

  1. Davis SR, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666.
  2. Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754–766.
  3. U.S. Food and Drug Administration. Testosterone Use in Menopausal Women; Public Workshop; Request for Comments. Federal Register, 18 August 2026.
  4. American College of Obstetricians and Gynecologists. Compounded Bioidentical Menopausal Hormone Therapy. Clinical Consensus No. 6, November 2023.
  5. The Menopause Society. Practice Pearl: Testosterone Use for Hypoactive Sexual Desire Disorder. March 2023.
  6. International Society for the Study of Women's Sexual Health. Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. J Sex Med. 2021;18(5):849–867.
  7. Wierman ME, et al. Androgen Therapy in Women: A Reappraisal — An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2014;99(10):3489–3510.
  8. AndroFeme 1 Product Information. Medsafe New Zealand data sheet, 10 June 2025.

This page is for education and does not replace individualized medical advice.

Your next step

Request a women's hormone consultation

You do not need to have decided anything before you come in. Bring what has changed, what you have already tried, and what you most want to be different. Dr. Mackey will tell you whether testosterone is a reasonable option for you, whether something else fits better, or whether the honest answer is that no prescription is the right next step.