Why Do Women Take Testosterone?

Physician-reviewed women's hormone education

Why Do Women Take Testosterone?

Women naturally produce testosterone. In selected women, testosterone may be prescribed for a specific clinical reason—most notably hypoactive sexual desire disorder after menopause—rather than simply to “optimize” a lab value.

Medically reviewed by Dr. Timothy Mackey
Medical Director · Updated September 2026

Do women naturally make testosterone?

Yes. Testosterone is produced by the ovaries and adrenal glands and is also generated through peripheral conversion of androgen precursors. Women have much lower circulating concentrations than men, but testosterone still participates in sexual function, bone and muscle physiology, and other androgen-dependent processes.

Levels vary with age, ovarian function, medications and health status. A laboratory number by itself does not determine whether a woman has an androgen-related disorder or needs treatment.

What happens to testosterone as women age?

Androgen concentrations generally decline across adult life, but menopause itself does not create a simple, abrupt “testosterone deficiency syndrome.” Surgical removal of both ovaries can produce a more abrupt reduction in ovarian androgen production.

Because symptoms such as fatigue, low mood, reduced muscle mass, poor sleep and low libido are nonspecific, they should not automatically be attributed to testosterone. Estrogen status, medications, thyroid disease, anemia, relationship factors, pain, depression, sleep disorders and other causes may be more important.

What is the best-supported reason to prescribe testosterone to women?

The best-supported indication is hypoactive sexual desire disorder (HSDD) in postmenopausal women. HSDD involves persistently reduced sexual desire that causes personal distress and is not better explained by another condition, medication, relationship issue or major psychosocial factor.

Major international consensus statements and the International Society for the Study of Women's Sexual Health support a trial of physiologic-dose testosterone in appropriately selected postmenopausal women with HSDD.

For broader causes of reduced desire, see our guide to low sex drive in women.

Does a low testosterone blood test diagnose HSDD?

No. There is no validated testosterone cutoff that diagnoses HSDD in women. Testosterone testing is useful primarily to establish a baseline, help avoid supraphysiologic dosing and monitor treatment—not to prove that a particular symptom is caused by “low T.”

This is an important distinction because women can have distressing low desire with testosterone values that fall within a laboratory reference interval, while other women with relatively low values may have no symptoms.

Does testosterone help energy, mood or weight loss in women?

Current evidence is not strong enough to recommend systemic testosterone for general energy, cognition, mood enhancement, prevention of aging, weight loss, muscle gain or overall wellness in otherwise healthy women.

Some women receiving testosterone for HSDD may report broader improvements in well-being, but those observations should not be used to market testosterone as a treatment for every menopausal symptom.

What about testosterone for muscle or bone health?

Testosterone has biologic effects on muscle and bone, but available clinical evidence does not support prescribing it primarily to prevent osteoporosis, build muscle or improve physical performance in women who do not have another established indication.

Bone health should be addressed using standard risk assessment, exercise, nutrition, vitamin D/calcium when appropriate, and FDA-approved osteoporosis therapies when indicated.

Is testosterone FDA-approved for women?

No testosterone formulation is currently FDA-approved specifically for women in the United States. Prescribing testosterone to women is therefore off-label.

Off-label prescribing is legal and common in medicine when supported by evidence and clinical judgment, but the lack of a female-specific approved product means dose selection and monitoring require particular care.

How is testosterone typically given to women?

Professional guidance generally favors transdermal testosterone because it can provide relatively stable systemic exposure and allows dose adjustment. When a male-formulation transdermal product is used off-label, only a small fraction of the male dose is typically required.

Oral testosterone formulations are generally discouraged because of unfavorable lipid and hepatic effects. Pellets and intramuscular injections can create supraphysiologic levels and are harder to reverse or titrate once administered, so many guidelines advise against them for HSDD.

Why dose matters so much

The goal is not to raise testosterone to a “youthful optimum” or to male concentrations. Treatment should keep levels within the physiologic range seen in healthy premenopausal women.

Supraphysiologic exposure increases the likelihood of acne, facial/body hair growth, scalp hair loss, voice changes and clitoral enlargement. Some androgenic effects may be irreversible if exposure is excessive or prolonged.

What should be checked before treatment?

Evaluation should begin with the symptom itself. For low sexual desire, clinicians should review relationship factors, medications, vaginal pain or dryness, menopausal symptoms, mood, sleep, medical conditions and other contributors.

A baseline total testosterone is commonly obtained before therapy, and sex hormone-binding globulin (SHBG) may be useful in selected patients. Baseline lipids and liver function may also be considered depending on the treatment plan and clinical context.

How is testosterone monitored in women?

Monitoring is intended to confirm that testosterone does not rise above the physiologic female range and to assess whether treatment is actually helping.

Guidance commonly recommends checking a testosterone level within several weeks after starting or changing a dose, then periodically once stable. Clinical follow-up should also assess acne, hirsutism, scalp hair changes, voice symptoms and other androgenic effects.

If there is no meaningful improvement after an adequate trial—commonly within about six months—continuing treatment solely because the laboratory number changed is difficult to justify.

What side effects can occur?

At physiologic female doses, the most common androgenic effects are acne and increased facial or body hair. Higher exposure can cause scalp hair loss, voice deepening, clitoral enlargement and other signs of virilization.

Long-term safety data beyond approximately two years remain limited, particularly for cardiovascular and breast outcomes. That uncertainty should be part of informed decision-making.

Who should be especially cautious?

Women who are pregnant or may become pregnant should not use testosterone because of potential fetal virilization. Women with active hormone-sensitive cancer or complex cardiovascular, hepatic or endocrine conditions require individualized specialist evaluation.

Any woman with unexplained virilization, markedly elevated baseline testosterone or signs suggesting an androgen-secreting disorder needs diagnostic evaluation rather than empiric hormone treatment.

What about premenopausal women?

The evidence base is much weaker than it is for postmenopausal HSDD. Professional guidance does not currently support routine testosterone therapy for broad symptoms in healthy premenopausal women.

Selected cases may warrant specialist assessment, but generalized claims that “low testosterone” explains fatigue, mood, weight gain or reduced libido in younger women are not supported by strong evidence.

How is testosterone different from estrogen therapy?

Estrogen and testosterone have different roles. Estrogen therapy is used for specific menopausal indications such as vasomotor symptoms and genitourinary syndrome of menopause, while testosterone's strongest evidence in women is for HSDD after menopause.

For treatment-specific estrogen information, see our estrogen therapy for women guide.

Frequently asked questions

Can testosterone increase libido in women?

Yes, in appropriately selected postmenopausal women with HSDD, physiologic-dose testosterone can improve sexual desire and related sexual-function outcomes.

Is low testosterone the cause of all low libido in women?

No. Sexual desire is influenced by hormones, relationship factors, medications, pain, mental health, sleep, medical conditions and other factors. A testosterone level alone cannot determine the cause.

Can testosterone help menopause symptoms?

It may help HSDD in selected postmenopausal women, but it is not considered a general treatment for hot flashes, night sweats, vaginal dryness, fatigue or every symptom associated with menopause.

Are testosterone pellets recommended for women?

Most major consensus guidance advises against formulations that can produce supraphysiologic concentrations or cannot be easily titrated, including pellets and many injectable approaches.

How long should a woman stay on testosterone?

Treatment should continue only when there is meaningful clinical benefit and testosterone remains within the physiologic female range without concerning adverse effects. Long-term safety data are limited, so ongoing reassessment is important.

Medical references

• Global Consensus Position Statement on the Use of Testosterone Therapy for Women
• ISSWSH Clinical Practice Guideline for Systemic Testosterone for HSDD in Women
• Global Consensus guidance on testosterone therapy for women

This article is educational and does not replace individualized medical advice, diagnosis or treatment.