Testosterone and Low Libido in Women

Although it’s common for men to take testosterone to treat low libido, the U.S. Food and Drug Administration (FDA) hasn’t approved testosterone replacement therapy for women. Some doctors do prescribe it for women as an off-label use, notes Jenna M. Turocy, MD, an ob-gyn at NewYork-Presbyterian Columbia University Irving Medical Center in New York City. “These products include testosterone skin patches, gels, creams or ointments, pills, implants, and injections, often designed and government-approved for men,” Dr. Turocy says.

Testosterone doses provided by these formulations generally are much too high for females, so women are given a fraction (usually one-tenth) of the dose that men are prescribed, notes Barbara Schroeder, MD, an assistant professor and ob-gyn with UTHealth Houston.

“There is no dose that we can say is absolutely safe for women,” she explains. “There are no large randomized trials that have looked at this.” That’s why Dr. Schroeder says to check baseline testosterone levels and re-check them every three to six months to make sure they’re not too high. “The goal is to aim for testosterone levels that are in the normal premenopausal range,” she adds.

Despite the lack of FDA approval, women in the United States are increasingly turning to testosterone for relief from symptoms. Data shows that the rate of women receiving a testosterone prescription off-label nearly tripled between 2023 and 2026.

But research regarding safety and effectiveness is still unclear. Studies have found that testosterone therapy can have a positive effect on hypoactive sexual desire disorder/dysfunction in postmenopausal women. However, there’s insufficient evidence to make recommendations for testosterone therapy in premenopausal women or for any use other than sexual dysfunction.

Another issue is that testosterone has side effects. Acne and hair growth at the application site are the most common, Schroeder says. Changes in your voice, weight gain, hair loss, oily skin, mood changes, and an enlarged clitoris, may also occur, Turocy adds.

But the biggest concern involves testosterone’s long-term safety in women, as no robust scientific studies have looked at potential lasting effects.

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