Testosterone Therapy
Testosterone is often thought of as a "male hormone," but it is also an essential hormone in women. Levels naturally decline with age — often earlier than estrogen — and low testosterone can contribute to a range of symptoms during perimenopause and menopause. When prescribed carefully and kept within the female physiologic range, testosterone therapy can be safe and beneficial for women.
Potential benefits
Not every woman experiences the same benefits — improvement depends on your symptoms, baseline hormone levels, and overall health.
- Brain fog & cognition — may improve concentration, verbal learning, memory, and mental clarity.
- Mood & emotional well-being — may help mood, motivation, and emotional resilience, and reduce anxiety or low mood related to hormonal changes.
- Energy & vitality — may improve overall energy, stamina, and sense of well-being.
- Muscle & physical function — supports muscle mass and strength, and may improve physical performance and mobility.
- Bone health — helps support bone density and reduce fracture risk alongside estrogen and lifestyle measures.
- Libido & sexual function — strong evidence for improvement in sexual desire, arousal, orgasm frequency, and satisfaction; particularly helpful for women with hypoactive sexual desire disorder (HSDD).
- Sleep — some women report improved sleep quality, though responses vary.
How testosterone is prescribed
Testosterone is prescribed off-label for women in the United States. Transdermal formulations (cream, gel, or patch) are preferred. The goal is to restore testosterone to normal premenopausal female levels — higher doses are not better and increase the risk of side effects.
How to use your prescription
Your testosterone is applied using a syringe to measure an accurate dose. The syringe is for measuring and applying to the skin only — there is no needle and nothing is injected.
- Transfer the medication from the container into a 5 mL syringe.
- Apply 0.5 mL once daily in the morning, alternating calves each day.
- Apply to clean, dry skin and let it dry completely before getting dressed — usually less than 5 minutes.
- Cover the application area with clothing once the gel is dry.
- Avoid skin-to-skin contact at the application site with others for at least 1 hour after applying.
Step-by-step walkthrough
Before your first dose, please watch the full instructional video — it walks through preparing the syringe, dosing, and application. Use the slideshow below as a refresher anytime after that.
Get your syringes
Quick dosing refresher
What to expect
Some women notice changes within 4–12 weeks. Full benefits may take 3–6 months. If there is no meaningful improvement by 6 months, therapy should be discontinued.
Monitoring
- Labs before starting
- Repeat labs at 6–8 weeks
- Ongoing monitoring every 6 months
- Symptom check-ins every 3 months
- One in-person visit before starting, and once every 8–10 months
Possible side effects
When testosterone is kept within the normal female physiologic range and monitored regularly, side effects are uncommon. Possible effects include acne or oily skin, increased facial or body hair, hair thinning, and mood changes. Voice deepening and clitoral enlargement are rare.
Who should not use testosterone
Testosterone therapy is not appropriate if you are pregnant or trying to conceive, have unexplained vaginal bleeding, have active or severe liver disease, have breast or genital cancers, or have a history of deep vein thrombosis (DVT) or pulmonary embolism (PE).
Cost & pharmacy information
There is no FDA-approved testosterone product for women, and insurance does not cover testosterone therapy. Typical cost ranges from $75–250 per box, lasting roughly 10 months — an average of about $10–25 per month.
Testosterone is a Schedule III controlled substance. Prescriptions cannot be electronically sent twice and cannot be transferred between pharmacies. We recommend checking availability and pricing with the pharmacy before filling; if the pharmacy is unable to fill it, we will provide a paper prescription.
Before you start
Before starting any medication, please read its full guide. Understanding how to use your treatment and what to expect makes it work better and helps you feel confident. All of your medication guides are available with your Care Guides — and you can always ask us if you can't find what you need.
Questions?
Message us through the patient portal anytime — that's the fastest way to reach us for anything that isn't an emergency. If anything feels off or you're unsure about dosing or timing, let us know. We can always make adjustments.