A couple's feet showing from under the covers, testosterone help women

If we say low testosterone, you might think of a TV ad starring a middle-aged man worried about “low T.” But even though testosterone is the quintessential “male” hormone, women make it too. Could a prescription for testosterone help women feel better? Some women have told us it does.

Does Testosterone Help Women, Too?

Q. After a friend told me that she had great success with testosterone cream, I asked my gynecologist about it. She prescribed a low-dose cream and I have been using it for years.

I am happy with the results. I have more energy, better mood, a high sex drive, amazing orgasms and less body fat. My husband is happy because I’m happy and our sex life is great. Why don’t more women know about this?

A. The FDA has not approved testosterone for women. The only way to get this topical medicine is with a prescription at a compounding pharmacy.

An oral medicine, Estratest, was once prescribed to treat symptoms of menopause. This is now only found as a generic pill, esterified estrogens with methyltestosterone. Like other estrogen replacement pills, it carries a black box warning about endometrial cancer and cardiovascular complications. That might help explain why many women haven’t considered whether they might need testosterone.

When Could Testosterone Help Women with Low Libido?

Most doctors will consider testosterone for a woman only if she has persistent difficulty with libido. However, measuring testosterone levels to make a diagnosis does not seem to be straightforward (Journal of Obstetrics and Gynaecology Canada, March 2017). Women’s sexual desire is not a simple barometer of testosterone in their systems. Psychological well-being and the state of the relationship also have strong effects on a woman’s interest in sexual activity (Journal of Sexual Medicine, March 2017).

A group of women approaching menopause reported on their libido and symptoms and provided blood for testing (Menopause, Nov. 2018). Those whose testosterone levels fluctuated most were more likely to report diminished interest in sex. Women who were depressed, those who reported vaginal dryness and those whose children were living at home were more likely to report decreased libido regardless of their testosterone levels.

Side Effects of Testosterone:

In some cases when testosterone levels are low, we expect that a cream or patch providing modest doses of this hormone might help women reclaim their libido. Excess testosterone may lead to irreversible side effects, including a deeper voice and enlarged clitoris. Some women may experience hoarseness, acne and growth of unwanted facial hair. Women who are still menstruating may notice changes in their periods. Liver problems and blood clots are other potentially serious reactions to testosterone.

Does Testosterone Help Women Athletes?

A study in the British Journal of Sports Medicine reveals that elite female athletes who have naturally high testosterone perform better than those with normal androgen levels. The investigators analyzed data for both male and female athletes from the 2011 and 2013 track and field world championships (Bermon & Garnier, British Journal of Sports Medicine, online, July 3, 2017 ).

Male sprinters tended to have higher free testosterone levels than men in other events. On the other hand, those in throwing events averaged lower testosterone than men in other events. Testosterone levels in women didn’t appear to vary by the event.

How Does High Testosterone Affect Competition?

When women with high testosterone were compared to those with low levels of this male hormone, performance differed slightly. Nonetheless, the small differences were significant.

Although the improvements in events such as pole vault, 400 meter hurdles, 800 meter runs and the hammer-throw were modest, at this level of competition, even a small advantage can lead to a championship. The women competing in the hammer-throw did 4.53 percent better if they had elevated testosterone levels. That was the greatest difference among all the contestants.

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  1. Richard

    They do not call testosterone the rage drug for nothing as it for many causes personality disorders as if synthetic estrogen’s where not bad enough???

  2. Sheryl

    Last year my doctor recommended bioidentical hormone pellets for osteoporosis. I’m 63. It has given me more energy and improved libido, and lowered my body fat. Still, I worry about long-term side effects. I won’t know until I get my bone scan next year if it has helped.

  3. Theresa G
    North Carolina

    I had been taking the bio-identical hormones consisting of estrogen and testosterone with progesterone Rx for about two years and the only thing I found them to give me was a constant desire for sex, which was o.k. for a while, but even my husband was getting a bit worried! They did not give me any more energy or raise my feeling of well being, in fact I was told after my last mammogram to stop taking them when new breast tissue was found growing in my right breast. I’m 69 and had a complete hysterectomy at age 30.

  4. April

    I tried some testosterone cream in my my mid 40s, about 15 years ago. I did not like it at all. It did boost my sex drive, but I felt very animalistic.

  5. Jayel

    I found a wonderful physician who put me on a low-dose testosterone implant (in addition to balancing out my estrogen and progesterone) to treat the absolutely crippling post-menopausal depression I was experiencing. I went through eight doctors, all of whom just wanted to put me on antidepressants, before I found a bioidentical hormone specialist. After he’d gotten all of my other hormones balanced, he added a tiny dose of time-release testosterone that shut off the depression like a light switch.

    And yeah, in addition, it has helped stimulate a buoyant sex drive.

    • Stephanie
      Dallas, TX

      I have had the same experience with the pellets. LIFE CHANGING!!!!!!

      • Richard

        If you want to increase your sex drive it would probably help many to change sex partners.

  6. Mary Jane

    I agree with Jane about tampering with various body parts. Do we know the long-term effects of taking testosterone?

  7. Nancy
    Summerville, SC

    Taking bio-identical testosterone has increased my joy in sex exponentially and is good for me in many other ways. Whoopie!

  8. Mary
    Houston, Texas

    I am 67 years old, and several years ago I began a relationship with a kind and loving man. He is 6 years younger than I. However, I had a very low sex drive. My children were not living at home, and I had plenty of money so there were no other depressing factors involved. I do not have a uterus. My Doctor put me on bio-identical hormone pellets which contain animal estrogen and some testosterone, and voila! Sex drive back full force, more energy, better sleep and no beard (LOL). Now everybody’s happy. I also take micro-ionized progesterone in a pill. Medicare pays only about 1/3 (for the pellet insertion only but not for the hormones), so plan on about $300 out of pocket every 3-4 months. If you can afford it. It’s been worth every penny for me.

  9. jane

    I would caution people to really evaluate this before starting. Hormones are VERY powerful chemicals. Remember when HRT was the magic pill that was going to ensure all women of a healthy life til they were 100 ( or some such thing)? Turns out years later it wasn’t so great for most. There are complex feedback loops involved with all these systems in the body, and tampering around here and there with parts of them seems not well thought out to me.

  10. Carol
    St. Louis

    I haven’t heard about cardiovascular complications from estrogen support. Is there a link for more info?

  11. Judy

    My internist put me on a low dose testosterone cream about 3 years ago because I had complained about always being tired. The difference was amazing! I don’t feel hyped up – just normal and can get through a busy day without feeling like I need a nap halfway through. He also put me on some progesterone because he said that is the “brake” for hormones. I’m 68 but feel and look 20 years younger

  12. Ellen Y.

    My doctor (alternative) prescribed testosterone oil to improve bone density. I have osteoporosis and osteopenia and do not want to use traditional meds. I have not noticed any positive or negative side effects.

  13. Nicolette K.
    Apex NC

    This is a bit confusing. Is there a way to do the compounding cream like 2 or 3 times weekly or a certain number of times based on bloodwork?

  14. Paul

    Susan Rako MD wrote a book several years ago called the “Hormone of Desire” which addressed the use of Testosterone in low dose as a treatment for lost libido in older women. It received quite a bit of publicity at the time it was written but since the FDA doesn’t like Testosterone for men or women it never caught on. But it is very interesting reading as she recommended compounding pharmacies as a source and also addresses the safety issues.

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