Testosterone is not approved by the U.S. Food
and Drug Administration (FDA) for treating sexual problems in women. At this time, there is no testosterone pill, patch, or cream approved for women in the U.S. Those made for men have too high a dose for women. But your doctor may prescribe testosterone in a compounded formula, which is a medicine made just for you by a pharmacist.
How It Works
Testosterone is known as a "male" hormone, or
androgen. It also is made in small amounts by a
adrenal glands and
ovaries. A woman's testosterone is highest around age
20 and slowly declines till it is half as high in her 40s.2
- In men, testosterone is linked to male physical
traits and sex drive.
- In women, testosterone may be linked to sex
drive. But for women, interest in sex is much more complicated than just
Testosterone therapy raises testosterone
levels in the body. But testosterone is only
FDA-approved for use in men.
Methyltestosterone probably does not work in
the body and the brain like natural testosterone does. It does not directly
raise a woman's testosterone levels. And it cannot be measured in the blood
like natural testosterone.
Why It Is Used
Methyltestosterone. This hormone product is sometimes also prescribed to menopausal
women for improving sexual desire and
Testosterone is an experimental treatment
used to raise a woman's sexual interest, arousal, and satisfaction. Women with
low androgen levels who might benefit from low-dose testosterone therapy
include those who:
- Have had their ovaries removed (oophorectomy).
This causes a sudden drop in testosterone, which may decrease sex drive and
- Have a low sex drive that does not seem to be caused
by a medicine, nor by relationship or stress-related problems.
- Have an
adrenal system problem or an underactive pituitary
Do not take testosterone if you:2
Some experts advise against using testosterone therapy for women
who have not reached menopause.4 If you use
testosterone and could become pregnant, be sure to use highly effective
How Well It Works
There is not strong enough evidence to support the use of
testosterone for improving menopausal symptoms.2 But for women who no longer have ovaries (or whose ovaries are not working), testosterone with estrogen therapy has been shown to increase sexual desire.1
In many women, testosterone may have a direct effect on sex drive
and sexual response. Women taking testosterone may have more sexual thoughts,
fantasies, activity, and satisfaction.3
There is no solid link between a woman's high testosterone and high
sex drive, nor between low sex drive and low testosterone. You can have a low
testosterone level in your body and have a normal sex drive or have high
testosterone and very little interest in sex.
In women, long-term testosterone side effects have not been
studied. Experts know that:
- Oral testosterone lowers
"good" HDL cholesterol and raises
"bad" LDL cholesterol in the blood. High cholesterol
is known to increase risks of heart disease and
stroke.2 This is why experts
want to know more about long-term oral testosterone therapy.
- Testosterone should not be taken during pregnancy, because it
affects a growing fetus.
Testosterone treatment for longer than 6 months has not been
studied. Experts do not yet know whether it raises risks of breast cancer,
heart disease, or dangerous blood clots. It may increase these risks, because
some testosterone in the body is made into estrogen. Higher-than-normal
estrogen in the body is linked to these risks.2
The goal of testosterone treatment is to raise a woman's
testosterone level no higher than what is normal for a young woman. All current
testosterone products are made for dosing in men. There is not yet a standard
dose or blood test for women, so dosing is adjusted based on your symptoms. You
are taking a dose that is too high if you have:
- Acne or oily skin.
hair loss from the scalp.
- Male-pattern hair growth on the face and
- Anger and hostility problems.
- Shrinking breast
- Hoarseness or a deeper voice.
- Irregular menstrual cycles, if you have been
- An increase in the size of your clitoris.
See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)
What To Think About
Taking testosterone by using a skin patch, gel, or cream does not
seem to affect cholesterol levels, but taking it by mouth does. This is because
hormones are processed through the liver when taken by mouth but not when they
are taken through the skin.2 At this time, there are no such
FDA-approved testosterone products for women.
Some women go to a compounding pharmacist for bioidentical
- Risks of bioidentical hormones are not known to
be any different than risks of hormones made by a pharmaceutical
- Many compounded hormone remedies
for menopausal symptoms include testosterone. Talk to your doctor
about testosterone risks before using any remedy with testosterone in
Many other supplements may interact with testosterone. Be sure to
tell your doctor about any nonprescription medicines, supplements,
or herbs you are taking.
An overdose of
androgens may cause seizures,
hepatitis, problems with blood clot formation, or
other serious health problems. Taking DHEA and testosterone together may be
dangerous. (DHEA is an androgenic dietary supplement that is derived from the
wild yam. It is also called prasterone in the United States.)
Testosterone should not be taken during pregnancy, because it
affects a growing fetus. If you use testosterone and could become pregnant, use
highly effective birth control.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Drugs for female sexual dysfunction (2007). Medical Letter on Drugs and Therapeutics, 49(1259): 33-35.
North American Menopause Society (2005). The role of
testosterone therapy in postmenopausal women: Position statement of the North
American Menopause Society. Menopause, 12(5):
Shifren JL (2004). The role of androgens in female
sexual dysfunction. Mayo Clinic Proceedings, 79(Suppl):
Basaria S, Dobs AS (2004). Safety and adverse effects
of androgens: How to counsel patients. Mayo Clinic Proceedings, 79(Suppl): S25-S32.
North American Menopause Society (2004). Treatment of
menopause-associated vasomotor symptoms: Position statement of the North
American Menopause Society. Menopause, 11(1):