Testosterone and Women’s Health: What the Science Actually Says

By Christine Sagan, MSN, APRN, FNP-BC

Many people think of testosterone as a “male hormone.” But women produce testosterone too.

In women, testosterone is made primarily in the ovaries and adrenal glands. It also has receptors throughout the body, including the brain, muscles, bones, and genital tissue. This means it plays a role in several aspects of health and well-being.

Understanding what testosterone does, and when treatment may be appropriate, can help women make more informed decisions about their care.

What Testosterone Does in Women

Testosterone supports several important systems in the body.

Sexual desire and arousal

The most well-studied role of testosterone in women relates to libido. Research shows it can help address hypoactive sexual desire disorder (HSDD) in postmenopausal women. This condition involves persistent low sexual desire that causes personal distress.

Mood and sense of well-being

Some studies suggest that restoring testosterone to physiologic levels may support improvements in mood, confidence, and overall vitality. These effects vary from person to person, and research is still evolving.

Muscle mass and strength

Testosterone helps maintain lean muscle. This becomes especially important with age, when muscle mass naturally declines. Healthy muscle supports strength, metabolic health, and daily physical function.

Bone health and cognition

Early research suggests possible benefits for bone density and cognitive function. These areas are still being studied and are not currently considered primary reasons to prescribe testosterone therapy.

Because testosterone affects multiple systems, women who receive appropriate treatment sometimes describe feeling more like themselves again.

Why Isn’t There an FDA-Approved Testosterone for Women?

Despite the role testosterone plays in women’s health, there is currently no testosterone product approved specifically for women in the United States.

The FDA has approved testosterone only for men with documented hypogonadism.

A number of medical organizations have reviewed the available research. Groups including the North American Menopause Society, the Endocrine Society, and the International Society for the Study of Women’s Sexual Health agree on one key point:

The only evidence-based indication for testosterone therapy in women right now is postmenopausal hypoactive sexual desire disorder.

In the past, pharmaceutical companies attempted to develop female-specific testosterone patches. These efforts were not approved, largely due to concerns about long-term safety, including potential effects on cardiovascular health, breast health, and androgen-related side effects.

Because there is no product specifically designed for women, clinicians who prescribe testosterone typically use low-dose compounded formulations, such as creams or pellets, off label.

What Medical Guidelines Currently Recommend

Most major medical societies are relatively aligned in their recommendations.

They generally support:

• Low-dose transdermal testosterone for carefully diagnosed postmenopausal HSDD

• Monitoring hormone levels and symptoms during treatment

They also emphasize caution.

Current evidence is not strong enough to broadly recommend testosterone for:

• mood

• energy

• cognitive concerns

• bone health

• general anti-aging purposes

  
  

Research in these areas is ongoing.

Bridging the Gap Between Research and Experience

Interest in testosterone therapy among women has grown significantly.

Many women report symptoms such as low desire, fatigue, brain fog, or loss of drive during midlife. At the same time, there are still limited approved treatment options specifically designed for women.

Recent media coverage and emerging research have highlighted this gap between women’s lived experiences and the pace of regulatory approval.

An Integrative Perspective

From an integrative medical standpoint, testosterone is only one piece of the picture.

Before considering hormone therapy, it is important to look at foundational factors that strongly influence energy, mood, and desire, including:

• sleep quality

• chronic stress

• nutrition

• thyroid health

• balance of estradiol and progesterone

• medications that may affect libido

• relationship and emotional factors

  
  

When these areas are addressed, some women find that symptoms improve without additional hormone therapy.

For others, testosterone may become part of a thoughtful treatment plan.

The Bottom Line

Testosterone is an important hormone in women’s physiology.

For the right woman, at the right dose, and for the right reason, testosterone therapy can be a helpful tool. At the same time, it requires careful evaluation, individualized decision-making, and ongoing monitoring.

Like much of women’s healthcare, the goal is not simply treatment. It is thoughtful, evidence-based care that looks at the whole person.