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Do women have a testosterone problem?<\/p>\n
Social media influencers believe they do. And with the rise of telemedicine and testosterone replacement clinics opening up across the country, access to the drug has never been easier.<\/p>\n
In the U.S., prescriptions for testosterone increased nearly 50% between 2013 and 2023, according to recent data from the health technology company IQVIA. Doctors say interest in the hormone isn\u2019t being driven only by men, but also by women in their 40s and 50s.<\/p>\n
\u201cIt feels almost like an epidemic,\u201d Dr. Rebecca Dunsmoor-Su, chief medical officer for Gennev, a national telemedicine company for menopause patients, said about middle-age women seeking testosterone.\u00a0\u201cThey\u2019re being told this is the miracle-drug pill that they\u2019ve been looking for.\u201d<\/p>\n
Because patients are often prescribed testosterone gels, pellets or pills through med-spas and telemedicine, there could be even more women taking the hormone than realized, Dunsmoor-Su said.<\/p>\n
Testosterone is the primary male sex hormone and plays a variety of roles in the human body. In men, testosterone boosts muscle mass, sex drive and deepening of the voice. In women, who also have testosterone generally in much lower levels, it also plays a role in libido, muscular health and energy.<\/p>\n
Typically, testosterone levels in men are around 15 times higher than in women.<\/p>\n
In both women and men, it\u2019s normal for testosterone levels to drop with age \u2014 starting at about age 30 in men and around 40 in women. The decline doesn\u2019t mean that it necessarily needs to be replaced, either for health or longevity.<\/p>\n
Levels for what is considered normal can vary depending on the lab, and just because levels are low, that does not necessarily mean testosterone should be started. Doctors use a combination of symptoms and blood work in deciding whom to treat.<\/p>\n
If a patient does have symptoms of \u201clow T\u201d \u2014 including depression, lethargy and low sex drive \u2014 doctors typically gauge levels with a blood test before deciding treatment.<\/p>\n
Testosterone treatment includes a gel rubbed on the shoulder, pills or an implantable pellet in the buttocks.<\/p>\n
Dr. Amy Voedisch, an OB-GYN at Stanford Medicine in Palo Alto, California, has noticed a dramatic rise in recent years in middle-age women asking for testosterone therapy.<\/p>\n
Perimenopausal symptoms begin when women reach their 40s, triggered by hormonal fluctuations and accompanied by irregular periods, brain fog, insomnia and hair loss. The changes typically begin a few years before menopause, when periods permanently end.<\/p>\n
Some women may notice a decrease in sex drive as levels of estrogen and testosterone, both of which play a role in libido, start to decline as they get older.<\/p>\n
\u201cI\u2019ll talk about menopausal hormone therapy and then they\u2019ll say \u2014 but what about testosterone?\u201d<\/p>\n
Topical testosterone products first hit the market in the early 2000s. <\/p>\n
Voedisch, who has been in practice for decades, says the phenomenon among women <\/strong>really started to take off just in the last couple of years. Previously, interest in testosterone therapy rarely came up in appointments, she said.<\/p>\n Now, virtually every new menopause patient she sees will ask about it.<\/p>\n A patient will say, \u201cI was listening to this podcast, and they said that I needed this,\u201d she said. \u201cOr I have this Instagram person that I follow and she said that I absolutely have to be on it.\u201d<\/p>\n On the Reddit community r\/menopause, scores of posts tout the drug\u2019s benefits of improved energy and sex drive for women.<\/p>\n Few of the claims are supported by evidence, Dunsmoor-Su said.<\/p>\n \u201cIt\u2019ll give them energy, it\u2019ll make them thin, it will make them horny, like they\u2019ve been promised,\u201d she said, describing common claims about the drug. \u201cIt does everything \u2014 and all of their problems are just because they\u2019re a little low in testosterone.\u201d<\/p>\n Dr. Traci Kurtzer, a menopause specialist at the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago, agreed the push for testosterone started happening in recent years. Her patients inquire about testosterone therapy for multiple problems \u2014 to improve mood, energy, sex drive, brain fog and muscle mass.<\/p>\n She tells patients that testosterone therapy is currently only recommended for a low sex drive, although future research may find other benefits.<\/p>\n \u201cIf that\u2019s the case, that\u2019ll be wonderful, but at this point in time we don\u2019t have the data to support that,\u201d Kurtzer said.<\/p>\n The Food and Drug Administration hasn\u2019t approved testosterone therapy for women. However, doctors can prescribe it for low sex drive after other causes, including medical and psychological ones, are ruled out, said Dr. Jan Shifren, director of Massachusetts General Hospital\u2019s Midlife Women\u2019s Health Center in Boston.<\/p>\n Shifren, who has been involved in clinical trials looking at testosterone therapy in women, said that the benefits for women with low libido aren\u2019t terribly impressive.<\/p>\n \u201cWomen who are randomized to testosterone, compared with placebo, have one additional satisfying sexual event in four weeks, compared with placebo,\u201d she said.<\/p>\n In addition to declining hormonal levels, causes of low libido in women can include relationship problems, anxiety or depression, and metabolic conditions such as high blood pressure or diabetes. Discomfort from vaginal dryness from menopause is another reason. Exhaustion from caregiving and other family responsibilities also take their toll, doctors say.<\/p>\n Shifren urges women to address all other possible causes of low libido before starting testosterone.<\/p>\n \u201cIt\u2019s not that I don\u2019t sometimes prescribe it, but it\u2019s after addressing a lot of other concerns,\u201d she said.<\/p>\n For Marcella Hill, 44, the symptoms of depression, body aches and low sex drive were affecting her relationship with her husband.<\/p>\n \u201cI was really suffering,\u201d said Hill who lives in Vineyard, Utah. Her doctor told her that <\/strong>it was just normal.<\/p>\n \u201cI thought that\u2019s insane. I can\u2019t live like this,\u201d Hill said.<\/p>\n At first, she was given a testosterone gel prescription but didn\u2019t notice an improvement and found it hard to use.<\/p>\n Frustrated that her doctor didn\u2019t offer more help, she went to a local medical clinic at a friend\u2019s urging and started testosterone pellet therapy, a more potent version of the hormone.<\/p>\n After two years of treatment, she says the results have been life-changing.<\/p>\n \u201cA couple months into it, all of a sudden my libido turns back on,\u201d she said. \u201cI want to be with my husband and I have this passion, this desire that I hadn\u2019t had since college.\u201d<\/p>\n She posts about her testosterone therapy on Instagram and other social media.<\/p>\n \u201c\u200b\u200bI opened TikTok to just tell that story, and the next day my phone blew up with 9 million views,\u201d she said. \u201cWomen all over the whole world were like, \u2018Wait, I have all these symptoms.\u2019\u201d<\/p>\n Hill isn\u2019t paid for promoting testosterone, although she has worked with a telehealth company in ads urging women to get regular medical checkups.<\/p>\n She gets her levels checked regularly and says that her testosterone is closer to the low end for a male. While she is not worried about her high levels, she does have an unwanted side effect \u2014 excess hair growth on her face.<\/p>\n When prescribed by a doctor and carefully monitored, testosterone is relatively safe for women and side effects are rare, experts said.<\/p>\n When men start testosterone therapy, it is typically given in a gel with a dose of 50-100 mg a day.<\/p>\n Women, on the other hand, are recommended to take just 5 mg a day \u2014 10% of the dose of a man.<\/p>\n Higher doses for women can cause side effects including acne, excessive body hair and even body odor. Some are permanent.<\/p>\n Voedisch recalls one patient who finally stopped testosterone therapy after her voice was altered.<\/p>\n \u201cShe said, \u2018What really did it for me was once I was on the phone and somebody called me \u2018sir,\u2019\u201d said Voedisch.<\/p>\n Voedisch warned about side effects from improper dosing. \u201cIt may not get better even once you stop, which is really unfortunate.\u201d<\/p>\n She\u2019s sympathetic to patients who feel ignored by doctors and are frustrated with the lack of treatment options available for perimenopausal and menopausal symptoms.<\/p>\n \u201cWe have ignored women\u2019s health for a very long time in this country,\u201d said Voedisch. \u201cThis comes from a place of frustration and it comes from a place of wanting to feel better.\u201d<\/p>\n<\/div>\nDoes testosterone help women?<\/strong><\/h2>\n
Is testosterone therapy safe?<\/h2>\n