When it comes to hormones, testosterone isn’t only a guy thing. It’s known as a male hormone. But, testosterone is produced by women, too. Women produce a smaller amount. It’s like a subtle player in the background, influencing various aspects of our health.

What does testosterone do for women?

Testosterone wears many hats in the female body. Here’s a glimpse into a few examples.

Sex Drive and Fertility

Testosterone revs up your libido. It’s the fuel behind that fire, contributing to your desire for intimacy. What’s more, testosterone even plays a role in your reproductive system. It affects your ovarian function and egg production.

Mood and Energy

This hormone can give you a boost of energy and positively affect your mood. It’s like a natural pick-me-up.

Muscle Mass

Testosterone aids in maintaining muscle mass and bone density. To this end, it’s like a supportive friend for your body’s structure.

Brain Function

Testosterone has links to cognitive function and memory. It’s like a little brain enhancer.

Hair Growth

In healthy levels, testosterone contributes to facial and body hair growth. It’s what gives us those fine hairs in certain areas.

When is testosterone a concern?

Like all hormones, balance is key. When testosterone levels get out of whack, it can lead to unwanted changes. Here are some signs to look out for:

  1. Irregular periods and acne. There are many reasons a menstrual cycle may become irregular. Conversely, it could be due to imbalanced hormones, including testosterone. An increase in testosterone might trigger breakouts and oily skin.
  2. Mood swings. Hormone imbalances can lead to mood swings, irritability, or even depression.
  3. Hypoactive Sexual Desire Disorder (HSDD) or Low libido. If your sex drive takes a nosedive, it might be related to testosterone levels.

What causes imbalanced testosterone levels?

Several factors can throw off your testosterone balance.

  1. Polycystic Ovary Syndrome (PCOS). PCOS is a common condition. It can lead to higher testosterone levels in women.
  2. Age and stress. Testosterone levels decline as you get older, resulting in various symptoms. Without a doubt, stress can mess with your hormone levels, including testosterone.
  3. Medications. Certain medications can impact hormone production, affecting your testosterone levels.

What does testosterone in women treat?⁣

Currently, it’s only indicated for appropriately treating Hypoactive Sexual Desire Disorder (HSDD) or distressing low libido that cannot be explained by other causes⁣. It should NOT be used for anything else, i.e. fatigue, weight gain, sleep, hot flashes⁣, etc. However, we do know that there is a large placebo effect. Accordingly, use of testosterone in women (who are not FTM) is considered off-label but has been shown to be beneficial in 1 diagnosis⁣.

Who is an appropriate candidate?⁣

Only postmenopausal women and possibly perimenopausal women⁣. It is NOT appropriate for pre-menopausal women⁣.

Should it be monitored?⁣

Yes, monitor with baseline labs: testosterone, liver function tests, fasting lipids⁣. subsequently testosterone levels should be followed at least every 6 months.

How is treatment?⁣

Usually in the form of patches, creams, gels⁣. The appropriate dose is 1/10th of the normal male dose⁣. Be very wary of testosterone injections and pellets. They have highly variable dosing and absorption and can lead to extremely high levels of testosterone in inexperienced hands⁣.

The NAMS (North American Menopause Society) states pellets can be used in certain dosages. But, this should only be done and followed by appropriately trained, NAMS certified physicians (NCMP), or ISSWSH Fellows (IF, International Society for the Study of Women’s Sexual Health). NCMP and IF are certifications for providers with specialized training in menopause and sexual health⁣.

What are the side effects?⁣

If doses are too high, you can get acne, coarse hair, balding, voice deepening, and clitoromegaly⁣. The side effects are often not reversible.

What are the long-term risks?⁣

The long term risks are not well known at this point as there is not enough data. In addition, there is concern for increased risk of heart disease and breast cancer⁣. Finally, psychotherapy and sex therapy are also treatment options for Hypoactive Sexual Desire Disorder (HSDD) or low libido.

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