Can Women Take Testosterone? Benefits, Safety, and What to Know

The question “can women take testosterone?” comes up frequently, and the answer may surprise many people. Yes, women not only can take testosterone — many women genuinely need it. Through a carefully managed female hormone replacement therapy program, women can safely restore testosterone to optimal levels. Testosterone is not exclusively a male hormone. Women produce it naturally, depend on it for critical aspects of their health, and can experience significant symptoms when levels decline.

Despite this, testosterone deficiency in women remains vastly underdiagnosed and undertreated. Most conventional medical practices do not routinely test women’s testosterone levels, and many women suffer for years with symptoms that are dismissed as “just part of getting older” or attributed solely to estrogen and progesterone changes. Understanding how testosterone functions in the female body, recognizing deficiency symptoms, and knowing what safe, effective treatment looks like is essential for women seeking comprehensive hormonal health.

Why Women Need Testosterone

Women produce testosterone primarily in the ovaries and adrenal glands, with smaller amounts converted from other androgens in peripheral tissues. While women produce roughly one-tenth to one-twentieth the amount that men produce, testosterone is far from insignificant in the female body. It is, in fact, the most abundant biologically active hormone in women throughout most of their adult lives — women have more testosterone than estradiol at every stage of life (1).

Testosterone plays essential roles in women’s health, including:

• Sexual desire and arousal — Testosterone is the primary hormonal driver of libido in women, just as it is in men
• Sexual satisfaction — Testosterone supports genital sensitivity, arousal response, and orgasm quality
• Energy and vitality — Adequate testosterone levels support sustained energy, motivation, and overall sense of well-being
• Muscle mass and strength — Testosterone promotes lean muscle development and maintenance
• Bone density — Testosterone works alongside estrogen to maintain skeletal health
• Cognitive function — Testosterone receptors in the brain support memory, focus, and mental clarity
• Mood regulation — Testosterone influences neurotransmitter systems involved in mood stability and emotional resilience
• Body composition — Adequate testosterone supports healthy fat distribution and metabolic function

When testosterone levels decline, the effects can be pervasive and profoundly disruptive to a woman’s quality of life.

How Testosterone Declines in Women

Women’s testosterone levels begin declining in their late twenties to early thirties — even earlier than many realize. By the time a woman reaches menopause, her testosterone levels may be roughly half of what they were at peak production (2). Several factors contribute to this decline:

Age-Related Decline

Testosterone production from the ovaries and adrenal glands gradually decreases with age. Unlike estrogen, which drops sharply during menopause, testosterone decline is more gradual and often begins a full decade or more before menopause.

Menopause and Perimenopause

While menopause is primarily characterized by the decline of estrogen and progesterone, testosterone levels also decrease during this transition. The ovaries continue to produce some testosterone after menopause, but overall production is diminished. For a closer look at the transition itself and how hormone therapy fits, see our guide to signs of menopause and HRT.

Surgical Menopause (Oophorectomy)

Women who have their ovaries removed experience an immediate and dramatic drop in testosterone — often a 50 percent reduction virtually overnight. This can produce sudden, severe symptoms that are often inadequately addressed with estrogen therapy alone.

Oral Contraceptive Use

Birth control pills significantly increase sex hormone-binding globulin (SHBG), the protein that binds testosterone and renders it inactive. Women on oral contraceptives frequently have very low free testosterone levels, which can cause symptoms even if total testosterone appears normal. Importantly, elevated SHBG levels can persist for months or even years after discontinuing oral contraceptives (3).

Adrenal Insufficiency

The adrenal glands produce a significant portion of androgens in women. Conditions affecting adrenal function, chronic stress, and long-term corticosteroid use can all suppress adrenal androgen output.

Other Contributing Factors

Additional causes of low testosterone in women include hypothalamic or pituitary disorders, chemotherapy, radiation therapy, chronic illness, excessive exercise, severe caloric restriction, and certain medications including opioids and some antidepressants.

Symptoms of Low Testosterone in Women

Low testosterone in women produces a constellation of symptoms that overlap significantly with other conditions, which is why it is so frequently missed. Common symptoms include:

Sexual Symptoms

• Markedly reduced or absent libido
• Difficulty becoming sexually aroused
• Decreased genital sensitivity
• Reduced frequency or intensity of orgasms
• Vaginal dryness (often in combination with low estrogen)
• Pain during intercourse
• General loss of interest in physical intimacy

These sexual symptoms are often the most distressing and the most common reason women seek evaluation. Research published in the New England Journal of Medicine has demonstrated that testosterone therapy significantly improves sexual desire and satisfaction in women with low androgen levels (4).

Physical Symptoms

• Persistent fatigue and low energy despite adequate sleep
• Loss of muscle tone and reduced exercise capacity
• Increased body fat, particularly around the midsection
• Decreased physical stamina
• Thinning hair on the scalp
• Dry, aging skin
• Joint discomfort

Cognitive and Emotional Symptoms

• Brain fog and difficulty concentrating
• Memory lapses
• Reduced motivation and drive
• Flat mood or emotional blunting
• Increased anxiety or depression
• Reduced sense of confidence and well-being
• Irritability

Many women visit multiple doctors over months or years seeking answers for these symptoms before testosterone is ever tested. When it finally is, the diagnosis often becomes immediately clear.

Benefits of Low-Dose Testosterone Therapy for Women

Clinical research has consistently demonstrated meaningful benefits of testosterone therapy for women with documented deficiency. The key phrase is “low-dose” — female testosterone therapy uses a fraction of male doses to restore levels to the normal female physiological range, not to achieve male levels.

Improved Sexual Function

The most extensively studied benefit is the restoration of sexual desire and function. A landmark systematic review and meta-analysis by Islam et al. published in The Lancet Diabetes & Endocrinology in 2019, which pooled data from 46 randomized controlled trials, found that testosterone therapy in postmenopausal women significantly increased satisfying sexual events, sexual desire, pleasure, arousal, orgasm, responsiveness, and self-image while decreasing sexual concerns and distress (5). Multiple individual trials reached the same conclusion: the INTIMATE NM1 study in naturally menopausal women on stable estrogen (Shifren et al. 2006) and the ADORE study in naturally menopausal women not using hormone therapy (Panay et al. 2010) both demonstrated significant improvements in satisfying sexual episodes, sexual desire, and personal distress with transdermal testosterone (5a, 5b).

The Global Consensus Position Statement on the Use of Testosterone Therapy for Women, published in 2019 by an international panel of experts from multiple medical societies, endorsed testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD) after other causes have been excluded (6).

Increased Energy and Vitality

Many women report a dramatic improvement in overall energy, motivation, and sense of well-being within weeks of starting testosterone therapy. The persistent fatigue that characterizes low testosterone often lifts noticeably, allowing women to re-engage with exercise, work, and daily activities with renewed vigor.

Better Body Composition

Testosterone supports lean muscle mass development and can help shift body composition toward more muscle and less fat. This is particularly valuable for women who have been unable to maintain muscle tone despite regular exercise — a common frustration with low testosterone. For women whose primary goal is fat loss, combining hormone optimization with a medical weight loss program can accelerate results.

Enhanced Mood and Cognitive Function

Clinical evidence supports improvements in mood, motivation, and cognitive clarity with testosterone optimization. Women frequently describe feeling “sharper,” more focused, and more emotionally resilient once levels are restored.

Bone Health Support

Testosterone works synergistically with estrogen to maintain bone mineral density. For postmenopausal women, the combination of estrogen and testosterone therapy may provide superior bone protection compared to estrogen alone (7).

Safety of Testosterone Therapy for Women

Safety is understandably a primary concern for women considering testosterone therapy. The evidence to date, when therapy is properly dosed and monitored, is reassuring.

Dosing: The Critical Difference

The most important safety factor is appropriate dosing. Female testosterone therapy typically uses:

• Topical creams or gels: Compounded to deliver 0.5 to 2 mg daily (compared to 50 to 100 mg daily in men)
• Subcutaneous pellets: Dosed at a fraction of male pellet doses
• Injections: Much lower doses and less frequent than male protocols

The goal is to restore testosterone to the mid-normal female range (approximately 30 to 50 ng/dL total testosterone), not to push levels into the male range. At these physiological doses, the risk of masculinizing side effects is minimal.

Potential Side Effects at Appropriate Doses

• Acne — Mild acne can occur, typically manageable with dosage adjustment or topical treatment
• Increased hair growth — Some women may notice slightly increased fine hair in androgen-sensitive areas; this is usually mild and dose-dependent
• Oily skin — A temporary effect that often stabilizes as the body adjusts
• Mood changes — Rarely, some women may experience increased irritability initially, which typically resolves with dose optimization

What About More Serious Concerns?

Cardiovascular health: The 2019 Global Consensus Statement noted that existing evidence does not demonstrate increased cardiovascular risk in women using physiological-dose testosterone therapy (6). However, long-term data beyond 24 months remains limited, underscoring the importance of ongoing monitoring.

Breast cancer: Current evidence has not demonstrated an increased risk of breast cancer with testosterone therapy at physiological doses. Some research has even suggested a potential protective effect, though this requires further study (8).

Liver function: Oral testosterone formulations (methyltestosterone) carry liver concerns and are not recommended. Transdermal and injectable formulations bypass first-pass liver metabolism and do not pose the same risks.

When Side Effects Do Occur

Virilizing side effects (deepened voice, significant facial hair growth, clitoral enlargement) are associated with excessive doses and are not expected at physiological female replacement levels. If any concerning changes occur, dose reduction or discontinuation typically reverses them. This is why regular monitoring and working with an experienced provider are essential.

How Rewind Anti-Aging Miami Approaches Female Testosterone Therapy

At Rewind, we take a thorough, evidence-based approach to testosterone therapy for women. Our process is designed to ensure safety, optimize results, and address the whole picture of hormonal health — not just a single hormone in isolation.

Comprehensive Evaluation

Every treatment plan begins with a detailed assessment:

• Symptom review — A thorough discussion of all symptoms, their timeline, and their impact on quality of life
• Medical history — Including menstrual history, surgical history, medication use, and prior hormonal treatments
• Comprehensive lab work — Including total and free testosterone, SHBG, DHEA-S, estradiol, progesterone, thyroid panel, complete metabolic panel, and other relevant markers through our diagnostic testing services

Individualized Treatment Design

Based on lab results and clinical presentation, we develop a personalized protocol that may include:

• Testosterone therapy — Typically topical cream compounded to female-appropriate concentrations, with dosing tailored to individual needs
• Estrogen and progesterone optimization — Through our female HRT program and including bioidentical hormone therapy options for women, addressing the full spectrum of hormonal changes rather than testosterone alone
• DHEA supplementation — When adrenal androgen precursors are low
• Additional support — Including peptide therapy or sexual health treatments as appropriate

Ongoing Monitoring

We recheck labs at 6 to 8 weeks after initiating therapy and at regular intervals thereafter to:

• Confirm testosterone levels are in the target range
• Assess estradiol levels (testosterone can convert to estrogen)
• Monitor liver function, lipids, and blood counts
• Evaluate symptom improvement and adjust dosing as needed
• Watch for any side effects and address them promptly

What Results to Expect

Women typically begin noticing improvements within 3 to 6 weeks of starting therapy:

• Weeks 2-4: Increased energy, improved mood, and initial improvement in sense of well-being
• Weeks 4-8: Noticeable improvement in libido, arousal, and sexual satisfaction
• Months 2-4: Enhanced body composition, improved exercise performance, and continued cognitive and mood benefits
• Months 4-6: Full optimization of all benefits with ongoing stable improvement

Who Is a Good Candidate for Female Testosterone Therapy?

Testosterone therapy may be appropriate for women who:

• Have documented low testosterone levels confirmed by lab work
• Are experiencing symptoms consistent with testosterone deficiency, particularly low libido, fatigue, or cognitive changes
• Are postmenopausal or perimenopausal with declining androgen levels
• Have had a surgical oophorectomy (ovary removal)
• Have adrenal insufficiency or are recovering from prolonged oral contraceptive use
• Have not found adequate symptom relief with estrogen and progesterone therapy alone
• Do not have contraindications such as androgen-sensitive cancers, uncontrolled polycystic ovary syndrome, or pregnancy

Taking the Next Step

If you have been experiencing persistent fatigue, low libido, brain fog, mood changes, or other symptoms that have not been adequately explained, testosterone may be the missing piece. Too many women suffer unnecessarily because this critical hormone is not part of the standard workup.

At Rewind Anti-Aging Miami, our female sexual health and female HRT programs provide comprehensive evaluation and evidence-based treatment to help you feel like yourself again. Schedule a consultation to discuss your symptoms, get comprehensive lab work, and find out whether testosterone optimization is right for you.

Related Articles

• TRT vs HRT: Understanding the Difference
• Signs of Low Testosterone in Men: Symptoms, Testing, and Treatment
• PT-141 for Sexual Health

See how your treatment plan is designed or view real patient results.

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Considering testosterone therapy for women? Rewind Anti-Aging of Miami offers personalized female HRT programs with comprehensive lab work and ongoing monitoring. Schedule a consultation →

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FDA Disclaimer: Testosterone therapy for women is prescribed off-label in the United States, as there is currently no FDA-approved testosterone product specifically formulated for women. Off-label prescribing is a common and legal medical practice, and the Global Consensus Position Statement endorsed by multiple international medical societies supports the use of testosterone therapy for appropriately selected women. Treatment should be supervised by a qualified medical provider with expertise in female hormone therapy.

References

1. Davis SR, Wahlin-Jacobsen S. Testosterone in women — the clinical significance. Lancet Diabetes Endocrinol. 2015;3(12):980-992.
2. Zumoff B, Strain GW, Miller LK, et al. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab. 1995;80(4):1429-1430.
3. Zimmerman Y, Eijkemans MJ, Coelingh Bennink HJ, et al. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(1):76-105.
4. Shifren JL, Braunstein GD, Simon JA, et al. Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. N Engl J Med. 2000;343(10):682-688.
5. Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754-766. PMID: 31353194. 5a. Shifren JL, Davis SR, Moreau M, et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 Study. Menopause. 2006;13(5):770-779. PMID: 16932240. 5b. Panay N, Al-Azzawi F, Bouchard C, et al. Testosterone treatment of HSDD in naturally menopausal women: the ADORE study. Climacteric. 2010;13(2):121-131. PMID: 20166859.
6. Davis SR, Baber R, Panay N, et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab. 2019;104(10):4660-4666.
7. Watts NB, Notelovitz M, Timmons MC, et al. Comparison of oral estrogens and estrogens plus androgen on bone mineral density, menopausal symptoms, and lipid-lipoprotein profiles in surgical menopause. Obstet Gynecol. 1995;85(4):529-537.
8. Glaser RL, Dimitrakakis C. Testosterone therapy in women: myths and misconceptions. Maturitas. 2013;74(3):230-234.