Testosterone Isn't Just for Men: What It Can Do for Women

You're exhausted. Your sex drive has vanished. You just don't feel like yourself. And when you finally bring it up, you hear what so many women hear: "It's just stress." "It's your age." "That's life with kids."

Sound familiar? You're far from alone. In a recent Oregon Health & Science University study, more than 60% of women with moderate to severe menopause symptoms weren't getting any treatment. The number one reason? Their doctor never recommended it. And in a survey of 1,000 women in Utah and neighboring states, women were more likely to be handed an antidepressant or sleeping pill than to have their hormones looked at, even when hormones were the root of the problem.

Here's the truth: your symptoms are real, and they have a cause. Finally understanding why you feel the way you do can be incredibly validating. It's often the moment hope comes back, because once you know what's going on, you can actually do something about it.

That's why we look at your health from every angle. Sleep, stress, thyroid, nutrition, iron, and hormones all shape how you feel. And one of the most powerful, and most overlooked, pieces of that puzzle is testosterone.

By the time you hit your 40s, you've likely lost about half the testosterone you had in your 20s. Most women have no idea.

Wait, Women Have Testosterone? Why Levels Decline

Absolutely. Your ovaries and adrenal glands make it every day, just in smaller amounts than men. It plays a role in everything from your sex drive to your muscles, bones, and mood.

Unlike estrogen, testosterone doesn't fall off a cliff at menopause. It slides slowly, starting as early as your 20s. Research suggests levels drop by about 50% between age 20 and age 60. Surgical removal of the ovaries causes a much faster drop, and birth control pills and oral estrogen can lower the amount your body can actually use.

Low Testosterone in Women: Signs You're Not Imagining

Low sexual desire is the most common sexual concern women have. In one national study, about 1 in 4 premenopausal women reported low desire. After menopause, that number climbed past 50%.

Low testosterone isn't always the cause, but it may be part of the picture if you notice:

• Your sex drive has faded and it bothers you
• Intimacy feels less satisfying than it used to
• You're tired in a way sleep doesn't fix
• You're strength training but can't build muscle
• Your mood feels flat, even when life is good
• It all started around perimenopause, menopause, or after a hysterectomy

These symptoms overlap with thyroid issues, low iron, poor sleep, and depression too. That's why we never guess. We test. See what blood tests to get before starting hormone therapy.

What the Research Actually Says

Here's the honest version.

The strongest evidence: An international consensus of menopause and endocrine experts found that testosterone can improve desire, arousal, and satisfaction in postmenopausal women with low libido that causes them distress.

The surprising part: There's still no FDA-approved testosterone made for women in the U.S. So it's prescribed off label, usually as a low-dose compounded cream. Some experts caution that compounded products can vary in strength from pharmacy to pharmacy. That's why where your cream comes from, and who's checking your levels, really matters.

More Than Your Sex Drive

Libido gets all the attention, but testosterone receptors are found all over a woman's body, including the brain, muscles, and bones. That's why researchers are looking at its role in much more:

• Energy and motivation. Many women describe feeling like the "spark" came back, with more drive to get through the day.
• Mood and well-being. Some women report feeling steadier, more confident, and less flat.
• Muscle and strength. Testosterone helps your body build and keep lean muscle, which matters more every year after 40.
• Bone health. It plays a role in bone density, an important piece of protecting yourself from osteoporosis down the road.
• Focus and brain fog. Researchers are studying its effects on memory and mental clarity, though answers are still early.

To be clear, these benefits are still being studied and aren't guaranteed. Every woman responds differently. That's exactly why we track how you feel, not just your lab numbers.

Why Who Prescribes Testosterone for Women Matters

Here's something most women don't realize: the dose that helps a woman is a tiny fraction of what a man uses. Research on women has typically used doses roughly one-tenth of a man's daily dose.

That small margin is where problems happen. Too little and you won't notice a difference. Too much and side effects can creep in. There's no one-size-fits-all dose. Getting it right takes a provider who:

• Starts low and adjusts slowly based on how you feel and respond
• Checks your labs regularly to keep levels in the healthy female range
• Knows the warning signs and adjusts before small side effects become big ones
• Looks at the whole picture, including estrogen, progesterone, thyroid, and your health history

Testosterone done carefully can be life changing. Testosterone done carelessly is how women end up with side effects they never signed up for.

How We Prescribe Testosterone for Women at Abbott

The goal is simple: bring your levels back to where a healthy younger woman's would be. Never into the male range.

1. We start with labs. A comprehensive blood panel gives us your baseline and helps rule out other causes. We also use a salivary hormone test to round out your broader hormone picture.
2. We use a low-dose cream. Most patients use a compounded cream that lets us fine-tune small doses. We only work with licensed, regulated compounding pharmacies. It's often paired with estrogen or progesterone in a bioidentical hormone plan.
3. We recheck and adjust. Follow-up labs make sure your levels stay right where they should be.
4. We give it a fair trial. Most women who benefit notice changes within a few weeks to a few months.

Will It Make Me Look Masculine?

This is the number one fear I hear, and the short answer is no, not at the right dose.

When levels stay in the female range, side effects are uncommon and usually mild, like acne, oily skin, or a few extra hairs. Lowering the dose typically fixes them. Bigger changes, like a deeper voice or hair thinning, are rare at proper doses.

Testosterone isn't for everyone. It's not used during pregnancy, breastfeeding, or while trying to conceive. It needs extra caution with a history of hormone-sensitive breast cancer or certain liver conditions. We'll go over your history together.

Is Testosterone Therapy Safe for Women?

Here's the honest answer: so far, the short-term research is reassuring, but we don't have long-term data yet.

Your heart: Testosterone applied to the skin hasn't been shown to negatively affect cholesterol the way oral testosterone can. That's one reason we use creams instead of pills.

Your breasts: Short-term studies of testosterone through the skin show it doesn't increase breast density or breast cancer risk. Even more interesting, early lab research from Cedars-Sinai found that testosterone seemed to calm the estrogen signals in breast tissue, the same signals that fuel the most common type of breast cancer. That research is in its earliest stages and was done on a small group of people, so it's not proof. But it's an exciting area to watch.

What we don't know yet: Most studies have followed women for about two years or less. That's why we monitor closely, recheck labs, and revisit your plan regularly instead of setting it and forgetting it.

The Bottom Line

Testosterone matters for women, and it declines years before menopause. If your energy, mood, or sex drive have slipped and no one has checked your hormones, that's worth changing. Learn more about hormone therapy at Abbott, low libido in women, and care through perimenopause and menopause, or book a consultation and let's start with your labs.

Sources

• Zumoff et al., Journal of Clinical Endocrinology & Metabolism, 1995
• Monash University: testosterone declines with age, not menopause
• West et al., Archives of Internal Medicine, 2008
• Global Consensus Position Statement on Testosterone Therapy for Women, 2019
• Cedars-Sinai: how androgen therapy affects breast tissue
• OHSU study: many patients aren't receiving treatment for menopause symptoms
• Fox 13: survey finds menopause care gaps leave many women feeling dismissed

This page is for general information and does not constitute medical advice. Treatment recommendations are individualized and confirmed at your consultation. — Abbott Health & Wellness, 45 North State Street, Salina, UT 84654.