Many people think of testosterone as a “male hormone,” but women also produce and need testosterone. In women, this hormone plays an important role in sexual desire, energy levels, and body composition.
Testosterone is made in small amounts by the ovaries, adrenal glands, and other tissues in the body. While levels are much lower than in men, testosterone still has meaningful effects on how women feel and function.
This article explains how testosterone works in women, how levels change with age, when treatment may be considered, and how doctors monitor therapy for safety.
Women produce testosterone in three main places:
Testosterone levels naturally fluctuate during the menstrual cycle and tend to rise around the middle of the cycle (around ovulation).
As women age, testosterone levels gradually decline. Levels often fall significantly after menopause.
Testosterone plays an important role in sexual desire (libido).
Research shows that many women experience a temporary increase in sexual desire around ovulation, when testosterone levels briefly rise.
Testosterone affects both:
After menopause, lower testosterone levels may contribute to reduced libido or sexual interest in some women.
In some women, particularly after menopause, doctors may consider testosterone therapy to treat a condition called hypoactive sexual desire disorder (HSDD).
HSDD occurs when a woman experiences:
Testosterone therapy has been shown in multiple studies to improve sexual desire in some women with this condition.
However, in the United States there is no testosterone medication specifically approved by the FDA for women, so treatment is usually prescribed off-label by experienced clinicians.
When testosterone is prescribed for women, the doses are much lower than those used in men.
The most common forms are:
These medications are applied to the skin so that small amounts of testosterone are absorbed into the bloodstream.
Because testosterone can transfer from skin to other people, patients should take precautions after applying the medication. Contact with children or pets should be avoided until the medication has fully absorbed.
When therapy is carefully dosed and monitored, some women report:
Some women also notice improvements in:
These effects may be helpful during postmenopausal changes, when muscle mass often decreases and body fat tends to increase.
Side effects are more likely if testosterone levels become too high.
Potential side effects include:
Because testosterone can also affect cholesterol levels and metabolism, doctors usually monitor blood tests during treatment.
Long-term safety data in women are still limited, which is why therapy should always be supervised by a knowledgeable clinician.
If testosterone therapy is started, doctors typically monitor:
The goal is to keep testosterone levels within the normal female range, not the male range.
If side effects occur or hormone levels become too high, the dose may be adjusted or therapy stopped.
Because testosterone therapy for women is not FDA-approved in the United States, doctors and patients should discuss:
Shared decision-making helps ensure treatment is safe and appropriate for each individual patient.
Testosterone is an important hormone for women and plays a role in sexual desire, energy, and body composition.
For some postmenopausal women with distressing low libido, carefully monitored low-dose testosterone therapy may improve sexual desire and satisfaction.
However, treatment should always be supervised by an experienced clinician to ensure hormone levels remain in the normal female range and to monitor for side effects.