Testosterone Therapy for Women: The Overlooked Hormone That Changes Everything

The Missing Piece in Women’s Hormone Therapy

Most women who come to discuss hormone therapy are aware of estrogen and progesterone. Far fewer know that testosterone — typically thought of as a male hormone — is produced by women’s ovaries and adrenal glands in amounts sufficient to play critical physiological roles, and that testosterone deficiency in women is common, underdiagnosed, and profoundly impactful on quality of life.

Women produce approximately one-tenth the testosterone of men, but their receptor sensitivity is proportionally higher — meaning small changes in testosterone levels can produce significant effects. Testosterone production in women peaks in the early 20s and declines progressively, with a particularly sharp drop around menopause as ovarian testosterone production ceases alongside estrogen and progesterone.

What Testosterone Does for Women

Testosterone exerts effects in women across multiple domains that are often attributed entirely to estrogen or progesterone deficiency:

• Libido and sexual function: Testosterone is the primary driver of sexual desire in women, as in men. Low testosterone in women — regardless of estrogen status — produces loss of libido, reduced arousal, decreased genital sensation, and difficulty with orgasm. Restoring testosterone frequently produces dramatic improvements in sexual function that estrogen and progesterone alone do not achieve.
• Energy and motivation: Testosterone supports dopaminergic function, competitive drive, motivation, and physical energy in women. Women with low testosterone often describe a “flat” quality to life — going through the motions without the energy or drive they once had.
• Muscle mass and strength: Testosterone is anabolic in women as in men. Low testosterone contributes to the muscle mass loss and increased fat mass of menopause, impairing physical capacity and metabolic rate.
• Cognitive function: Testosterone supports verbal memory, working memory, and spatial cognition in women. Emerging evidence suggests protective effects against age-related cognitive decline.
• Mood: Women with low testosterone report higher rates of depression, irritability, and emotional blunting — symptoms often attributed to estrogen deficiency or treated with antidepressants when testosterone deficiency is the actual driver.
• Bone density: Testosterone directly stimulates osteoblasts and contributes to bone mineral density independent of estrogen.

Testosterone Therapy Options for Women

No testosterone preparation is currently FDA-approved specifically for women in the United States — the approved products are all dosed for men. However, off-label use of low-dose testosterone in women is supported by substantial evidence and is well-established in clinical practice, endorsed by major societies including the Endocrine Society and the International Menopause Society.

Options include low-dose compounded testosterone cream (most common), low-dose testosterone pellets (implanted subcutaneously), and in some cases very low-dose testosterone cypionate injections. Doses are 10–20 times lower than male TRT doses, with corresponding lab targets for total and free testosterone adjusted to female reference ranges.

Getting Evaluated for Testosterone Deficiency

Testosterone testing in women should include total testosterone and, when possible, free testosterone (calculated or direct assay). SHBG elevation — common in women on oral estrogen or with thyroid disease — can produce “normal” total testosterone with markedly low free testosterone and full deficiency symptoms.

If you are experiencing low libido, fatigue, or mood changes that your current HRT has not fully addressed, testosterone deficiency may be the missing piece. Call Multigen Wellness at (800) 259-0015 to discuss women’s testosterone therapy.