From the Research
Intramuscular testosterone dosing in women for low testosterone should be initiated at a low dose, such as 5-10 mg every 2-4 weeks, with careful monitoring to avoid virilization and other adverse effects. This approach is supported by the principle of using the lowest effective dose to minimize side effects while achieving symptom relief, although there is limited direct evidence from studies like 1 that focused on hypogonadal men. The goal of therapy in women is to achieve testosterone levels in the upper normal female range, which is significantly lower than the levels targeted in men.
When considering testosterone replacement therapy (TRT) for women, it's crucial to understand the physiological role of testosterone in females, which includes contributing to libido, energy levels, muscle mass maintenance, and overall well-being. However, the doses required to achieve these benefits in women are much lower than those used in men, as evidenced by the typical starting regimens of testosterone cypionate or enanthate at 5-10 mg IM every 2-4 weeks.
Key considerations in the management of low testosterone in women include:
- Baseline measurement of testosterone levels before initiating therapy
- Regular follow-up monitoring of testosterone levels, complete blood count, lipid profile, and liver function tests every 3-6 months
- Evaluation for adverse effects such as acne, hirsutism, voice deepening, clitoral enlargement, and mood changes
- Individualization of treatment, with the aim of using the lowest effective dose to minimize side effects while achieving symptom relief. Although studies like 1 compare different modes of testosterone administration in men, such as intramuscular testosterone cypionate (IM-TC) versus subcutaneous testosterone enanthate autoinjector (SCTE-AI), the principles of minimizing side effects and achieving therapeutic goals can be applied to the treatment of women with low testosterone, albeit at much lower doses.