Typical Starting Dose for Testosterone Cream in Women
For women requiring testosterone therapy, the typical starting dose for testosterone cream is 10 mg daily (2 cm of Andro-Feme cream). This dosage has been shown to significantly improve sexual desire and function in women with hypoactive sexual desire disorder without causing side effects during treatment periods 1.
Dosing Considerations for Women
Evidence-Based Starting Doses
- 10 mg daily (2 cm of cream) has been demonstrated as an effective and safe starting dose for menopausal women with low sexual desire 1
- For premenopausal women, a 90-μL spray (metered-dose transdermal) has shown efficacy for improving sexual satisfaction 2
Monitoring Parameters
When initiating testosterone therapy in women:
- Monitor testosterone levels 2-3 months after starting treatment
- Target testosterone levels should be in the female physiological range
- Once stable levels are confirmed, monitoring every 6-12 months is typically sufficient
Application Sites
- Apply to skin of the back, abdomen, upper thighs, or upper arms
- Avoid application to genital areas unless specifically formulated for intravaginal use (as in some specialized formulations)
- Ensure thorough hand washing after application to prevent transfer to others
Clinical Considerations
Indications for Testosterone in Women
Testosterone therapy may be considered for women with:
- Hypoactive sexual desire disorder
- Menopausal symptoms not adequately addressed by estrogen therapy alone
- Decreased sexual satisfaction with documented low testosterone levels
Potential Benefits
- Improved sexual desire and frequency
- Enhanced sexual receptivity and initiation
- Better overall sexual satisfaction
- Improved vaginal symptoms in some cases 3
Safety Considerations
- Testosterone cream at appropriate doses does not typically affect mood, energy, lipids, blood pressure, or weight over short treatment periods 1
- The most common side effect is hypertrichosis (excessive hair growth), which is dose-related and usually confined to the application site 2
- Monitor for signs of virilization (deepening voice, clitoromegaly, acne)
- Women and children should avoid contact with application sites to prevent inadvertent exposure
Important Caveats
- Commercial testosterone products are preferred over compounded formulations when available 4
- Most testosterone products are not FDA-approved specifically for women and are used off-label
- Testosterone levels should be monitored to avoid supraphysiologic concentrations
- Long-term safety data in women is more limited than in men
- Transdermal formulations have better safety profiles compared to oral alkylated testosterone, which should be avoided due to potential liver toxicity 4
While the evidence primarily focuses on sexual function outcomes, testosterone therapy in women at appropriate doses appears to have a favorable short-term safety profile when properly monitored.