From the Research
Topical testosterone therapy for women typically involves applying a cream or gel containing 0.5-2% testosterone to the skin, usually once daily, with a typical starting dose of 0.5-1 mg applied to the inner thigh, upper arm, or lower abdomen, as recommended by the most recent guidelines 1. The dosing should be individualized based on symptoms and hormone levels, with adjustments made every 4-6 weeks until optimal results are achieved. Some key points to consider when prescribing topical testosterone therapy for women include:
- Blood testing is recommended before starting therapy and periodically thereafter to maintain testosterone levels within the normal female range (15-70 ng/dL) 2.
- Side effects may include acne, hair growth, and voice deepening if levels become too high.
- Compounded formulations are often used since FDA-approved topical testosterone products specifically for women are limited.
- Testosterone therapy in women aims to address symptoms of androgen deficiency such as decreased libido, fatigue, and reduced muscle mass by restoring hormonal balance.
- The topical route allows for steady absorption while avoiding first-pass liver metabolism, potentially reducing side effects compared to oral administration. It's also important to note that long-term data on cardiovascular, cancer, and cognitive safety are lacking, and no approved testosterone preparation is available for women 2. Some studies have shown that transdermal testosterone therapy, dosed within premenopausal physiologic testosterone ranges, can be effective in improving sexual function in postmenopausal women with hypoactive sexual desire disorder 1, 3. However, it's crucial to weigh the potential benefits and risks of testosterone therapy in women and to carefully monitor patients for signs of androgen excess and total testosterone levels 1.