Testosterone Patch Dosing for Women
The typical starting dose of testosterone transdermal patch for women is 150-300 μg/day, with 300 μg/day being the most effective dose for addressing female sexual dysfunction. 1, 2
Dosing Guidelines
- For women with surgically-induced menopause or hypoactive sexual desire disorder (HSDD), the recommended starting dose is 300 μg/day via transdermal patch 1
- Lower doses (150 μg/day) have shown less effectiveness in clinical trials, while higher doses (450 μg/day) don't demonstrate additional benefits over the 300 μg/day dose 1
- Testosterone patches are typically applied to dry, intact skin of the back, abdomen, upper thighs, or upper arms 3
- Patches are designed for twice-weekly application, delivering the daily dose continuously 1
Clinical Considerations
- Peak testosterone levels occur 6-8 hours after patch application 3
- For women with premature ovarian insufficiency (POI), transdermal patches releasing 50-100 μg of 17β-estradiol daily are often combined with testosterone therapy 3
- When monitoring therapy, testosterone levels can be measured at any time during patch use, unlike with injectable testosterone which requires specific timing 3
- Transdermal delivery avoids first-pass hepatic metabolism, providing more stable hormone levels compared to oral administration 3
Efficacy and Safety
- Clinical trials have demonstrated that the 300 μg/day dose significantly increases sexual desire (67% vs 48% with placebo) and frequency of satisfying sexual activity (79% vs 43% with placebo) 1
- Common adverse effects include application site reactions and unwanted hair growth, which are typically mild 4
- Long-term safety data (up to 4 years) shows no clinically meaningful changes in serum chemistry, lipid profiles, or liver function with testosterone patch therapy 4
- Potential androgenic side effects include acne, hirsutism, and hair loss, which may not resolve upon treatment cessation in 30-60% of affected women 5
Special Populations
- For adolescents and young women with chemotherapy or radiation-induced POI, transdermal estradiol patches (50-100 μg/day) are often used before considering testosterone supplementation 3
- In premenopausal women with reduced libido, a lower dose of testosterone may be effective (90 μg/day via transdermal spray has shown benefit) 6
- For women with endometriosis who have undergone oophorectomy, combined estrogen/progestogen therapy is typically initiated before considering testosterone supplementation 3
Monitoring
- Evaluate treatment effect after 3-6 months of therapy 3
- Testosterone therapy should possibly be limited to 24 months due to limited long-term safety data 3
- Annual clinical reviews are recommended, with particular attention to compliance and side effects 3
- No routine laboratory monitoring is required, but testing may be prompted by specific symptoms or concerns 3