What is the recommended dose of testosterone (testosterone) for women requiring testosterone therapy?

From the Guidelines

Testosterone therapy for women should be initiated at a dose of 2-5 mg daily for transdermal testosterone creams or gels, with the goal of achieving testosterone levels in the lower half of the normal female range (typically 20-60 ng/dL) 1.

Key Considerations

• The dose of testosterone therapy for women is typically lower than for men, and treatment should be individualized based on symptom improvement and blood testosterone levels.
• Transdermal testosterone creams or gels are a common formulation for women, with doses ranging from 2-5 mg daily.
• Testosterone patches may be prescribed at 150-300 mcg daily, while testosterone implants might deliver 25-100 mg over 3-6 months.

Monitoring and Follow-up

• Regular follow-up appointments every 3-6 months are essential to assess effectiveness and monitor for adverse effects, such as acne, hair growth, voice deepening, and clitoral enlargement.
• Women generally need testosterone therapy for conditions like hypoactive sexual desire disorder, surgical menopause, or adrenal insufficiency.

Formulations and Dosing

• The choice of testosterone formulation and dose should be based on the individual patient's needs and preferences, with consideration of factors such as skin tolerability, risk of transference, and ease of application.
• The dosing ranges for different testosterone formulations are as follows:
  • Transdermal gels/pumps/solutions: 50-100 mg/d (e.g., AndroGel 1%, Testogel 1% gel)
  • Transdermal patches: 2-6 mg/d (e.g., Testosterone 24-h patch, Androderm)
  • Subcutaneous implants (pellets): 150-450 mg every 3-6 mo (e.g., Testosterone pellets, Testopel)
  • Buccal tablets: 30 mg twice daily (e.g., Buccal testosterone system, Striant) 1

From the Research

Testosterone Therapy for Women

The dose for women needing testosterone therapy is not explicitly stated in the provided studies, but some guidelines and recommendations can be found:

• According to 2, systemic transdermal testosterone is recommended for women with hypoactive sexual desire disorder (HSDD), and government-approved transdermal male formulations can be used cautiously with dosing appropriate for women.
• 3 suggests that testosterone treatment without concomitant estrogen therapy cannot be recommended because of a lack of evidence, and transdermal patches and topical gels or creams are preferred over oral products.
• The study 4 mentions that most clinical trials in postmenopausal women with loss of libido have demonstrated that the addition of testosterone to estrogen significantly improved multiple facets of sexual functioning, and low-dose regimens of testosterone therapy are efficacious for the treatment of Women's Sexual Interest and Desire Disorder in postmenopausal women who are adequately estrogenized.
• Key points to consider when prescribing testosterone therapy for women include:
  • Dosing: appropriate dosing for women, using government-approved transdermal male formulations cautiously
  • Formulation: transdermal patches and topical gels or creams are preferred over oral products
  • Monitoring: monitoring for supraphysiologic levels, subjective assessments of sexual response, desire, and satisfaction, as well as evaluation for potential adverse effects
  • Contraindications: testosterone therapy is contraindicated in women with breast or uterine cancer, or in those with cardiovascular or liver disease
  • Administration: testosterone therapy should be administered at the lowest dose for the shortest time that meets treatment goals, with counseling regarding potential risks and benefits provided before initiating therapy 3