Does testosterone replacement therapy (TRT) affect female orgasm?

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Last updated: April 4, 2025View editorial policy

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From the Guidelines

Testosterone replacement therapy in women can enhance orgasms for those with low testosterone levels, as evidenced by a study of 76 postmenopausal breast cancer survivors on aromatase inhibitor therapy, which found that intravaginal testosterone cream improved vaginal atrophy and sexual function 1. Women with testosterone deficiency may experience improved sexual function, including increased orgasm intensity and frequency, when testosterone is restored to normal physiological ranges. Testosterone therapy options include transdermal gels, creams, or implantable pellets, which work by increasing blood flow to genital tissues, enhancing clitoral sensitivity, and improving neural pathways involved in sexual arousal and orgasm. However, testosterone therapy should only be used under medical supervision, as excessive doses can cause unwanted side effects like acne, hair growth, voice deepening, and clitoral enlargement. Some key points to consider when prescribing testosterone therapy for women include:

  • Monitoring testosterone levels regularly during treatment to maintain appropriate levels and minimize side effects
  • Addressing psychological and relationship factors that may affect sexual function
  • Considering individual responses to testosterone therapy, which can vary based on underlying causes of sexual dysfunction and personal physiology
  • Being aware of the potential benefits and risks of testosterone therapy, including the potential for improved sexual function and the risk of unwanted side effects. It is also important to note that the evidence base for interventions to treat female sexual dysfunction in survivors is weak, and high-quality studies are needed to fully understand the effects of testosterone replacement therapy on orgasms in women 1.

From the Research

Testosterone Replacement in Women and its Effect on Orgasms

  • The use of testosterone replacement therapy (TRT) in women with hypoactive sexual desire disorder (HSDD) has been shown to be effective in increasing the frequency of satisfying sexual activity and sexual desire 2, 3, 4, 5, 6.
  • Studies have demonstrated that transdermal testosterone therapy can improve sexual function in postmenopausal women with HSDD, including an increase in the number of orgasms 2, 6.
  • The optimal dosage of testosterone for the treatment of HSDD in women has been found to be 300 µg/d, which has been shown to be effective in increasing sexual desire and frequency of satisfying sexual activity 2, 6.
  • The use of TRT in women with HSDD has been associated with minimal side effects, including mild hirsutism and acne 5, 6.
  • Long-term safety of TRT in women is not yet established, and further research is needed to assess the potential risks and benefits of androgen treatment in women with sexual dysfunction 4, 5.
  • The evidence suggests that testosterone replacement therapy can be used safely in women without increased risk of endometrial or breast cancer, although one study showed a trend for higher risk of breast cancer in long-term use 2, 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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