From the Guidelines
Testosterone therapy for women is available in several forms beyond creams, with alternatives including injections, subcutaneous pellets, and patches, as the most recent and highest quality study suggests 1. When considering alternatives to cream for testosterone therapy in women, it's essential to weigh the pros and cons of each option.
- Injections, such as testosterone enanthate or cypionate, offer precise dosing but require regular administration, typically 5-25 mg weekly, as outlined in the study by Bhasin et al. 1.
- Subcutaneous pellets, like Testopel, provide consistent hormone levels without daily application, but require implantation every 3-6 months.
- Patches, such as Androderm, are easy to apply but may cause skin rash or irritation at the site of application. The choice of alternative depends on individual preference, absorption issues, and treatment goals.
- Women typically need much lower doses than men, about 1/10th, and therapy should be monitored with blood tests to maintain levels within the female physiological range (15-70 ng/dL) 1.
- Side effects to watch for include acne, hair growth, voice deepening, and mood changes. Testosterone therapy can help improve libido, energy, muscle mass, and bone density in women with deficiency, particularly after menopause or following ovary removal, as supported by the study published in the Journal of the National Comprehensive Cancer Network 1. Consultation with a healthcare provider specializing in hormone therapy is essential to determine the most appropriate form and dosage for your specific needs.
- It's crucial to consider the potential risks and benefits of each alternative, including the limited safety data for androgen-based therapy in survivors of hormonally mediated cancers, as noted in the study 1.
From the Research
Alternatives to Testosterone Cream for Women
- Transdermal testosterone patches are a well-accepted alternative to cream for the treatment of testosterone deficiency in women, as discussed in 2.
- Topically applied gels are also being developed for androgen therapy in women, as mentioned in 2.
- Testosterone therapy via a skin patch has been shown to improve sexual desire and other sexual function domains in oophorectomized women with hypoactive sexual desire disorder, as reported in 3.
- Vaginal testosterone cream is another option, which has been evaluated for safety in postmenopausal women with early-stage breast cancer receiving aromatase inhibitors, as described in 4.
Forms of Testosterone Therapy
- Transdermal patches and topical gels or creams are preferred over oral products due to first-pass hepatic effects documented with oral formulations, as stated in 5.
- Custom-compounded products should be used with caution because the dosing may be more inconsistent than it is with government-approved products, as warned in 5.
- Testosterone products formulated specifically for men have a risk of excessive dosing, although some clinicians use lower doses of these products in women, as noted in 5.
Safety and Efficacy of Testosterone Therapy
- The safety and efficacy of testosterone therapy in women are still being researched and established, as mentioned in 6 and 5.
- Testosterone therapy has been shown to have a positive effect on sexual function in postmenopausal women, primarily desire, arousal, and orgasmic response, as reported in 5 and 3.
- However, the actual risks of testosterone therapy, such as hirsutism and acne, are not well defined, and it is not known whether testosterone therapy increases the risk of breast cancer, cardiovascular disease, or thromboembolic events, as discussed in 5.