From the Research
A 39-year-old female using a vaginal ring with a testosterone level less than 3 ng/dL likely has symptoms of testosterone deficiency that should be addressed, and I recommend considering testosterone supplementation, typically starting with a low dose of 1-2 mg daily of transdermal testosterone cream or gel applied to the inner thigh or labia, as supported by recent studies such as 1 and 2. The goal of testosterone replacement therapy is to improve symptoms and signs of testosterone deficiency, including decreased libido, fatigue, decreased muscle mass, and mood changes, by increasing serum testosterone levels to a physiologic range, as described in 3.
- Key considerations for treatment include:
- Starting with a low dose and adjusting based on symptom improvement and follow-up testosterone levels, aiming for a level between 20-45 ng/dL.
- Continuing the current vaginal ring for contraception or hormone therapy as prescribed.
- Monitoring for side effects like acne, hair growth, or voice changes, which would indicate the dose is too high.
- Follow-up testing should be done in 6-8 weeks to ensure testosterone levels have reached the appropriate range without exceeding it, as recommended in 4 and 5. Testosterone deficiency in women can significantly impact quality of life, and supplementation often helps restore energy, sexual function, and overall wellbeing, as highlighted in 1 and 2.
- It is essential to weigh the benefits and risks of testosterone therapy, considering the individual patient's needs and goals, and to closely monitor patients receiving this therapy, as emphasized in 3.