A recent report from the BBC highlights a concerning trend: some women are disguising themselves as men to acquire testosterone gel aimed at alleviating menopausal symptoms. The limited availability of female testosterone products has spurred this unconventional approach. This raises questions about the growing interest in testosterone therapy among women and the associated risks.
Traditionally classified as a male hormone, testosterone is pivotal for various physiological processes, including puberty, muscle mass, and reproductive functions. However, this perspective neglects to account for the fact that women also produce testosterone, which plays significant roles in their health. While females have testosterone levels that are approximately ten to fifteen times lower than males, the hormone remains biologically active within them.
Women synthesize testosterone primarily in the ovaries and adrenal glands, and the body can produce it during the conversion of other hormones in fat, skin, and muscle. This hormone is partially utilized to create estradiol, the predominant estrogen in women during their reproductive years. Beyond being a precursor to estrogen, testosterone directly influences various body tissues, including bones, muscles, the heart, blood vessels, and the brain, prompting researchers to investigate how it may impact women’s overall health.
Testosterone levels in women decline gradually throughout their reproductive years, beginning long before menopause. Unlike estrogen, which typically plummets at menopause, testosterone levels decrease slowly and evenly over time. However, measuring these low hormone levels accurately has always been challenging due to the limitations of routine blood tests.
The Reasons Behind Increased Interest in Testosterone Therapy
The primary reason many women seek testosterone therapy, particularly after menopause, relates to its known effect on sexual desire. Research has shown that testosterone can play a beneficial role in treating hypoactive sexual desire disorder (HSDD), a condition characterized by a persistent lack of sexual desire that leads to distress. A meta-analysis from 2019, reviewing 36 randomized trials, concluded that properly administered testosterone can enhance sexual desire and satisfaction in some postmenopausal women. Current international guidelines support the use of testosterone therapy for HSDD, recognizing it as an evidence-based treatment for this specific condition.
However, it is crucial to understand that sexual desire is influenced by numerous factors, including relationships, stress, fatigue, and mental health, thus making testosterone just one of many components involved.
Aside from sexual desire, robust clinical trial evidence demonstrating testosterone’s broader impact on women’s health remains scarce. While randomized trials are critical for establishing treatment effects, they don’t always reflect realities encountered in typical medical settings. Patients with various health issues or those taking multiple medications can obscure whether improvements result from testosterone treatment or other factors. It is worth noting that testosterone should not be viewed as a replacement for standard hormone replacement therapy (HRT) during menopause. When prescribed, it’s often in conjunction with estrogen and possibly progesterone. Some women report that even with optimized HRT, they experience unaddressed symptoms, suggesting that adding testosterone may provide substantial benefits.
Recent findings from a UK study involving 510 women at a menopause clinic indicated that after four months of using testosterone gel, significant improvements in mood, cognitive symptoms, and libido were reported. This evidence, while compelling, does not definitively establish causation, highlighting the need for more research in this area.
Challenges in Accessing Women’s Testosterone Therapy
The most robust evidence supporting testosterone use in women pertains to sexual desire. Yet, despite this, the availability of products designed specifically for women has lagged. In the United States, there is currently no FDA-approved testosterone product for women, while other major hormones, such as estrogen and progesterone, have numerous licensed treatments available. This gap exists even though it is established that testosterone can be administered safely to women at doses that maintain hormonal levels within the physiological female range.
International health guidelines have identified the need for testosterone treatments designed for women and called for regulatory attention. Notably, in September 2026, the U.S. Food and Drug Administration hosted a workshop to address existing evidence gaps and the imperative for future drug development.
Australia has made strides in this area, being the first to officially register a testosterone cream called Androfeme for female use in 2020. The UK followed suit, granting marketing authorization in July 2025; however, it is not yet widely available through the NHS.
As a workaround, many women have resorted to measuring men’s testosterone gel themselves, a practice fraught with precision issues, especially given the minuscule therapeutic dose required. Applying excess gel can lead to elevated testosterone levels, increasing the likelihood of adverse effects like acne and excessive hair growth. Additionally, the long-term safety of testosterone use in women is not fully understood, particularly concerning the risks of heart disease, stroke, and breast cancer, as many existing trials have been brief and often excluded women with elevated risk profiles.
Nonetheless, demand remains on the upswing. NHS prescriptions for women in England surged tenfold from 2015 to 2022, while testosterone prescribing has nearly tripled in the United States over the past decade. The pressing need for licensed testosterone products tailored for women is undeniable, not just to enhance access but also to facilitate rigorous scientific inquiry into the effects of testosterone on women’s health.
