Testosterone Prescriptions for Women Surge Amid Pharmacy Access Barriers
A recent analysis found that testosterone prescriptions for women have nearly tripled in the past few years. AzmanL · E+/Getty
A recent analysis found that testosterone prescriptions for females increased 146% between January 2023 and July 2026.
There are currently no FDA-approved testosterone products specifically for females, which can create dosing and prescription access challenges.
Current clinical guidance supports testosterone therapy for hypoactive sexual desire disorder (HSDD) in postmenopausal females.
More research is needed to determine whether testosterone provides benefits for other menopause-related concerns, such as fatigue, mood, and muscle strength.
Over the past few years, there has been a surge in prescriptions of testosterone for females experiencing menopause, according to an analysis by the research analytics company Truveta for Reuters that was published on September 15. However, these results have not been published in a scientific journal.
The rise in prescriptions has also come amid reports of prescription delays and denials at pharmacies.
This may be due in part to the fact that there are currently no testosterone products approved by the Food and Drug Administration (FDA) specifically for females, despite years of off-label use and evidence supporting testosterone therapy for hypoactive sexual desire disorder (HSDD) in postmenopausal females.
However, on September 17, the FDA called for more data on testosterone therapy for females and encouraged manufacturers to conduct studies that could support future approval of female-specific products.
What can testosterone actually help with during menopause?
Organizations such as the Menopause Society support the use of testosterone for HSDD in postmenopausal females, but not for other menopause symptoms.
However, Stephanie Faubion, MD, MBA, Director of the Mayo Clinic Center for Women’s Health and Medical Director for The Menopause Society, told Healthline that evidence does not support the use of testosterone for most menopause symptoms.
“There is evidence for its use for hypoactive sexual desire disorder in postmenopausal women. Testosterone does not decline specifically with menopause, but declines as a function of aging,” she said. “It has not been shown to help with things like fatigue, well-being, bone density, muscle mass, or mood.”
However, despite a lack of supporting evidence or guideline recommendations, some clinicians have been prescribing testosterone off-label to help with fatigue and loss of muscle strength.
Sherry Ross, MD, board certified OB/GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, said that testosterone is much more important in the menopause conversation than people realize.
“This powerful hormone helps in promoting muscle strength, bone growth, libido, balancing mood and energy, and reducing anxiety. Since menopause negatively affects all these systems, giving it some consideration can be life changing in perimenopause and menopause,” she added.
Testosterone has long been thought of as a “male” hormone. However, females also naturally produce testosterone. Testosterone levels decline with age, but this decline is not specifically caused by natural menopause.
Faubion also stated, “When postmenopausal or late perimenopausal women use testosterone, it’s very important that their levels are maintained in the normal range for a premenopausal woman.”
How testosterone may help with hypoactive sexual desire disorder
HSDD is a common sexual health condition characterized by persistently low sexual desire that causes significant personal distress.
One study found that 52.4% of naturally menopausal females experienced low sexual desire, while 6.6% had HSDD.
HSDD also affects around 1 in 8 females ages 45–65.
“Testosterone has been shown to increase sexual desire and improve other aspects of sexual functioning, including arousal and sexual satisfaction,” said Faubion.
However, this is still considered an off-label use of testosterone.
Why testosterone can be difficult for females to access
Ross noted that testosterone can be prescribed in various forms, such as lozenges, ointments, creams, and gels. She also noted that the dose you are given should be carefully discussed with your healthcare professional.
This is especially important because there are currently no FDA-approved testosterone products specifically for females. As a result, clinicians may prescribe products formulated for males at much lower doses.
Because products formulated for males may need to be divided to provide a lower dose, some females may have difficulty getting their prescriptions filled.
Nurse practitioners told Reuters that they’d had prescriptions rejected by pharmacies, and many of their patients had trouble getting them filled.
Amazon Pharmacy also told Reuters that it doesn’t dispense some testosterone prescriptions that require females to customize doses in order to ensure safe and compliant dispensing. It added that the policy is not specific to testosterone or based on a person’s sex or gender identity.
More research on testosterone use in females is underway
Along with the FDA’s encouragement for more data and studies, there are more than 30 trials studying the use of testosterone for various health conditions in females underway or planned, according to ClinicalTrials.gov.
For example, Avivo Bio is developing a testosterone therapy designed specifically for females and is studying its potential effects on breast tissue.
“Testosterone should no longer be an afterthought when managing the symptoms of perimenopause and menopause,” said Ross.
“More research is needed to continue supporting its benefits beyond improving libido, but the train has left the station, and people are enjoying the ride. Its whole-body benefits should not be minimized or downplayed.”
Current clinical guidance supports testosterone therapy for HSDD in postmenopausal females, while more research is needed to determine whether it provides benefits for other menopause-related concerns.
