Is Testosterone Worth It for Women's Low Libido?

If you are past menopause and low desire bothers you, testosterone can give a small gain. The strongest trial added about one extra satisfying time a month compared with placebo, and about half the women in clinic care said desire improved. Extra hair growth and acne are common, and long term effects on the breast remain uncertain.

How much difference does it actually make?

Researchers tested a daily testosterone patch for 24 weeks in 814 postmenopausal women who had distressing low desire and were not taking estrogen. Distressing low desire means you want sex much less and it bothers you, which researchers call hypoactive sexual desire disorder. Women on the 300-microgram patch averaged 2.1 more satisfying times per 4 weeks, compared with 0.7 more on placebo with no hormone, while the 150-microgram dose did not differ clearly from placebo APHRODITE trial.

In a UK menopause clinic, 510 peri and postmenopausal women already taking hormone therapy but still reporting low libido used testosterone cream or gel for 4 months. In that group 52% said libido improved, 47% said mood improved and 39% said thinking felt clearer UK clinic study.

What are the downsides to weigh?

Androgenic side effects, primarily unwanted hair growth, occurred in 30.0% on the higher testosterone dose compared with 23.1% on placebo. Combined trials also found mild rises in acne and body or facial hair. Physicians at UT Southwestern list deepening voice, clitoral enlargement, excess body hair and acne as possible effects, and note that low testosterone is rarely the root cause of low desire before menopause UT Southwestern guidance.

Four women on testosterone received a breast cancer diagnosis compared with none on placebo, with one diagnosed in the first 4 months and one with symptoms before the trial started. The trial authors called long term breast effects uncertain. A 2019 Global Consensus of menopause and endocrine societies found no severe adverse events in trials of physiological dose testosterone for postmenopausal distressing low desire, but women at high heart and metabolic risk were excluded. The consensus noted that no national regulator had approved a testosterone product for women at that time, so clinicians use male products at female doses with blood level checks Global Consensus.

What women report

"my libido is the highest it's been since I was in my 20s" (50-year-old, r/Menopause, 4 weeks on 10 mg gel every 2 days) gel report. "I'm having a lot of sexual thoughts but it hasn't quite translated to actually being super horny" (47-year-old, r/TRT_females, 1 month on twice-weekly injections) injection report. "Libido is through the roof!" (compounded 2% cream user, Drugs.com, 2015 to 2016 reports, after 4 years of use) cream reports. From the same thread, "2-3 facial hairs that need to be waxed or plucked."

These stories alone cannot show how most women respond. The common thread is more sexual thoughts, dreams and energy within the first week to month, with full desire returning for some and only a partial shift for others. Two users listed $30 and $41 per fill, and plucking a few facial hairs was the downside they named.