New Guidelines Limit Testosterone Supplements for Women - MGH Center for Women's Mental Health (2024)

Both men and women produce testosterone. The big difference is that the levels are much lower in women, around 15 to 40 ng/dL. In women, testosterone levels begin to decline gradually after the age of 20. In postmenopausal women, testosterone levels are between 0 and 20 ng/dL. Various symptoms have been attributed to falling levels of testosterone in midlife women, including lower sex drive, decreased muscle mass and bone density, decline in cognitive functioning, and depression. Some refer to this constellation of symptoms as “female androgen insufficiency syndrome”; others debate the clinical validity of this diagnosis in women.

Clinically testosterone has been used most commonly in postmenopausal or oophorectomized women in order to improve sexual functioning. But if you wander around the Internet, you can quickly see that many sites promote the use of testosterone in midlife women, stating that testosterone supplements increase strength and muscle mass, boost energy, treat depression, improve cognition, reverse the effects of aging, and improve overall quality of life.

A new report entitled “Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline,” was published online in the Journal of Clinical Endocrinology and Metabolism. The Society updated its 2006 recommendations concerning testosterone and dehydroepiandrosterone (DHEA) therapy in women.

This report questions the existence of androgen insufficiency syndrome in women, noting that most women with low testosterone levels do not have any specific signs or symptoms. Importantly, the authors of this report note we have no data regarding the long-term effects of androgen therapy in women. Use of testosterone in women has been linked to changes in cholesterol levels, as well as acne and hirsutism (excessive growth of hair). Long-term risks to the breast or cardiovascular system are unknown.

The only situation where the Society supports prescribing testosterone therapy is in post-menopausal women diagnosed with Hypoactive Sexual Desire Disorder (HSDD). This condition occurs when a woman has decreased interest in sex, and when this lack of interest causes personal distress. In these situations, the guidelines suggest a three- to six-month trial of testosterone to determine if the therapy improves sexual functioning.

The guidelines discourage the off-label use of testosterone in women to treat low libido and infertility, or for other reasons (e.g., to improve cognitive functioning, mood, or physical well-being).

Ruta Nonacs, MD PhD

Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N. Androgentherapyinwomen: areappraisal: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014 Oct; 99(10):3489-510.

Information for Patients: Therapeutic Use of Androgens in Women

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One Comment

  1. New Guidelines Limit Testosterone Supplements for Women - MGH Center for Women's Mental Health (7)

    vanessaMarch 5, 2015 at 11:10 am

    Interesting to know the facts, but it would be nice to know the author’s view on the guidelines.

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New Guidelines Limit Testosterone Supplements for Women - MGH Center for Women's Mental Health (2024)

FAQs

Can I take testosterone supplements as a woman? ›

In the United States and many other countries, government agencies that regulate medicines haven't approved testosterone therapy for women. But it can be prescribed if it might have a medical benefit for someone. Testosterone comes in many forms.

Why is testosterone not recommended for women? ›

Although studies have shown that testosterone can be beneficial in women not using concomitant estrogen containing hormone therapy, the incidence of adverse androgenic effects such as acne and excess hair growth is higher; this strategy is therefore not usually recommended in routine clinical practice.

How does testosterone affect women's mental health? ›

Evidence from multiple studies indicates that testosterone has anxiolytic and antidepressant effects, with the potential to promote improved mood and mental health in both men and women [10,13,14].

Do testosterone boosters affect mental health? ›

Testosterone Replacement and Depression

The effect was especially beneficial in men who only recently started to experience a decrease in mood. Testosterone replacement in men with hypogonadism not only improves mood, but also cognitive ability and libido.

Can too much testosterone in a woman cause anxiety? ›

On the other side, also an association between higher testosterone levels and anxiety has been shown in women with polycystic ovarian syndrome (state of hyperandrogenism) (15).

How much testosterone should a woman take? ›

I accepted the range of 80-120 to be a safe and desirable range for women. And my anecdotal experience since then is that they were correct. This was the range that helped women feel relief of “low T” symptoms such as night sweating, poor quality sleep, daytime fatigue, mental fog, moodiness and reduced libido.

Can too much testosterone be bad for women? ›

Some women with high testosterone levels develop frontal balding. Other possible effects include acne, an enlarged cl*tor*s, increased muscle mass, and deepening of voice. High levels of testosterone can also lead to infertility and are commonly seen in polycystic ovarian syndrome (PCOS).

What happens if a postmenopausal woman takes testosterone? ›

Published evidence from randomized controlled trials, although limited, indicates that exogenous testosterone, both oral and nonoral formulations, has a positive effect on sexual function, primarily desire, arousal, and org*smic response, in women after spontaneous or surgically induced menopause.

Can testosterone help women lose weight? ›

For women, testosterone has the power to decrease fat mass, but it can also promote insulin resistance – thus causing belly fat. As testosterone levels drop, previously youthful women begin aging rapidly, often becoming overweight and more passive. Women with low T feel tired and lazy and gain weight easily.

Does testosterone affect women's emotions? ›

Abstract. Testosterone modulates mood and sexual function in women. However, androgen levels decline with age, which may relate to the age-associated change in sexual functioning and the prevalence of mood and anxiety disorders. These effects of testosterone are potentially mediated by the amygdala.

What are the emotional effects of taking testosterone? ›

Does Testosterone Boost Risk of Depression and Suicide? Some physicians advocate testosterone supplementation to give men "new vigor." However, a recent large study links T supplementation to increased risk of depression and suicide.

Does testosterone cause anger issues? ›

When used this way, without proper medical supervision, testosterone has been linked to unwanted side effects such as mood swings and aggressive “roid rage.”

Do testosterone boosters increase anger? ›

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed.

What does testosterone pills do for females? ›

Testosterone supplementation can increase muscle mass and strength in women. Improved mood and energy levels: Testosterone plays a role in regulating mood and energy levels, and low levels of this hormone can lead to fatigue, depression, and anxiety.

What happens if a woman takes testosterone booster? ›

A doctor may administer testosterone injections or pellets, expecting these treatments to have the same effect on females as on males: raising energy levels, decreasing fatigue, and increasing sex drive. However, many doctors advise females not to take testosterone.

What are the signs of low testosterone in females? ›

What are the symptoms of low testosterone in women?
  • Low sex drive (hypogonadism).
  • Lack of energy and feeling tired.
  • Loss of strength and muscle tone.
  • Infertility or trouble conceiving.
  • Irregular menstrual cycle.
  • vagin*l dryness.
  • Depression or anxiety.
  • Thinning hair.
Apr 12, 2023

Can a woman raise a man's testosterone? ›

Even brief, 5 minute interactions with (attractive) women cause an elevation in men's testosterone levels, in particular among men with an aggressive dominant personality (Van der Meij, Buunk, Van de Sande, & Salvador, 2008) .

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