Testosterone

 Too much testosterone (especially relative to low estrogen) may cause:

• Acne and oily skin
   
• Hirsutism (unwanted facial or body hair)
   
• Male-pattern hair thinning
   
• Weight gain
   
• Anxiety or irritability
   

Too little testosterone may cause:

• Low libido or hypoactive sexual desire disorder (HSDD)
   
• Fatigue and reduced vitality
   
• Mood changes, including anxiety or depression
   
• Headaches and cognitive fog

• Skin & Hair: Increased oiliness, acne, and hair thinning on the scalp; new or darker facial hair may appear on the chin, upper lip, or jawline.
   
• Body Odor: Testosterone influences sweat composition, especially in apocrine glands (underarms, groin, chest). When broken down by bacteria, this can cause stronger or unfamiliar odors.
   
• Vaginal & Urinary Health: Androgens, including testosterone and DHEA, help maintain vaginal tissue strength, lubrication, and sexual function. Local intravaginal DHEA has shown benefits for dryness without raising systemic hormone levels.
   
• Brain Health: Testosterone interacts with estrogen and progesterone in the brain. Imbalances may affect memory, mood, and cell-to-cell communication.
   
• Weight & Fat Distribution: Estrogen loss drives weight gain around the abdomen more than testosterone, but testosterone imbalances may influence muscle mass and metabolism.

 In select cases, testosterone therapy may be considered for postmenopausal women, particularly those with:

• Low sexual desire (libido)
   
• Hypoactive sexual desire disorder (HSDD)
   
• Muscle loss and reduced strength
   
• Mood fluctuations or cognitive decline not improved with estrogen therapy

• Dosing is much lower for women: Careful adjustment is needed to avoid side effects like acne, hair growth, or voice changes.
   
• Not FDA-approved for women: No testosterone product is currently FDA-approved specifically for women in the U.S., though off-label prescribing is common under medical supervision.
   
• Testing is essential: Baseline testosterone and sex hormone-binding globulin (SHBG) should be measured before starting therapy.
   
• Monitoring is required: Regular follow-ups are necessary to adjust dosage and manage side effects.
   
• Whole-person assessment: Other causes of low libido—such as medication side effects, stress, or relationship issues—should be ruled out first.
   
• Stop if no benefit: If symptoms do not improve after 6 months, treatment should be discontinued.

Transdermal Gel or Cream
Applied to the skin (arms, abdomen); provides steady absorption and mimics natural daily rhythms.

Transdermal Patch
Delivers testosterone through the skin. Worn daily for consistent dosing.

Intramuscular Injection
Given every 1–2 weeks. Causes peaks and troughs in hormone levels.

Subcutaneous Injection
A newer option with more stable levels and less discomfort than intramuscular routes.

Buccal Tablets
Placed between gum and cheek. Absorbed through oral mucosa.

Pellet Implants
Inserted under the skin (hip or buttock). Release testosterone slowly over 3–6 months.

Oral Capsules
Less commonly used due to liver metabolism and variable absorption. Not recommended for long-term HRT.

• Testosterone plays a role in women’s health — supporting libido, mood, muscle mass, and energy.
   
• Levels decline with age and menopause, which may contribute to symptoms like low desire, fatigue, or reduced muscle strength.
   
• Therapy options exist (patch, gel, injections, pellets, buccal tablets), but all are off-label for women in the U.S.
   
• Dosing must be carefully managed — too much testosterone can cause acne, hair growth, or voice changes.
   
• Baseline labs and ongoing monitoring are essential for safe use.
   
• Other causes of low libido and fatigue should be considered before starting testosterone therapy.
   
• Safety data is limited, so treatment decisions should always be individualized and guided by a healthcare provider.