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Testosterone for Women

Testosterone for women is considered case by case, after a full assessment. Testosterone is a women’s hormone too, and it may be considered for some women, for example when low libido is a concern. No testosterone product is approved by Health Canada for use in women, so any use is off-label and explained by your physician first.

Medically reviewed by Amber Bocknek, MD, CCFP, ABAARM, FAAMM, MSCP, Medical Director, November 4, 2026

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When is testosterone for women considered?

Testosterone isn’t only a men’s hormone. Women make it in the ovaries and adrenal glands, and research shows levels drift down gradually with age, starting in a woman’s 20s and 30s, rather than dropping suddenly at menopause. Women who’ve had both ovaries removed tend to have lower levels than women of the same age who haven’t, because the ovaries keep making testosterone after menopause.

Research on testosterone for women focuses mainly on sexual desire after menopause. Because no testosterone product is approved by Health Canada for women, any use is off-label, and your physician explains exactly what that means before you decide.

Low testosterone in women: what it can and can’t explain

Low desire in midlife is common, it’s real, and it’s rarely about one hormone. Before testosterone is on the table, we look at everything else that can quiet desire:

vaginal dryness or pain with sex (genitourinary syndrome of menopause)

poor sleep and night sweats

mood, stress and relationship strain

medications, including some antidepressants, as well as birth control pills or oral estrogen, which raise SHBG, the protein that binds testosterone

thyroid problems, low iron and other medical conditions

Sorting these out first is how we make sure the treatment matches the actual cause.

Why one number isn’t the whole story

Here’s the simplest way to picture it: total testosterone is what you have in the bank. Bioavailable testosterone is what you can actually spend.

Most of the testosterone in your blood is bound tightly to a carrier protein called sex hormone-binding globulin (SHBG). While it’s locked up, your tissues can’t use it. So we don’t stop at a total testosterone. Our hormone panel includes bioavailable testosterone, SHBG, DHEA-S and DHT, read alongside your estrogen and progesterone, thyroid, iron and metabolic markers.

In our practice, we sometimes see a woman whose total testosterone looks fine on paper while her SHBG is high, so the testosterone her body can actually use is low. Estrogen taken by mouth can push SHBG up, which is one reason the route of estrogen matters. Your symptoms are data, and so are your lab results. Neither tells the whole story alone.

One honest limit: a testosterone level can’t diagnose low desire on its own. Guidelines use it as a baseline before treatment and to monitor treatment afterwards, which is exactly how we use it, reading your results for what is optimal for you and keeping any treatment within the range that’s normal for women.

What does research show about testosterone therapy for women?

A 2019 review in The Lancet Diabetes & Endocrinology pooled 36 randomized trials with more than 8,000 women. In postmenopausal women with low desire causing distress, testosterone improved desire, arousal, orgasm and the number of satisfying sexual experiences, and it reduced distress. The International Society for the Study of Women’s Sexual Health describes the benefit as moderate.

The same review found that testosterone through the skin (a cream or gel) had a neutral effect on cholesterol, while testosterone taken by mouth raised LDL cholesterol. That’s why guidelines prefer transdermal forms.

What the research doesn’t show: current evidence doesn’t support testosterone for energy, bone strength or memory, and long-term effects, including on the breast and heart, haven’t been established.

Testosterone for menopause: the risks to weigh

Acne and unwanted hair growth were more common than with placebo in clinical trials.

Above the normal female range, testosterone can cause a deeper voice, hair thinning on the scalp or enlargement of the clitoris, and some of these changes may not reverse when treatment stops. That’s why levels are monitored.

Pregnancy and breastfeeding: testosterone isn’t used.

The unknowns: long-term safety data are limited, so treatment is reviewed regularly and stopped if it isn’t helping.

How is testosterone therapy for women started and monitored?

A full assessment: symptoms, sexual health history, medications, and personal and family history.

Baseline blood work: our comprehensive panel, including bioavailable testosterone and SHBG. See what we test.

A clear conversation about off-label use, benefits, risks and alternatives, so the decision is yours.

If you go ahead, a transdermal (through the skin) product at a dose suited to women, prescribed and adjusted by your physician, never self-directed.

Follow-up blood work and check-ins on how you feel and any side effects. If there’s no meaningful benefit after a fair trial, it’s stopped.

Talk it through with our physician-led team

Losing your sense of desire can feel like losing a piece of yourself. It deserves a real look at your biology, your health and your life. Our physician-led team, led by Medical Director Amber Bocknek, MD, looks at the whole picture with you and talks through every option, hormonal and not. We see patients in Aurora and by virtual visit anywhere in Ontario.

Thrive! is private-pay and does not bill OHIP. Before testing, we tell you which lab tests carry a fee. Our hormone and menopause care is complementary, functional medicine care, which is uninsured. It works alongside your family doctor or nurse practitioner and doesn’t replace them, so we encourage you to keep them. Return to our menopause care hub.

Also called: testosterone therapy for women, female testosterone therapy, low T in women, androgen therapy for women

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FAQ

What does testosterone do for women?

Testosterone is a normal part of women’s biology. It’s made in the ovaries and adrenal glands, and it plays a role in sexual desire. There are testosterone receptors in muscle, bone and the brain too. Levels decline gradually with age rather than dropping suddenly at menopause. Testosterone isn’t a fix for every midlife symptom, so a physician looks at the whole picture first.

What is the normal testosterone level for women?

Reference ranges differ from lab to lab and by age, and women’s levels are much lower than men’s, so your physician explains where your result sits. A single number can mislead: most testosterone is bound to SHBG and unavailable to your tissues. At Thrive!, we read total and bioavailable testosterone together with SHBG, your symptoms and your other results.

What is testosterone therapy used for in women?

Testosterone is a women’s hormone too. After a full assessment, testosterone may be considered for some women, for example when low libido is a concern. No testosterone product is currently approved by Health Canada for use in women. Canadian menopause guidelines describe transdermal testosterone as an off-label option for some menopausal women after a full assessment.

How is testosterone dosed for women?

Dosing is individual. It’s prescribed and monitored by a physician and is never self-directed. Guidelines aim to keep blood levels within the range that’s normal for women, so baseline blood work comes first, followed by repeat tests and check-ins for side effects such as acne or hair growth. If there’s no meaningful benefit after a fair trial, treatment is stopped.

Do I need to fast for a testosterone blood test?

A testosterone test on its own doesn’t usually need fasting. Thrive!’s comprehensive hormone panel does: please fast for at least 10 hours, because it includes fasting glucose, insulin and lipids, and have your blood drawn first thing in the morning for the 8 a.m. cortisol. If you still have periods, the draw is ideally on days 19 to 21 of your cycle. Virtual patients can have blood drawn at any LifeLabs or Dynacare location near them. See personalized testing.