Testosterone isn’t solely a “males’s hormone” — ladies make it too, simply in a lot smaller quantities. In ladies, testosterone helps with sexual need and arousal and plays a role in bone, muscle and mind well being. Many consultants agree the proof factors to utilizing testosterone remedy in ladies to deal with low sexual need that’s upsetting or distressing after menopause, a situation referred to as hypoactive sexual need dysfunction (HSDD).
There’s no FDA‑authorised testosterone made only for ladies in america but, so care can really feel complicated. Here is what you need to know.
What’s testosterone?
Testosterone is without doubt one of the physique’s intercourse hormones that performs an enormous position within the reproductive system for each women and men. “In ladies, we suppose it is likely to be important for bone mass, temper and different areas of well being, however we’re nonetheless figuring that out,” stated Nora Lansen, M.D., a household doctor and chief medical officer at Elektra Well being.
Much more is understood about testosterone’s direct results for males, together with its robust impression on libido, bone mass, temper and muscle progress, defined Lansen. “Common ranges are about 10 to twenty occasions greater in males than in ladies,” she stated.
For ladies, testosterone ranges slowly decline with age, attain a low level within the late 50s, then rise barely once more. Research exhibits this sample has extra to do with age than with the menopause transition itself.
What’s testosterone used for?
Testosterone is greatest supported for postmenopausal ladies with low sexual need that’s upsetting or distressing, after a full verify of different causes like drugs, sleep, temper, ache and relationship elements, stated Sameena Rahman, M.D., an OB‑GYN and sexual drugs specialist. Main medical teams together with The Menopause Society follow this approach and advise cautious dosing and monitoring.
Lansen famous that remedy is private and that need could be influenced by different elements. If a lady’s testosterone ranges are regular or excessive, placing further testosterone into her system could be neither protected nor useful, she defined. Whereas testosterone is most frequently prescribed postmenopause, Lansen stated it could be thought-about for ladies in late perimenopause on a case-by-case foundation after analysis and lab overview.
How testosterone remedy works
Earlier than any prescription, your healthcare provider (HCP) ought to take a look at the entire image. If low desire continues to be upsetting after that workup, testosterone could also be thought-about for HSDD.
Types and doses
Consistent with the International Society for the Study of Women’s Sexual Health (ISSWH), most consultants prescribe very low-dose pores and skin gels or lotions that had been designed for males however given at a fraction of the male dose. Many begin their sufferers round one-tenth (some use even much less) and alter slowly. A small, measured quantity is utilized as soon as a day to scrub pores and skin, such because the thigh. Pellets are normally prevented as a result of they can’t be adjusted or eliminated and will elevate ranges too excessive, stated pharmacist Jobby John, PharmD, founding father of compounding pharmacy Lake Hills in Bee Cave, Texas.
Metered dosing helps
Compounded, metered‑dose gadgets let every “click on” equal one dose, which cuts down on measuring errors and lowers switch threat, famous John. Some suppliers additionally use tiny vaginal tablets for native tissue results when applicable, that are made per‑affected person with a legitimate prescription, and may comply with particular high quality requirements, John stated.
Monitoring and security
HCPs often check complete testosterone about three to 6 weeks after beginning or altering a dose, then each 4 to 6 months when secure. The aim is to maintain ranges in a standard premenopausal vary and look ahead to unwanted side effects. Name your HCP if you happen to discover:
- Zits
- Extra facial hair
- Thinning hair on the scalp
- A deeper voice
- Clitoral progress
We don’t but know the long-term results on the guts, mind, bones or breast tissue. Observe shared decision-making along with your HCP to find out whether or not the advantages of utilizing testosterone outweigh the dangers for you.
Insurance coverage and value
As a result of there isn’t a FDA-approved testosterone for ladies within the U.S., the medication is commonly not coated by insurance coverage. Workplace visits and labs could also be coated. “Compounded testosterone is nearly by no means coated by insurance coverage, and most girls pay about $45 to $90 monthly, relying on the components,” stated John. Coupons might decrease the price of male-labeled gels used at very low doses.
Read: What You Need to Know: Compounded Medications >>
Entry and fairness
Off-label standing and cash-pay prices make care tougher for folks with decrease incomes and those that reside removed from specialty clinics. Research exhibits there are already gaps in menopause care by race and earnings. Ladies of coloration are much less more likely to be supplied or to obtain customary hormone remedy, and value, bias and medical distrust can all play a job in these disparities.
When a remedy is off‑label and money‑pay, these gaps can widen. “Though it’s actually nice that menopause is a subject being more and more mentioned within the media, it’s not honest to supply menopause data to all however reserve remedy for less than those that can afford it,” stated Lansen.
If value or entry is a barrier, ask about:
- Insurance coverage‑pleasant clinics (together with Medicaid) and monetary counseling
- Telehealth options and pharmacies that ship
- Money costs and reductions for low‑dose, male‑labeled gels used off‑label
- Accredited compounding pharmacies (PCAB/NABP) and clear, metered dosing to keep away from waste
The way forward for testosterone remedy for ladies
Researchers are engaged on women-specific formulations and higher long-term security knowledge. Australia already has a testosterone cream dosed for ladies, and a few experts want an FDA‑authorised possibility within the U.S. so dosing and entry are clearer. Till then, care will doubtless stay off‑label, with cautious monitoring and a focus to fairness and value.
