Testosterone Therapy in Women: A Literature Review of Clinical Indications, Dosing, Routes of Administration, and Safety

Testosterone therapy is used to treat symptoms like low libido, fatigue, and mood disturbances in women, despite the lack of FDA-approved formulations. This review highlights the importance of testosterone in female health, noting its production in the ovaries and adrenal glands and its role in addressing androgen insufficiency symptoms, particularly after menopause. While diagnostic challenges exist, a symptom-based approach is favored over serum level assessments. Evidence supports the safety and effectiveness of testosterone therapy, especially through subcutaneous implants and transdermal patches, with mild and reversible side effects such as acne and hirsutism. Long-term safety data do not indicate increased risks of breast cancer or cardiovascular disease at therapeutic doses. The absence of FDA-approved options leads many women to use compounded therapies, underscoring the need for long-term RCTs to establish dosing guidelines and safety standards, ensuring women have access to regulated and effective treatments.