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Are you a women that has recently been prescribed testosterone? Are you worried about using it because you are afraid of what it might do to your body? My name is Andrea Barrera and I am a pharmacist at Peoples. I have noticed many of my female customers are a little uneasy about starting hormone replacement with testosterone, so I’d like to share some knowledge concerning why your doctor might think this treatment is right for you.

When many people hear the word “testosterone” they think of it as a male hormone. Yet, testosterone is not only a male hormone. Women produce testosterone, as well, simply in lesser amounts than men. The physiologic testosterone level of a male is much higher than females, which is pretty obvious when you think about how men have deeper voices, more facial hair, larger muscle mass, etc. As we age, both women and men start making fewer hormones, including testosterone.

There are many reasons why a woman’s testosterone may be low, but the most common reason is menopause. The ovaries and the adrenal glands are primarily responsible for the production of women’s testosterone. The post-menopausal ovaries markedly produce lower amounts of estrogen and have been shown to substantially produce lower amounts of testosterone in 50% of women. Following menopause, a woman loses a significant portion of her ovarian testosterone and adrenal testosterone production. There are other possible causes of low testosterone. Our pharmacists can inform you of certain medical conditions or medications that may lower testosterone levels.

Some signs and symptoms that your body may be low in testosterone include fatigue, reduced muscle tone, alteration in body composition, lower self-esteem, low libido, difficulty reaching orgasm, pain during intercourse, dry/thin skin with poor elasticity, dry/brittle scalp hair, dry skin, droopy eyes, sagging cheeks and thin lips. In testosterone deficient women, testosterone supplementation can provide beneficial effects on libido, quality of life, vital energy, mood, and may result in increased bone mineral density.

When speaking with your doctor about hormone replacement therapy, consider the following:

1. Start with a low dose: Most women start at a strength between 0.1 % to 2% testosterone applied daily and then decreased to 2-3 times per week. Testosterone supplementation within the physiological range of 0.25mg to 0.8mg per day has not been shown to produce the androgenic side effects that you may be concerned about (listed below).
2. Topical application is the preferred route of administration for women. It can be applied to the inner and outer vagina or your physician may prefer application to the inner thigh, back of calves or inner arms. Testosterone can be transferred through contact so inner arms would not be the best place if you are caring for children.
3. Hormone replacement therapy for women typically involves estrogen, progesterone (if you have an intact uterus) and testosterone. Your doctor will often get your estrogen and progesterone levels stable before starting testosterone or combine them. One concern may be, testosterone given alone, without estrogen can increase plaque formation and can increase risk of heart disease.
4. Natural testosterone versus methyltestosterone. Methyltestosterone has been associated with liver abnormalities, including tumors and cholestatic jaundice. Therefore, natural testosterone is often preferred. Peoples compounds testosterone cream by using the form derived from plant-based sources, which are chemically identical to what your body naturally produces. This allows your body to utilize the hormone without the side effects that are commonly associated with the non-bio identical hormones, like methyltestosterone.

Depending on your history, present symptoms, and past conditions, it is necessary to develop a plan with your doctor that best suits you and your body. Hormone replacement therapy might not be for everyone and it is worth noting that testosterone can be increased in a variety of different ways. COme talk to our practitioners about alternative ways to increase your testosterone and speak to your doctor about what is right for you.

by Andrea Barrera, RPh, PharmD


Miller, K. 2001. Androgen Deficiency in Women. J Clin Endocrinol Metab. 86: 2395-2401.
Rako, S. Testosterone Deficiency and Supplementation for Women.
Berkson, DL. 2010. Safe Hormones Smart Women.
Smith, PW. 2012. What You Must Know About Women’s Hormones. BHRT & Women’s Health Symposium. 24-26.