Social media influencers believe they do. And with the rise of telemedicine and testosterone replacement clinics opening up across the country, access to the drug has never been easier.
In the U.S., prescriptions for testosterone increased nearly 50% between 2013 and 2023, according to recent data from the health technology company IQVIA. Doctors say interest in the hormone isn’t being driven only by men, but also by women in their 40s and 50s.
“It feels almost like an epidemic,” Dr. Rebecca Dunsmoor-Su, chief medical officer for Gennev, a national telemedicine company for menopause patients, said about middle-age women seeking testosterone. “They’re being told this is the miracle-drug pill that they’ve been looking for.”
Because patients are often prescribed testosterone gels, pellets or pills through med-spas and telemedicine, there could be even more women taking the hormone than realized, Dunsmoor-Su said.
Testosterone is the primary male sex hormone and plays a variety of roles in the human body. In men, testosterone boosts muscle mass, sex drive and deepening of the voice. In women, who also have testosterone generally in much lower levels, it also plays a role in libido, muscular health and energy.
Typically, testosterone levels in men are around 15 times higher than in women.
In both women and men, it’s normal for testosterone levels to drop with age — starting at about age 30 in men and around 40 in women. The decline doesn’t mean that it necessarily needs to be replaced, either for health or longevity.
Levels for what is considered normal can vary depending on the lab, and just because levels are low, that does not necessarily mean testosterone should be started. Doctors use a combination of symptoms and blood work in deciding whom to treat.
If a patient does have symptoms of “low T” — including depression, lethargy and low sex drive — doctors typically gauge levels with a blood test before deciding treatment.
Testosterone treatment includes a gel rubbed on the shoulder, pills or an implantable pellet in the buttocks.
Why do women use testosterone?
Dr. Amy Voedisch, an OB-GYN at Stanford Medicine in Palo Alto, California, has noticed a dramatic rise in recent years in middle-age women asking for testosterone therapy.
Perimenopausal symptoms begin when women reach their 40s, triggered by hormonal fluctuations and accompanied by irregular periods, brain fog, insomnia and hair loss. The changes typically begin a few years before menopause, when periods permanently end.
Some women may notice a decrease in sex drive as levels of estrogen and testosterone, both of which play a role in libido, start to decline as they get older.
“I’ll talk about menopausal hormone therapy and then they’ll say — but what about testosterone?”
Topical testosterone products first hit the market in the early 2000s.
Voedisch, who has been in practice for decades, says the phenomenon among women really started to take off just in the last couple of years. Previously, interest in testosterone therapy rarely came up in appointments, she said.
Now, virtually every new menopause patient she sees will ask about it.
A patient will say, “I was listening to this podcast, and they said that I needed this,” she said. “Or I have this Instagram person that I follow and she said that I absolutely have to be on it.”
Few of the claims are supported by evidence, Dunsmoor-Su said.
“It’ll give them energy, it’ll make them thin, it will make them horny, like they’ve been promised,” she said, describing common claims about the drug. “It does everything — and all of their problems are just because they’re a little low in testosterone.”
Dr. Traci Kurtzer, a menopause specialist at the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago, agreed the push for testosterone started happening in recent years. Her patients inquire about testosterone therapy for multiple problems — to improve mood, energy, sex drive, brain fog and muscle mass.
She tells patients that testosterone therapy is currently only recommended for a low sex drive, although future research may find other benefits.
“If that’s the case, that’ll be wonderful, but at this point in time we don’t have the data to support that,” Kurtzer said.
Does testosterone help women?
The Food and Drug Administration hasn’t approved testosterone therapy for women. However, doctors can prescribe it for low sex drive after other causes, including medical and psychological ones, are ruled out, said Dr. Jan Shifren, director of Massachusetts General Hospital’s Midlife Women’s Health Center in Boston.
Shifren, who has been involved in clinical trials looking at testosterone therapy in women, said that the benefits for women with low libido aren’t terribly impressive.
“Women who are randomized to testosterone, compared with placebo, have one additional satisfying sexual event in four weeks, compared with placebo,” she said.