Testosterone and Low Libido in Women

Testosterone may be known as a male sex hormone, but women need it, too. Testosterone is part of what drives female desire, fantasy, and thoughts about sex. It also plays a role in ovarian function, bone strength, and the overall well-being of women, says Kelli Burroughs, MD, an obstetrician-gynecologist at Memorial Hermann in Houston. Yet while your testosterone level plays a key role in your sex drive, taking it in supplement form to treat low libido remains controversial.

Here’s what doctors know about testosterone’s role in low libido in women and how the hormone might be used as a treatment.

Women’s testosterone levels gradually go down as they age, and lower amounts of the hormone can also reduce muscle mass, affect skeletal health, impact mood, cause fatigue, and decrease sensitivity in the vagina and clitoris, which affects libido, Dr. Burroughs says.

Although it’s common for men to take testosterone to treat low libido, the U.S. Food and Drug Administration (FDA) hasn’t approved testosterone replacement therapy for women. Some doctors do prescribe it for women as an off-label use, notes Jenna M. Turocy, MD, an ob-gyn at NewYork-Presbyterian Columbia University Irving Medical Center in New York City. “These products include testosterone skin patches, gels, creams or ointments, pills, implants, and injections, often designed and government-approved for men,” Dr. Turocy says.

Testosterone doses provided by these formulations generally are much too high for females, so women are given a fraction (usually one-tenth) of the dose that men are prescribed, notes Barbara Schroeder, MD, an assistant professor and ob-gyn with UTHealth Houston.

“There is no dose that we can say is absolutely safe for women,” she explains. “There are no large randomized trials that have looked at this.” That’s why Dr. Schroeder says to check baseline testosterone levels and re-check them every three to six months to make sure they’re not too high. “The goal is to aim for testosterone levels that are in the normal premenopausal range,” she adds.

If you have low libido, testosterone may help, but it’s important to weigh the benefits with the risks. Know that there are other options that may be beneficial.

“If concerned about low sex drive, women should consult a knowledgeable healthcare provider who can evaluate their individual medical history, symptoms, and hormone levels,” Turocy says. “It's essential to take a comprehensive look at their sexual health, considering not only hormonal factors but also psychological, emotional, and relational aspects.”

Other potential causes of low sex drive, such as stress, relationship problems, medication side effects, or underlying medical conditions, like nerve issues or endometriosis, should be explored and addressed before considering hormone supplementation, she says.