Cate Corridor’s intercourse drive tanked when she hit 40. After months of making an attempt—and failing—to spice up it, she learn a pamphlet in a health care provider’s workplace in regards to the results of low testosterone in girls, together with low libido, lack of power, lack of power and muscle tone, and cognitive difficulties, like bother concentrating. “I simply had form of an ‘aha’ second,” says Corridor, a 41-year-old in Berkeley, Calif. “It clicked that that is perhaps what was occurring, as a result of there was such a superb match between the issues I used to be experiencing and the signs of low testosterone.”
Corridor scheduled an appointment with a specialist, and in 2024 began testosterone substitute remedy (TRT)—receiving common small doses of the hormone that’s nearly synonymous with male well being. Inside a couple of week, she began noticing enhancements throughout most elements of her life. “The cognitive results have been very dramatic,” she says; it shortly resolved her mind fog and reminiscence issues. “I really feel sharper now mentally than I did 10 years in the past.” She has much less anxiousness and extra confidence, will get at the very least eight hours of sleep an evening (in comparison with six pre-testosterone), and has welcomed again the power she must train usually. She’s additionally misplaced 6% of her physique fats since beginning TRT—and her libido improved. “I actually suppose it has been, by far, the most important quality-of-life enchancment I’ve ever made for myself,” she says.
Corridor’s story isn’t distinctive: Cisgender girls throughout the web are touting the anecdotal advantages of testosterone remedy, and a few specialists say these tales match what they’re listening to of their workplaces. Many describe being requested about TRT a number of occasions a day. “There’s been growing consideration to it,” says Dr. Kathleen Jordan, chief medical officer of Midi Well being, a digital care clinic centered on navigating perimenopause and menopause. “We name it the ‘e-book membership impact’—girls who’ve super outcomes share it with their mates, after which we see mates of our sufferers coming in to inquire about related options.”
However can testosterone remedy for ladies actually result in such profound well being enhancements? We requested specialists to clarify its potential advantages—and limitations.
What precisely is testosterone remedy?
Opposite to in style notion, testosterone isn’t merely a male hormone. Whereas girls have smaller quantities than males, testosterone performs an necessary position in regulating the menstrual cycle, sustaining bone density and muscle mass, and enhancing cognitive well being, temper, sexual perform, and power. “After 30, our testosterone ranges lower,” Jordan says. “And by the point we’re in midlife, within the premenopause and menopausal section, they’re all the way down to about 25% of what they have been after we have been youthful.”
Enter testosterone substitute remedy. Greater than 30 completely different testosterone merchandise are accredited for males by the U.S. Meals and Drug Administration (FDA), however the company has by no means accredited testosterone for ladies. Nonetheless, medical doctors can nonetheless prescribe it off-label to girls they really feel would profit. Traditionally, testosterone was utilized in mixture with estrogen and progesterone, hormones that decline with age. However as of late, it’s additionally prescribed as a standalone remedy, says Dr. Traci A. Kurtzer, a gynecologist on the Northwestern Drugs Middle for Sexual Drugs and Menopause, opening the door to individuals who can’t or don’t need to take different hormones for numerous causes.
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To find out if a girl is an effective candidate for TRT, medical doctors sometimes begin by checking hormone ranges to verify somebody “isn’t already coming in on the excessive facet of regular,” Kurtzer says. (Testosterone ranges underneath 20 ng/dL in girls 50 and older are sometimes thought of low.) It’s additionally necessary to verify intercourse hormone binding globulin, or SHBG, as a result of if it’s excessive, “any exogenous testosterone we give somebody is simply going to be sure up,” she says. “It’s not going to be helpful to them, so it turns into type of wasted.” The precise dose that ladies take varies, however the objective is to realize the identical stage of testosterone they might have had of their premenopausal years.
There are just a few types of testosterone, together with pellets injected underneath the pores and skin, capsules taken orally, and topical gels and lotions. Docs sometimes want a cream or gel that’s utilized to the pores and skin, often to the again of the thigh, calf, or buttocks. Girls must take 1/tenth of the dose males take, which might be troublesome to estimate, so many get their prescriptions from compounding pharmacies focusing on customized dosing. The downsides of utilizing a compounding pharmacy are that their merchandise aren’t FDA-approved, and dosing might be inconsistent. In a single examine, some merchandise contained greater than 20% of the prescribed dose, whereas others had primarily no testosterone. “It might be very nice,” Kurtzer says, “if we did have an FDA-approved product for ladies that was dosed appropriately.”
Potential advantages
One of the best evidence-based use case for TRT for ladies is growing sexual perform in a protected, efficient method. It’s “fairly clear” that low doses of testosterone can enhance libido for post-menopausal girls experiencing hypoactive sexual want dysfunction (HSDD), which suggests lack of want with out another underlying trigger, Kurtzer says. “It’s not as a result of they hate their associate, or have ache, or as a result of they’re exhausted from working two jobs and might’t focus.” In line with one analysis overview, TRT improved the frequency of sexually satisfying occasions, arousal, and orgasm in surgically and naturally postmenopausal girls.
But the image will get murkier past that. Anecdotally, many ladies expertise a number of advantages. Toi-Yan Littlejohn, 57, a retired firefighter in California, tried testosterone pellets and sublingual testosterone earlier than switching to a supplier at Midi Well being who prescribed testosterone cream. Littlejohn had all the time valued an energetic way of life, however discovered that when she reached perimenopause, issues began altering. “I imply, drastically,” she says. “I had no want to rise up, no libido, nothing.” It took a while for her and her physician to determine the precise testosterone dosage, however as soon as they did, she felt like one of the best model of herself once more. “Inside every week, I believed, ‘I really feel so significantly better. I really feel extra clear.’ I used to be figuring out and my depth was again, my libido was again,” she says. ‘I believed, ‘That is implausible. Who wouldn’t do that? I want to inform extra individuals.’”
So is TRT actually all that? There’s merely not sufficient knowledge to again up the hype. “We actually cannot say that it isn’t doubtlessly useful,” Kurtzer says. “Might it assist with physique composition and changing that muscle? Might it assist with bodily functioning, power, and even cognitive well being and temper?” Perhaps. “The issue is,” she says, “we simply do not have enough knowledge.”
The research that do exist have yielded unsure outcomes past enhancing sexual perform; plus, little is understood in regards to the long-term results of testosterone in girls. “We’ve no long-term research—even utilizing it for HSDD, the research actually are round two years,” she says. “With the concept it is a long-term resolution, what is the tradeoff? Are you now impacting that girl’s total coronary heart illness danger? Are we growing breast most cancers danger? We’ve no long-term knowledge on that.”
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Extra knowledge exist for males. Giant analyses have discovered no proof that testosterone will increase cardiovascular issues within the short- to medium-term, for instance, and an individual’s danger of dying early doesn’t seem to vary. One other examine discovered that TRT doesn’t improve the danger of prostate most cancers, even after greater than 15 years of remedy. But it’s arduous to attract conclusions about girls primarily based on these findings, specialists say, since dosage isn’t the identical (although it’s often decrease) and ladies’s our bodies work in another way.
Nonetheless, Kurtzer—who has been prescribing testosterone to girls for years—hopes analysis will at some point affirm that TRT is as helpful as a few of her sufferers declare. “I’d love for it to be true that it helps with all these issues, as a result of we do not have numerous different options, and it’s irritating for individuals,” she says. “I used to liken it to a drug—and I meant that facetiously—however individuals who have been on it felt so elated and good. It’s a robust type of feeling. That is why I am like, ‘Wow, if it is true and it is protected, and we are able to use it long run, I am all for it.’ However at this level, we simply do not know the detrimental piece of it.”
Unwanted effects of testosterone remedy
When April Sandefer first tried TRT 10 years in the past, it went properly. “I felt nice,” she says. However she stopped taking it when the compounding pharmacy she used went out of enterprise. A pair years in the past, she determined to start out again up once more, and inside just a few months, she observed her hair was turning into skinny and her face was breaking out. She additionally grew to become aggressive at work, she says—an out-of-character growth. “I stated some actually inappropriate issues,” recollects Sandefer, 64, who lives in Oklahoma Metropolis. “My boss pulled me apart and was like, ‘April, you may’t speak like that to me.’” She ended up stopping remedy. “It’s disappointing that as we grow old, we simply have to just accept [annoying symptoms], as a result of they do not appear to have numerous issues created for ladies,” she says. She doesn’t plan to strive testosterone once more: “It’s not value it to me.”
Certainly, analysis suggests that within the brief time period, TRT may result in hair progress on the face, chest, and again, in addition to pimples and behavioral and persona modifications. That may be very true for these receiving pellets, which generally include greater doses than different types of testosterone. “As soon as they’re in your physique, you may’t alter or alter the dose or how lengthy you are uncovered to it,” Kurtzer says. “These have sometimes been the individuals who come to us with issues, as a result of it’s far more than their our bodies can accommodate.” It takes about three to 4 months for testosterone pellets to metabolize out of your system, she provides, which is a very long time to cope with disagreeable uncomfortable side effects. That is why specialists together with Kurtzer sometimes advocate towards utilizing pellets.
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Nonetheless, specialists say that one widespread fear about TRT in girls—creating male traits—is overblown. “Concern about masculinization is disproportionate to what actually occurs,” Jordan says. She hasn’t seen sufferers develop male sample baldness, develop a beard, or begin talking in a deeper voice, for instance. Common blood testing is useful, she provides, and permits clinicians to make dosage changes if uncomfortable side effects like delicate masculinization do happen.
“The way in which we method it’s we take heed to girls, determine what their signs are and what well being profit they’re in search of, and what is going on to assist them really feel properly and important—relatively than simply saying it’s a blanket anti-aging remedy that each one girls ought to have,” Jordan says. “When it’s achieved with that form of steering and counseling, it may be very protected and efficient.”
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