Cate Corridor’s intercourse drive tanked when she hit 40. After months of attempting—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 type of an ‘aha’ second,” says Corridor, a 41-year-old in Berkeley, Calif. “It clicked that that is perhaps what was happening, 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 alternative remedy (TRT)—receiving common small doses of the hormone that’s virtually synonymous with male well being. Inside a few week, she began noticing enhancements throughout most points of her life. “The cognitive results have been very dramatic,” she says; it rapidly 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 nervousness and extra confidence, will get not less than eight hours of sleep an evening (in comparison with six pre-testosterone), and has welcomed again the power she must train commonly. 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 largest 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 instances 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 ‘guide membership impact’—girls who’ve super outcomes share it with their associates, after which we see associates of our sufferers coming in to inquire about related options.”
However can testosterone remedy for girls actually result in such profound well being enhancements? We requested specialists to elucidate its potential advantages—and limitations.
What precisely is testosterone remedy?
Opposite to fashionable notion, testosterone isn’t merely a male hormone. Whereas girls have smaller quantities than males, testosterone performs an vital position in regulating the menstrual cycle, sustaining bone density and muscle mass, and enhancing cognitive well being, temper, sexual operate, and power. “After 30, our testosterone ranges lower,” Jordan says. “And by the point we’re in midlife, within the premenopause and menopausal part, they’re all the way down to about 25% of what they have been once we have been youthful.”
Enter testosterone alternative remedy. Greater than 30 completely different testosterone merchandise are accepted for males by the U.S. Meals and Drug Administration (FDA), however the company has by no means accepted testosterone for girls. Nevertheless, 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 therapy, says Dr. Traci A. Kurtzer, a gynecologist on the Northwestern Medication Middle for Sexual Medication and Menopause, opening the door to individuals who can’t or don’t wish to take different hormones for numerous causes.
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To find out if a lady is an efficient candidate for TRT, medical doctors usually begin by checking hormone ranges to verify somebody “isn’t already coming in on the excessive facet of regular,” Kurtzer says. (Testosterone ranges beneath 20 ng/dL in girls 50 and older are usually thought of low.) It’s additionally vital 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 form of wasted.” The precise dose that girls take varies, however the objective is to attain the identical stage of testosterone they’d have had of their premenopausal years.
There are a couple of types of testosterone, together with pellets injected beneath the pores and skin, capsules taken orally, and topical gels and lotions. Medical doctors usually choose a cream or gel that’s utilized to the pores and skin, normally to the again of the thigh, calf, or buttocks. Ladies have to take 1/tenth of the dose males take, which may be tough to estimate, so many get their prescriptions from compounding pharmacies specializing in customized dosing. The downsides of utilizing a compounding pharmacy are that their merchandise aren’t FDA-approved, and dosing may be inconsistent. In a single research, some merchandise contained greater than 20% of the prescribed dose, whereas others had basically no testosterone. “It could be very nice,” Kurtzer says, “if we did have an FDA-approved product for girls that was dosed appropriately.”
Potential advantages
One of the best evidence-based use case for TRT for girls is growing sexual operate in a secure, efficient method. It’s “fairly clear” that low doses of testosterone can enhance libido for post-menopausal girls experiencing hypoactive sexual need dysfunction (HSDD), which implies lack of need with out another underlying trigger, Kurtzer says. “It’s not as a result of they hate their accomplice, or have ache, or as a result of they’re exhausted from working two jobs and may’t focus.” In keeping with one analysis evaluate, 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 at all times valued an lively way of life, however discovered that when she reached perimenopause, issues began altering. “I imply, drastically,” she says. “I had no need to rise up, no libido, nothing.” It took a while for her and her physician to determine the fitting testosterone dosage, however as soon as they did, she felt like the perfect model of herself once more. “Inside every week, I assumed, ‘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 assumed, ‘That is unbelievable. Who wouldn’t do that? I would like to inform extra individuals.’”
So is TRT actually all that? There’s merely not sufficient information to again up the hype. “We actually cannot say that it is not 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 haven’t got ample information.”
The research that do exist have yielded unsure outcomes past enhancing sexual operate; plus, little is understood in regards to the long-term results of testosterone in girls. “We’ve got no long-term research—even utilizing it for HSDD, the research actually are round two years,” she says. “With the concept this can be a long-term resolution, what is the tradeoff? Are you now impacting that lady’s total coronary heart illness danger? Are we growing breast most cancers danger? We’ve got no long-term information on that.”
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Extra information exist for males. Massive 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 alter. One other research discovered that TRT doesn’t improve the danger of prostate most cancers, even after greater than 15 years of therapy. But it’s exhausting to attract conclusions about girls based mostly on these findings, specialists say, since dosage isn’t the identical (although it’s normally decrease) and girls’s our bodies work in another way.
Nonetheless, Kurtzer—who has been prescribing testosterone to girls for years—hopes analysis will someday affirm that TRT is as useful as a few of her sufferers declare. “I might love for it to be true that it helps with all these issues, as a result of we do not have loads of 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 form of feeling. That is why I am like, ‘Wow, if it is true and it is secure, 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.”
Unintended effects of testosterone remedy
When April Sandefer first tried TRT 10 years in the past, it went effectively. “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 begin again up once more, and inside a couple of months, she observed her hair was turning into skinny and her face was breaking out. She additionally turned aggressive at work, she says—an out-of-character growth. “I stated some actually inappropriate issues,” remembers Sandefer, 64, who lives in Oklahoma Metropolis. “My boss pulled me apart and was like, ‘April, you may’t discuss like that to me.’” She ended up stopping therapy. “It’s disappointing that as we grow old, we simply have to simply accept [annoying symptoms], as a result of they do not appear to have loads of issues created for girls,” she says. She doesn’t plan to strive testosterone once more: “It’s not price it to me.”
Certainly, analysis suggests that within the brief time period, TRT might result in hair progress on the face, chest, and again, in addition to pimples and behavioral and character adjustments. That may be very true for these receiving pellets, which generally comprise greater doses than different types of testosterone. “As soon as they’re in your physique, you may’t alter or modify the dose or how lengthy you are uncovered to it,” Kurtzer says. “These have usually been the individuals who come to us with problems, 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 take care of disagreeable uncomfortable side effects. That is why specialists together with Kurtzer usually suggest 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 gentle masculinization do happen.
“The best way we strategy it’s we hearken 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 effectively and important—moderately than simply saying it’s a blanket anti-aging therapy that every one girls ought to have,” Jordan says. “When it’s achieved with that type of steering and counseling, it may be very secure and efficient.”
