While testosterone is often considered a male hormone, it plays an important role in women’s health as well—particularly in sexual desire, mood, energy, and general well-being. A decrease in testosterone levels can contribute to low libido, but addressing the issue with hormone supplementation is more complex than it might seem.

This article explores the function of testosterone in women, how declining levels can affect libido, and what current research says about using testosterone therapy for women. It also outlines alternative approaches to supporting sexual health naturally and safely.

 

The Role of Testosterone in Female Sexual Health

Testosterone, though present in smaller quantities than in men, is a crucial hormone for women. It is produced by the ovaries and adrenal glands and contributes to several important functions, including:

  • Sexual desire and arousal

  • Vaginal and clitoral sensitivity

  • Mood and emotional stability

  • Energy levels

  • Muscle mass and bone density

  • Cognitive clarity and mental focus

Testosterone levels tend to decline gradually with age, particularly during and after menopause. This reduction can be associated with decreased sexual interest, lower arousal, fatigue, and mood shifts. Some women may also notice changes in body composition, such as reduced muscle mass or increased abdominal fat.

Testosterone and Libido: What's the Connection?

Sex drive—or libido—is influenced by many factors, both physical and emotional. Hormones, especially testosterone, play a central role in triggering sexual desire. Lower levels can result in:

  • Less frequent thoughts about sex

  • Reduced responsiveness to sexual stimulation

  • Difficulty achieving orgasm

  • Lower sensation in genital areas

In menopausal and postmenopausal women, the natural decline in estrogen and testosterone often coincides with decreased libido, vaginal dryness, and discomfort during intercourse. These symptoms may be part of a larger pattern referred to as hypoactive sexual desire disorder (HSDD).

 

Is Testosterone Therapy an Option?

In men, testosterone therapy is a common treatment for low libido. However, in women, the issue is more complex. Testosterone supplementation is not formally approved in the United States for use in females, though it may be prescribed off-label by some healthcare providers.

Treatment options—adapted from formulations approved for men—may include:

  • Topical creams or gels

  • Skin patches

  • Oral tablets or capsules

  • Injections

  • Hormone implants (pellets)

Since these formulations are designed for male hormone levels, women typically receive much lower doses—often one-tenth or less of the male dosage. The goal is to raise testosterone levels to a normal premenopausal range without exceeding it.

However, medical professionals emphasize that there is no universally agreed-upon safe dose for women. Without standardized guidelines, treatment is often individualized and closely monitored.

What Does the Research Say?

Although some small studies suggest that testosterone therapy can improve sexual function in postmenopausal women, larger clinical trials are lacking—especially concerning long-term safety.

For example, a comprehensive analysis published in a leading endocrinology journal reviewed 36 randomized controlled trials and concluded that testosterone could improve sexual desire and satisfaction in postmenopausal women. However, the same review raised concerns about:

  • Increases in LDL cholesterol when taken orally

  • Decreases in HDL (good) cholesterol

  • The lack of clear data on cognitive or bone health effects

  • Potential risks in premenopausal women due to insufficient research

Creams and patches appear to have fewer adverse effects on lipid levels compared to oral forms. Nonetheless, there is limited evidence to determine whether testosterone therapy is safe for long-term use in women.

Potential Side Effects of Testosterone Use in Women

Like any hormone therapy, testosterone carries risks. Common side effects include:

  • Acne or oily skin

  • Increased body or facial hair

  • Voice deepening

  • Changes in mood or irritability

  • Enlarged clitoris

  • Irregular menstrual cycles (in premenopausal women)

  • Weight changes or fluid retention

Rare but serious side effects may include liver changes, cardiovascular effects, or potential negative impacts on breast tissue. This is why healthcare professionals typically recommend monitoring hormone levels every few months and discontinuing use if side effects appear or hormone levels rise too high.

Why Testosterone Therapy Isn’t Widely Prescribed

Testosterone therapy is not commonly recommended for women—particularly for those who are premenopausal—due to the absence of FDA-approved products specifically designed for female use and the limited research available on its safety.

Doctors generally proceed with caution, often advising lifestyle and psychological interventions first. When testosterone is prescribed, it is usually reserved for postmenopausal women who experience distress related to low sexual desire and who have ruled out other possible causes.

Other Causes of Low Libido in Women

It’s important to understand that low libido is not always linked to hormone levels. Many physical, psychological, and social factors can contribute, including:

  • Chronic stress or fatigue

  • Anxiety, depression, or other mood disorders

  • Relationship difficulties or emotional disconnection

  • Medications such as antidepressants or birth control pills

  • Medical conditions like diabetes, thyroid disorders, or chronic pain

  • Past trauma or unresolved emotional issues

Because of this, addressing low libido often requires a comprehensive, multifactorial approach rather than focusing solely on hormones.

Non-Hormonal Strategies for Improving Libido

If testosterone therapy isn’t the right fit, or if you’re seeking more natural alternatives, there are many other ways to support sexual health and well-being.

1. Lifestyle Modifications

  • Regular physical activity improves circulation and boosts mood

  • A nutrient-rich diet supports hormone balance

  • Adequate sleep and stress management reduce fatigue and anxiety

  • Avoiding smoking and excessive alcohol benefits overall health

2. Open Communication with a Partner

Sharing your needs, feelings, and desires openly can improve intimacy and reduce pressure or misunderstanding in the relationship.

3. Counseling or Sex Therapy

Working with a licensed therapist can help address emotional or psychological blocks to sexual satisfaction. Cognitive-behavioral therapy (CBT) and mindfulness approaches may also enhance sexual responsiveness.

4. Pelvic Floor Therapy

Some women experience improved sexual sensation and reduced pain with the help of pelvic floor physical therapy, which strengthens key muscles and enhances blood flow to the genital area.

5. Vaginal Moisturizers and Lubricants

For those experiencing vaginal dryness, using water-based lubricants or prescription vaginal estrogen can ease discomfort and make intimacy more enjoyable.

When to Seek Medical Advice

If you’re experiencing a persistent decline in sexual desire that causes distress or affects your quality of life, consider speaking with a healthcare provider. They may evaluate:

  • Hormone levels through blood testing

  • Medication history

  • Psychological well-being

  • Overall physical health

Depending on the findings, your provider may recommend lifestyle changes, counseling, or carefully managed hormone therapy.

Final Thoughts

Testosterone plays a vital role in female sexual health, but supplementing it to treat low libido is not a one-size-fits-all solution. The science is still evolving, and long-term safety data for women remains limited.

If you are struggling with low libido, there are many ways to support your sexual well-being—ranging from hormonal assessments and medical support to therapy, lifestyle changes, and open communication. The key is taking a holistic, patient-centered approach that honors both your physical health and emotional needs.