The New York Times Magazine calls it a cultural phenomenon. No, it’s not social media influencers or artificial intelligence. It’s the rise of testosterone therapy among women — a type of therapy that research indicates won’t benefit a lot of women.
Testosterone is traditionally a male thing. Millions of men in the U.S. undergo testosterone replacement therapy to raise abnormally low testosterone levels and treat symptoms like decreased libido, erectile dysfunction and fatigue, according to U.S. Pharmacist.
Meanwhile, millions of American women turn to hormone therapy (including estrogen) to treat hot flashes, night sweats, sleep disruptions and other health issues experienced during menopause, the Menopause Society says.
Although we focus on testosterone levels in men and estrogen levels in women, men need estrogen and women need testosterone. Estrogen affects men’s sex drive, along with their ability to get an erection and produce sperm, the Cleveland Clinic says. For women, testosterone plays a key role in bone development, muscle development and sexual function, according to The New York Times Magazine.
Why are women flocking to testosterone therapy?
Women increasingly are relying on testosterone therapy to boost testosterone levels. As The New York Times Magazine explains, testosterone peaks in women in their late teens and early 20s, then declines over time. By age 60, their testosterone levels have dropped by about half
Now, some menopausal women who complain of low libido are discovering the benefits of testosterone therapy.
“High-quality research has shown that testosterone can meaningfully revive sex drive when prescribed in doses that restore women to roughly the levels they had in their late 30s — what’s often considered standard dosing,” The New York Times Magazine reports.
Men can take advantage of more than 30 testosterone-boosting products approved by the U.S. Food and Drug Administration (FDA), according to The New York Times Magazine. But women have no such products at their disposal. Without the FDA’s blessing, many physicians won’t prescribe testosterone therapy for women. And even if doctors do prescribe testosterone for women, health insurance won’t pay for the treatments.
AARP explains that U.S. health care providers who want to prescribe testosterone for women must use a compounding pharmacy or prescribe an approved men’s treatment off-label and adjust the dosage downward.
When mainstream doctors reject testosterone prescription requests, some women are finding alternatives for buying the hormone. Among them are med spas, longevity practices and wellness centers, The New York Times Magazine says.
“I see more and more of these places popping up because of all the hype around testosterone,” Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director of the Menopause Society, told The New York Times Magazine. “And a lot of them are giving women testosterone in doses that get them to levels that are normal in a man — but definitely not in a woman.”
Margaret Wierman, an endocrinologist at the University of Colorado Anschutz medical campus, also expresses concern about testosterone therapy for women.
“What’s really concerning to me is that people are out there looking for the silver bullet, for that magic that’s going to transform their lives,” Weirman, who helped write international guidelines on the use of testosterone in women, told AARP. “Testosterone is just not that silver bullet.”
The only benefit of testosterone treatment for women that’s backed by research
AARP notes that the only research-backed benefit of testosterone treatment for women is improved sexual desire in menopausal women.
“Specifically, it can help with what’s called hypoactive sexual desire disorder, which is marked by a reduced interest in sex that is causing distress or difficulties in your relationship,” AARP says.
AARP cites research published in 2019 that examined 36 trials involving nearly 8,500 women and compared testosterone therapy with a placebo or an alternative. Study author Susan Davis, an endocrinologist and chair of the Women’s Health Research Program at Monash University in Australia, told AARP that about 60% of women with low libido will see an improvement in sexual interest with testosterone therapy. However, the average woman taking testosterone experienced only one additional satisfying sexual encounter per month, coupled with just modest improvements, the study shows.
“I could cherry-pick the data and write an article that says testosterone is going to fix everything,” Davis told AARP, “but cherry-picking the data is not what you want to do. You need to see the results replicated across studies to really believe them.”
Before embracing testosterone therapy, women should talk to a health care provider about the pros and cons.
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