Is testosterone therapy safe for women?

This is a difficult question to answer because the long-term effects of testosterone therapy for women have not been widely studied. There are some concerns about testosterone therapy and heart disease, breast cancer, and endometrial cancer. Some side effects, such as clitoral enlargement and voice deepening, could be permanent.

In many countries, such as the United States, Canada, and Australia, testosterone therapy for women has not been approved by regulating agencies. However, many doctors prescribe testosterone “off-label.” This means that the prescribed medication has not been approved for the condition it’s meant to treat.

In September 2012, Canadian researchers reported that short-term testosterone therapy is safe for postmenopausal women with hypoactive sexual desire disorder (HSDD), according to evidence presented in clinical trials. Women with HSDD have low sex drive to the point that it causes them personal distress.

The Canadian researchers suggested that the safest way for women to take testosterone is transdermally, through a patch worn on the skin.

Some experts advise patients to have regular blood tests while on testosterone therapy. By doing this, they can make sure that there isn’t too much testosterone in the system. Safety becomes more of a concern when doses are too high.

In October 2014, a group of experts representing five medical societies issued updated clinical guidelines that recommended against prescribing testosterone therapy for healthy women.

The societies included the Endocrine Society, the American Congress of Obstetricians and Gynecologists, the American Society of Reproductive Medicine, the European Society of Endocrinology, and the International Menopause Society.

After reviewing published research, the experts felt that there was not enough evidence to show that the benefits of this treatment outweighed the risks.

In addition, data did not show a correlation between low testosterone levels and specific signs or symptoms.

They noted that a three-to-six month course testosterone therapy may help women with HSDD. However, careful monitoring is important.

Otherwise, testosterone should not be prescribed to women at all, they said. It is still unclear how long-term use of testosterone affects breast and cardiovascular health. Also, women taking testosterone may be at higher risk for cholesterol changes, acne, and the development of excessive hair growth on the face, back, or chest.