The Facts About Testosterone Replacement Therapy for Women

1. Women Naturally Produce Testosterone — When That Production Drops, It Needs to Be Replaced
2. Symptoms of Low T in Women
3. How Does Testosterone Replacement Therapy Work for Women?
4. What Method of Testosterone Replacement Therapy Is Best For Me?
   1. The Case for Testosterone Injections For Women
      1. Research Supports Testosterone Shots to Treat Menopause
   2. The Problem With Topical Testosterone Supplements (Creams, Gels, or Patches)
      1. Topicals Aren’t Designed for Women
      2. Increasing the Risk of Side Effects: Absorbing Too Much Testosterone
      3. Topicals Can Rub off on Loved Ones’ Skin Accidentally and Harm Them
   3. Why We Never Recommend Testosterone Pellets
   4. Topicals Often Work Well For Estrogen And Progesterone
   5. Testosterone Supplements for Women — A Summary of What Works and What Doesn’t
5. Why Does TRT focus on Restoring Women’s Hormone Balance?
6. How Do I Choose My TRT Provider?
7. TRT for Women: How Do I Get Started?

At Testosterone Centers of Texas (TCT), we base our work on facts, the main one being that TRT is an effective treatment for many symptoms of testosterone deficiency, including anything from the classic lack of interest in sex and weight gain to anxiety and hair loss.

1. Women Naturally Produce Testosterone — When That Production Drops, It Needs to Be Replaced

Estrogen and progesterone are most often associated with women’s hormone imbalances due to their connection to age-related menopausal change and its associated hormonal fluctuation, which every woman will eventually go through.

Women are also familiar with high testosterone in proportion to the female sex hormones but seem surprised to find they could suffer from the opposite—low testosterone.

In fact, women’s bodies naturally produce testosterone just like men’s bodies, but at about 1/10th the level.

It’s a major misconception that, because testosterone is a male hormone, only men’s bodies require it. The truth is that testosterone plays a huge role in women’s reproductive cycle and their health.

That means women can also suffer from low testosterone, and, just like men, the best remedy for relief of symptoms associated with female low testosterone is through Testosterone Replacement Therapy (TRT).

2. Symptoms of Low T in Women

Often mistaken and overlooked as the normal signs of aging, low testosterone levels in women can cause a variety of terrible symptoms, much the same as men. Those symptoms include:

• Fatigue
• Exhaustion
• Weight gain
• Difficulty losing weight
• Difficulty concentrating
• Decreased libido
• Anxiety
• Hair loss

This isn’t even a complete list. What’s difficult to grasp is that most of these are common symptoms of all hormone imbalances, and while the focus is usually just on your estrogen or progesterone levels, what you really need is balance is all three hormones, including testosterone, to feel well.

If your body has stopped producing a normal amount of any of these critical hormones—testosterone, estrogen, or progesterone—hormone replacement therapy to rebalance them may be the only recourse.

As this fact becomes better recognized by the medical community with each passing year, TRT for women is becoming more and more prevalent.

Most notably, testosterone has been found to be quite efficient at treating a lack of libido in postmenopausal women.

TRT for women is safe and effective when proper methods are used, and it can help treat many different symptoms, helping you feel like yourself again.

3. How Does Testosterone Replacement Therapy Work for Women?

The best way to find out if you can benefit from Testosterone Replacement Therapy is to get your hormone levels tested.

We would start with a series of blood tests and consultations to determine your symptoms and see if you’re a candidate for TRT.

If TRT turned out to be right for you, we would start you on weekly intramuscular injections. The actual methods we use are exactly the same for women as for men.

Obviously, the doses need to be much smaller for women—about 10% of the amount we give to men generally.

Dosing determines your clinical response, so you want to be able to use the lowest effective dose at the most efficient intervals.

Intramuscular injections, given weekly, are the most efficient way to ensure you receive the precise amount you need.

Testosterone needs to be injected weekly because it degrades in about 7 days and needs to be replaced.

Therapy begins with a dose based on best practices and our clinical experience. Our clinicians will adjust the dose as needed.

Once your symptoms start to respond and lab values support that observation, we’ll know we’ve found a good maintenance dose for you, assuming your other hormones aren’t too high or too low.

Blood samples are taken on a regular basis to see how you’re progressing. It can sometimes take a few injections before an optimal level is reached.

4. What Method of Testosterone Replacement Therapy Is Best For Me?

Injections are the most effective form of testosterone treatment. They’re better than gels, better than creams, better than patches, and certainly better than pellets.

The reason they’re better is that injections allow for precise dosing in a way that other methods do not.

You need to make sure you get an exact dose created specifically for you, and you need a provider who carefully analyzes your natural levels and adjusts your dosage to treat your unique symptoms.

This is the main reason we almost exclusively recommend injections when it comes to testosterone therapy for women; however, sometimes topicals are a viable option.

Since this is a very important question, we’ll look at each method in detail.

4.a The Case for Testosterone Injections for Women

We almost exclusively recommend testosterone injections with doses at about 1/10th of what a man would receive.

While it is quite common for other healthcare providers to recommend compounded testosterone medications like creams and gels, we recommend weekly testosterone injections instead because it allows for a more precise calculation of the dosage.

Testosterone injections are absorbed at a much higher percentage through the muscle than topical supplements are absorbed through the skin, meaning your body can utilize a more exact amount of what we give it.

This enables us to find an exact amount that’s right for you — not too high (dangerous) and not too low (ineffective).

That’s why we use a rigorous testing method to figure out what the right amount of testosterone is for you.

The dose is targeted slightly above the normal range because levels fall consistently throughout the week. The goal is to keep your levels within an optimum range. Unfortunately, no method yet exists to permanently keep levels in an optimum range.

As we mentioned in the above section, once your symptoms begin to improve, we stop increasing the dose and begin a maintenance program of weekly injections.

Injections:

• Are only administered once per week (topicals must be applied daily)
• Are relatively pain-free
• Are quick, easy, and convenient
• Are scientifically proven
• Are simply more effective based on patient results and our clinical experience

There are very few cases where we will recommend a method other than testosterone injections, and no cases where we recommend pellets or a testosterone patch.

4.a.i Research Supports Testosterone Shots to Treat Menopause

Testosterone for women used to be a highly debated topic.

Though women were regularly given estrogen or progesterone during or after menopause to treat symptoms, many felt testosterone couldn’t play an important role due to its comparatively tiny amount.

However, as researchers started looking at the action of testosterone in women’s bodies more closely, that idea was proven inaccurate.

In a study that came out in the mid-nineties, researchers found that adding testosterone shots for women already on the estrogen/progesterone combination reduced symptoms further than the estrogen/progesterone combination alone.

Researchers concluded that, although women have a much smaller amount of testosterone in their bodies than men, it has a significant impact on how you feel every day.

Testosterone in general is still not indicated for women thanks to the sloth-like pace of the FDA, but research and clinical work has shown it to be a safe and effective treatment for women suffering from the symptoms of menopause.

4.b The Problem With Topical Testosterone Supplements (Creams, Gels, or Patches)

Testosterone is a fickle hormone: a high level for one person isn’t so high for another, which leads to the real problem with topicals, like gels, creams, and patches — they are unable to provide the exact amount of testosterone that you need.

Even in cases where they “work,” topical testosterone supplements for women also have serious drawbacks directly related to their method of application.

Topicals:

• Are formulated for men, meaning incorrect dosages for women
• Are not well absorbed by many patients
• Can cause testosterone levels to climb too high
• Are expensive and usually not covered by insurance due to lack of FDA approval for use by women
• Can be easily transferred to someone who doesn’t need it

Some gels even specifically warn against use by women.

4.b.i Topicals Aren’t Designed for Women

Probably the biggest issue with testosterone gels, creams, and patches is that they simply aren’t made for women’s lower testosterone levels.

Because topical testosterone preparations are made exclusively for men, the levels of testosterone they contain are much higher than the amount of testosterone a woman would need.

With topicals, the medical practitioner is limited to the level of testosterone the compound was manufactured with.

The need for precision is the primary reason why we expressly recommend against topical applications of testosterone for women and instead recommend injections.

The FDA has not approved a topical testosterone preparation specifically formulated for women, although some medical care providers do recommend this when made by a compound pharmacy.

Only you and your medical care provider can determine if this is the right medical solution for your unique needs.

4.b.ii Increasing the Risk of Side Effects: Absorbing Too Much Testosterone

It’s worth mentioning again: A commercially available testosterone patch, cream, or gel designed and formulated specifically for women doesn’t exist.

Any testosterone product manufactured with an unchangeable dose of testosterone formulated for men could be detrimental to women’s health.

Too much testosterone, sometimes resulting from the use of patches or other topical steroid supplements, can lead to a wide variety of side effects in women:

• Excessive acne
• Male-patterned hair growth
• Deepening of the voice
• Infertility

Because the amount of testosterone normally present in a woman’s body is so miniscule, it’s important to make absolutely certain you don’t get too much.

4.b.iii Topicals Can Rub off on Loved Ones’ Skin Accidentally and Harm Them

Accidentally transferring testosterone medication to others is an especially serious danger of topical medications.

These medications can accidentally rub off directly onto your children or partner, causing their testosterone levels to elevate. It might also be left on sheets, clothes, or furniture, putting your children or loved ones at risk.

This is dangerous for children, who can undergo sexual development before they are ready when exposed to topical testosterone supplements.

This can also be dangerous for other women in your family, who may experience hyperandrogenism as a result of contact.

It can be dangerous for men in your family as well, accidentally elevating their testosterone beyond normal levels and putting them at risk of side effects.

While topicals do work in some instances, each individual situation should be considered carefully to be sure it’s the best fit. For example, testosterone cream may work well for women who are unable to come into the clinic regularly and live alone.

4.c Why We Never Recommend Testosterone Pellets

Testosterone pellets are problematic at best.

Although these are created by compounding pharmacies and can possibly be manufactured to suit women, they generally don’t work as advertised.

Pellets don’t work well because they don’t have a true time-release mechanism.

Although they are supposed to be absorbed over time, they actually send your testosterone levels soaring, increasing the risk of side effects for a few months.

They then leave you deficient for the remaining months.

4.d Topicals Often Work Well For Estrogen And Progesterone

While we generally find topical testosterone inadvisable for women, estrogen and progesterone cream are often effective, and we often recommend both of these creams for women who have low levels of these two hormones.

Topical preparations of both progesterone and estrogen are effective at treating a variety of symptoms in women and have long been used to treat the symptoms of menopause, so much so that they have become a standard treatment.

4.e Testosterone Supplements for Women — A Summary of What Works and What Doesn’t

We primarily recommend testosterone injections for women because testosterone gels, creams, patches, and pellets are imprecise and designed for men.

These methods assume both a higher body weight and a higher level of natural testosterone. They may lead to unsafe hormonal fluctuations.

Topicals also pose unnecessary risks to others, especially children.

With injections, we are able to measure the exact amount of testosterone women need, the dosage can be closely monitored and adjusted over time, and there’s no possibility of transferring the medication and contaminating loved ones.

However, there are some situations where topical testosterone supplements for women may be indicated — every patient is different, so we evaluate all parameters of a patient’s specific needs before recommending a course of action.

5. Why Does TRT focus on Restoring Hormone Balance?

While hormone replacement therapy for estrogen and progesterone has become an accepted treatment for women experiencing imbalances (including those related to menopause), the serious health benefits of Testosterone Replacement Therapy for women are a relatively new realization.

Testosterone alone may not relieve your symptoms. You may find that your testosterone levels are fine and that your estrogen and progesterone levels are what really need to be addressed.

It’s impossible to know until we’ve done some investigative blood testing.

Research has shown that the true key to feeling better is achieving or restoring proper hormone levels across the board, in proper proportion to each other.

The three major sex hormones—testosterone, estrogen, and progesterone—work as a team. When one hormone is under-or over-performing, it can affect the functioning of others.

More complex hormone issues might require other hormones to be administered alongside supplemental testosterone.

6. How Do I Choose My TRT Provider?

Because testosterone is currently indicated for men only in the United States, you need to choose your testosterone provider carefully.

If you use a provider who employs outdated or dangerous methods of Testosterone Replacement Therapy, you put yourself at risk.

You especially want someone experienced in testosterone injections for women.

You want to make sure you’re choosing a provider who is dedicated to hormone replacement and is sensitive to your needs.

Be sure to share as much information with your healthcare provider as possible.

With all the available information, they can more easily make an informed decision about which methods of hormone replacement treatment are best.

Your body is complicated. Testosterone is only one of the many hormones necessary to keep the amazing machine that is your body running.

While you may find that testosterone shots help you get back to feeling like yourself again, be sure you and your provider look closely at other hormones, like estrogen and progesterone, when you begin considering hormone therapy.

Taken together, testosterone might just be the last little nudge you need to feel normal again.

7. TRT for Women: How Do I Get Started?

If you just don’t feel the same anymore, possibly because:

• You’re going through or have been through menopause
• You’ve undergone a hysterectomy
• You’ve had a major life event like breast cancer

And you’re experiencing some of the symptoms above, then it may be time to consider TRT.

At Testosterone Centers of Texas, we have experience working to find the precise level that works best for each patient.

We don’t come up with a dose to reach a certain level or number.

Instead, we choose your dose based on your symptoms, finding the specific dose that works best for you, keeping you (hopefully) feeling better while maintaining safety.

The recommended weekly injection can be done quickly and easily.

We have flexible hours and multiple clinics throughout the DFW area, allowing you to get your dose at a time and place that fits into your schedule.