Global Consensus Position Statement on the Use of Testosterone Therapy for Women

Tier 1: Established: peer-reviewed research or government health authority
Publisher: Journal of Clinical Endocrinology & Metabolism, endorsed by the International Menopause Society, The Endocrine Society, NAMS, RCOG, ISSWSH, EMAS · Published: August 8, 2026 · Accessed: August 8, 2026

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Claims this source supports

• The only evidence-based indication for testosterone therapy in women is hypoactive sexual desire disorder (HSDD); there are insufficient data for using testosterone for any other symptom or condition, or for disease prevention.
• Direct assays for the measurement of total and free testosterone are highly unreliable in the female range; total testosterone can be measured with high accuracy using liquid/gas chromatography and tandem mass spectrometry (LC-MS/MS) assays.
• No blood level cutoff differentiates women with and without sexual dysfunction.
• Testosterone therapy should be given in doses that approximate physiological testosterone concentrations for premenopausal women; use of any preparation that results in supraphysiologic concentrations, including pellets and injections, is not recommended.
• If no benefit is experienced by 6 months, treatment should be ceased.
• At physiological doses, testosterone therapy is associated with mild increases in acne and body/facial hair growth in some women, but not with alopecia, clitoromegaly, or voice change.
• Oral testosterone therapy is associated with adverse lipid profiles; short-term transdermal therapy does not increase mammographic breast density, and RCT data are insufficient to assess long-term breast cancer risk; caution is recommended in women with hormone-sensitive breast cancer.