What are the side effects of testosterone therapy for women? At low doses, acne, oily skin, skin irritation and extra hair growth can happen; higher blood levels can bring scalp-hair thinning, voice deepening and clitoral enlargement. Testosterone may be considered for distressing low sexual desire around or after menopause, with a plan for dose adjustment and follow-up.
The downside is not simply taking testosterone. It is taking more than your body needs, or using a form that is hard to adjust. The useful question is whether your goal, medical history, treatment form and monitoring plan fit together.
What can testosterone therapy do for women?
Testosterone is made by ovaries and adrenal glands and contributes to sexual motivation and arousal. Cedars-Sinai says carefully monitored low-dose therapy may improve sexual desire and satisfaction for women diagnosed with hypoactive sexual desire disorder (HSDD), meaning low desire that causes personal distress.
A British Journal of General Practice review on PubMed Central describes improved sexual wellbeing as the recognized benefit for postmenopausal women with HSDD. It can take weeks or months to notice a change, so the first sign worth tracking is the goal you and your clinician chose, such as sexual desire or less distress about it—not a sudden change in weight, energy or personality.
If menopause symptoms are also part of your decision, this guide to menopause hormone therapy explains the broader conversation.
What are the negative effects and downsides?
Testosterone-related effects are most likely when levels rise above the usual female physiologic range. The form matters: creams, gels and topical solutions can be adjusted; injections and pellets can be harder to fine-tune once given.
| Possible effect | What it can look like | Why follow-up matters |
|---|---|---|
| Skin and hair changes | Acne, oily skin, skin irritation, or increased hair at the application site | A clinician can review the dose and application approach. |
| Androgenic changes | More facial or body hair, scalp-hair thinning, a deeper voice, or clitoral enlargement | These are associated with excessive levels; voice and clitoral changes may be irreversible. |
| Cycle and bleeding changes | Menstrual changes or abnormal uterine bleeding | Bring any bleeding change to your clinician promptly. |
| Mood and body changes | Irritability, aggression, changes in body odor, sweating, or weight gain | Track the timing and discuss whether the dose or another factor is involved. |
| Blood-lipid changes | Changes in cholesterol-related blood lipids | Your clinician can decide what testing fits your history. |
Cleveland Clinic lists voice changes, hair growth at the cream site, male-pattern baldness, clitoral enlargement, acne and blood-lipid abnormalities among potential effects. It also notes that women with cardiovascular disease, liver disease, or hormone-sensitive breast or uterine cancer generally are not recommended for testosterone treatment.
Can low-dose testosterone cream still cause side effects?
Yes. “Low dose” describes the treatment plan, not a promise of zero effects. NHS Highland lists skin irritation, acne, oily skin, increased hair at the application site and weight gain; it says facial hair growth, alopecia, voice deepening and clitoral enlargement are concerns when levels exceed the female physiologic range. Its NHS Highland guidance recommends baseline testing and repeat total-testosterone testing after treatment starts to help keep levels in range.
For cream or gel, ask exactly where to apply it, how long to let it dry, and how to prevent transfer to another person through skin contact. Those details make a practical difference every day.
Will testosterone change your personality?
Testosterone is not a personality treatment. Irritability or aggression can occur when levels are high, but mood shifts also have many possible causes. If you notice a new mood change, write down when it began, the dose and form you use, sleep changes, cycle changes and any other medication changes; that gives your clinician something concrete to assess.
Will it reduce belly fat or help with weight loss?
Do not make testosterone therapy a weight-loss plan. Research and clinical guidance discussed by Cedars-Sinai support its use most clearly for HSDD in postmenopausal women, rather than for belly-fat loss, energy, cognition or general body-composition goals. If body changes are your main concern, ask what approach fits that goal before starting a hormone that is being considered for a different reason.
Why is testosterone testing complicated?
Clinicians may test because a baseline result can guide safer follow-up, not because they dislike testing. Testosterone naturally fluctuates, including across the menstrual cycle, and Cleveland Clinic explains that interpreting a single result can be difficult. Symptoms such as fatigue, insomnia, brain fog and mood changes can have many causes, so a number by itself does not answer the whole question.
NHS Highland recommends a baseline total-testosterone level, a recheck two to three months after starting, and annual monitoring thereafter for menopausal treatment. Ask which test, timing and target range your clinician uses for your situation.
How do creams, injections and pellets compare?
| Option | Practical advantage | Key decision point |
|---|---|---|
| Topical cream, gel or solution | Can be adjusted gradually and is commonly used for women in the United States. | Requires consistent application and care to avoid skin transfer. |
| Injection | Does not require daily skin application. | Cedars-Sinai cautions that controlling absorbed amounts can be more difficult. |
| Pellet | Releases hormone over months. | It cannot be dose-adjusted or removed once placed if levels are higher than expected. |
There is no FDA-approved testosterone formulation specifically for women in the United States; clinicians may prescribe a lower-dose product approved for men off label. Do not use someone else’s injection schedule or a weekly dose from a review as your own plan—dose selection depends on the formulation, your baseline, response and follow-up results.
Can you stop after six months?
Yes—stopping is a conversation to have before you start. The PubMed Central review describes stopping after six months when there has been no response, while Cleveland Clinic advises ongoing assessment and cautions against extending treatment beyond two years because longer-term safety questions remain. If you are considering stopping, contact the prescriber who manages the therapy so your symptoms, dose and next steps can be reviewed together.
What else can help low desire during menopause?
Low desire can be affected by vaginal dryness, pain, sleep, stress, relationship context, medications and menopause symptoms. Cedars-Sinai names menopausal hormone therapy, vaginal estrogen, flibanserin and bremelanotide among options clinicians may discuss, alongside sleep, stress and relationship factors. For a fuller look at dryness, libido and care options, see sexual health during menopause.
If future pregnancy matters to you, raise it before treatment begins. Our overview of fertility-friendly testosterone care can help you prepare that conversation.
Before you start testosterone therapy
- What symptom are we trying to improve, and how will we measure whether it is helping?
- Which form is easiest to adjust if I have side effects?
- When will my follow-up blood test and symptom review happen?
- What should I do if I notice acne, new hair growth, bleeding, scalp-hair thinning, voice changes or mood changes?
- How could this plan affect my fertility goals, pregnancy plans or other medications?
A clinician visit would help if low desire is distressing, you are considering testosterone, or you notice side effects; bring your medication and supplement list, relevant cycle or menopause notes, fertility goals and the questions above.
By ReproductiveHealthCtr.com Health Education Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.