As a physician with years of experience in women’s health, I often hear this frustrating statement from patients: “My primary care doctor said I don’t need testosterone for hormone therapy.” Unfortunately, this belief is a persistent myth that continues to undermine women’s health and quality of life.
The truth? Testosterone is not just a “male” hormone. It plays a critical role in a woman’s overall well-being, especially during perimenopause and menopause. Yet, many conventional doctors dismiss its importance due to outdated medical paradigms, leaving women without the full benefits of bioidentical hormone replacement therapy (BHRT).
Let’s explore the role of testosterone in women’s health, dispel common myths, and highlight the scientific evidence supporting its use in hormone therapy.
Myth #1: “Testosterone Is Only Important for Men”
This is one of the most damaging myths about hormone health. While men do have higher levels of testosterone, women also produce it, primarily in the ovaries and adrenal glands.
In fact, testosterone is the most abundant biologically active hormone in women throughout their lives, with levels declining naturally after age 30 and more dramatically during menopause.
The Science Says:
- Testosterone supports energy, mood, and cognitive function. Studies have shown that testosterone therapy can improve mental clarity and motivation and reduce brain fog in menopausal women.
- It plays a crucial role in sexual health. Research published found that testosterone therapy significantly improves sexual desire and arousal in women with hypoactive sexual desire disorder (HSDD).
- It helps maintain muscle mass and bone density. Studies have shown that testosterone therapy in postmenopausal women can enhance muscle strength and prevent osteoporosis.
Myth #2: “Women Don’t Need Testosterone Replacement”
Despite strong scientific support, many doctors hesitate to prescribe testosterone to women, arguing that it’s unnecessary or even dangerous. But let’s look at the facts.
Testosterone levels in women decline with age, and this drop can lead to symptoms such as:
- Persistent fatigue and lack of motivation
- Depression and mood swings
- Loss of libido and sexual dysfunction
- Weight gain, especially around the midsection
- Decreased muscle strength and endurance
- Cognitive decline and memory issues
Functional and longevity medicine practitioners understand that optimizing testosterone as part of a balanced bioidentical hormone replacement therapy (BHRT) plan can help address these issues.
Bioidentical testosterone, when dosed appropriately, does not lead to masculinization or harmful side effects in women. In contrast, low testosterone levels have been linked to an increased risk of metabolic syndrome, insulin resistance, and cardiovascular disease.
Myth #3: “Testosterone Will Make Women Masculine”
A common fear is that taking testosterone will cause women to develop a deeper voice, facial hair, or bulk up like bodybuilders. However, these side effects are associated with high doses of synthetic androgens, not the carefully calibrated doses of bioidentical testosterone used in BHRT.
The Science Says:
- Proper dosing prevents unwanted side effects. Studies confirm that physiological doses of bioidentical testosterone do not cause masculinization but instead restore natural hormone balance.
- Testosterone is critical for female metabolism. It helps regulate fat distribution, muscle tone, and insulin sensitivity—all essential for maintaining a healthy weight and preventing metabolic diseases.
Myth #4: “There’s No FDA-Approved Testosterone Therapy for Women, So It Must Be Unsafe”
Yes, it’s true that there is currently no FDA-approved testosterone therapy specifically formulated for women in the U.S. However, this does not mean it’s unsafe, it simply means that pharmaceutical companies have not invested in the research and approval process for a female-specific formulation.
In functional medicine, we frequently use compounded bioidentical testosterone to customize treatment for each woman’s needs. The safety and efficacy of this approach have been well-documented in medical literature, and millions of women worldwide have benefited from personalized bioidentical hormone therapy.
Myth #5: “Estrogen and Progesterone Are Enough”
Many conventional practitioners believe that addressing estrogen and progesterone alone is sufficient for hormone therapy in menopausal women. But this ignores the crucial role of testosterone in maintaining:
- Cognitive sharpness and mental well-being
- Healthy metabolism and body composition
- Cardiovascular function and blood sugar regulation
A well-balanced BHRT approach includes all essential hormones—estrogen, progesterone, and testosterone—to optimize health and longevity.
The Future of Women’s Hormone Health
It’s time to move beyond outdated beliefs and embrace the full potential of bioidentical hormone therapy for women. Testosterone is not just a “male” hormone; it is a human hormone, and women deserve access to its benefits.
If you’ve been told that you “don’t need” testosterone, I encourage you to seek out a physician who specializes in functional and longevity medicine. The right balance of hormones can be life-changing, helping you reclaim energy, vitality, and overall well-being.
Take Action:
- Find a knowledgeable provider. Work with a physician who understands the role of testosterone in women’s health.
- Get comprehensive diagnostic testing. Saliva, blood, or urine testing can help determine your testosterone levels and overall hormonal balance.
- Educate yourself. Don’t settle for misinformation, stay informed and advocate for your health.
Women deserve better than outdated myths and half-measures in hormone therapy. Testosterone is a vital part of the equation, and it’s time we start treating it that way.
Dr. Sadia Ali attended FIU in her hometown of Miami, Florida, and received her Bachelor of Arts in Biochemistry. She attended medical school at USF Morsani College of Medicine in Tampa, Florida, and completed her Family Medicine Residency Training at Atrium Health in Concord, North Carolina.
Dr. Ali completed her medical training in Winter Park, Florida, where she was a Junior Faculty and became fellowship-trained in Women’s Health & Obstetrics. Dr. Ali is also trained in functional, aesthetic & obesity medicine.