Testosterone for Women: Muscle, Mood, and Libido

Colin Renaud, PA-C says the most common misconception is that testosterone is not a woman's hormone. It is not the dominant hormone in women, but he describes it as playing a real role in sexual desire, energy, mood, motivation, bone and muscle health, and body composition. He calls it the get up and go hormone, the one that helps you feel like getting things done. The goal of treatment, he says, is to support normal function, not to change how a woman looks or sounds.

Renaud lists low libido over a long stretch of time, reduced sexual response, and not feeling that spark when a partner initiates. Beyond sexual health he sees low motivation, fatigue, poor recovery, loss of muscle, gaining fat while losing muscle, and just not feeling resilient or like yourself. He points out that this is a wide set of symptoms that can also come from thyroid problems, blood sugar issues, poor sleep or low protein intake, which is why he does not read one lab number on its own. If desire has been absent for at least six months and it is causing personal distress, he explains that can meet the definition of hypoactive sexual desire disorder, or HSDD.

Renaud says the amount given to a woman is a small sprinkle, far below what would cause voice deepening or masculine features. He does tell patients that some women notice oily skin, an occasional pimple they have not had in years, or a stray chin hair when they first start. That is one of the reasons he rechecks labs at follow-up, so the dose is not too high or too low. As he puts it, the goal is never to make a woman more masculine.

Partly, according to Renaud. In a woman who is still having periods, estrogen and progesterone differ between the first and second half of the cycle, so a single blood draw is only a snapshot of that day, and symptoms carry more weight than the number. For a woman who is already postmenopausal, he does not need labs to prove hormones are low, because low hormones are the definition of menopause. Testing matters most once treatment begins, so he can confirm the dose is landing in a therapeutic range and is not too much or too little.

Renaud tells patients to expect some change in symptoms in the first couple of weeks, often motivation, energy or libido. The bigger changes, especially in muscle mass and physical strength, usually take about three to six months. He follows up around three months after starting care to review symptoms alongside total testosterone, free testosterone, SHBG, any other hormones started, blood counts, and liver and kidney function. He is also clear that expectations matter, so patients are not hoping for the world in a week.

Renaud says it is often assumed hormone replacement will not work once a woman is past 65 or more than 10 years out from menopause, and that assumption is not necessarily true. It is not contraindicated in that group. He has seen it be less effective in the 60s and 70s simply because hormones have been absent for so long, so those parameters need careful thought. His answer is individualized care rather than an automatic no.