Should Women Take Testosterone? What the Research Actually Shows
Spencer Nadolsky, DOPublished on November 3, 2025
Summary authored by editor@wellifi.com
TLDR Summary
In this episode, Dr. Susan Davis discusses the complexities of testosterone therapy for women, particularly regarding low sexual desire. While testosterone can help some post-menopausal women, it is not a catch-all solution, and proper evaluation of underlying causes is necessary.
Key Points
- Sexual dysfunction in women can be categorized into desire, arousal, orgasm difficulties, and other related issues.
- Low desire is considered a disorder only when it causes distress.
- Testosterone therapy may benefit some post-menopausal women with low libido, but it is not a universal solution.
- Accurate testosterone testing in women is challenging, and levels may not reflect actual sexual function.
- FDA-approved testosterone formulations are preferable to compounded medications for treating low libido in women.
Understanding Testosterone Therapy in Women: Insights from Dr. Susan Davis
Welcome to the Docs Who Lift podcast, a space where we simplify the complexities of a healthy lifestyle, exercise, medicine, and weight loss. In this episode, host Dr. Spencer Nadolsky is joined by Dr. Susan Davis, a leading endocrinologist and researcher from Australia, to discuss testosterone therapy in women, especially in the context of sexual dysfunction.
The Basics of Sexual Dysfunction
Dr. Davis starts by explaining the classifications of sexual dysfunction in women, which are defined by two main guiding bodies: the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). The ICD distinguishes between different types of sexual difficulties, such as:
- Desire difficulties
- Arousal difficulties
- Orgasm difficulties
- Other difficulties (e.g., sexual self-image)
It's crucial to note that low sexual desire is only considered a disorder if it causes distress to the woman. Dr. Davis emphasizes that many women with low desire may not see it as a problem unless it interferes with their relationships or personal satisfaction.
Identifying Organic Causes of Low Desire
When patients present with low libido, it is essential to explore both psychosocial and organic factors. Dr. Davis highlights that conditions such as fatigue, depression, and hormonal changes can all contribute to low desire. A thorough conversation with the patient can reveal underlying issues that may not be immediately apparent.
Testosterone Therapy: The Evidence
Dr. Davis provides insights into the current understanding of testosterone therapy for women, particularly post-menopausal women. The research indicates that about 60-65% of post-menopausal women with low libido may experience improvement with testosterone therapy. However, it's important to note that not all women will benefit, and the improvement may not be dramatic.
Dr. Davis warns against the widespread assertion that testosterone is a panacea for all sexual dysfunctions. She stresses the importance of evidence-based practice and highlights the dangers of cherry-picking studies that support the belief that testosterone can fix all issues related to sexual health.
Common Misconceptions and Risks
One major misconception is that testosterone blood levels can accurately diagnose low desire in women. Dr. Davis explains that most lab tests for testosterone in women are inaccurate, and blood levels do not necessarily correlate with sexual desire or function. Additionally, higher testosterone levels do not guarantee better outcomes and may lead to unwanted side effects.
Compounded Medications vs. FDA-Approved Treatments
In the U.S., many women are being prescribed compounded testosterone therapies, which are often unreliable. Dr. Davis advocates for using FDA-approved testosterone formulations that have been shown to be safe and effective for women. In Australia, a 1% transdermal cream is available, which is considered a more reliable option.
Conclusion: A Holistic Approach to Sexual Health
In summary, the discussion around testosterone therapy for women is complex and nuanced. While it can be a beneficial treatment for some, it is not a one-size-fits-all solution. Dr. Davis emphasizes the need for thorough evaluation and a holistic approach that considers all aspects of a woman's health, including psychological, relational, and physical factors.
For those interested in diving deeper into this topic, stay tuned for upcoming updates to clinical practice guidelines from the International Society for the Study of Women's Sexual Health, which will provide further evidence-based recommendations.
Key Takeaways
- Sexual dysfunction in women can be categorized into desire, arousal, orgasm difficulties, and other related issues.
- Low desire is considered a disorder only when it causes distress.
- Testosterone therapy may benefit some post-menopausal women with low libido, but it is not a universal solution.
- Accurate testosterone testing in women is challenging, and levels may not reflect actual sexual function.
- FDA-approved testosterone formulations are preferable to compounded medications for treating low libido in women.
TLDR
In this episode, Dr. Susan Davis discusses the complexities of testosterone therapy for women, particularly regarding low sexual desire. While testosterone can help some post-menopausal women, it is not a catch-all solution, and proper evaluation of underlying causes is necessary.
Authors
- Dr. Spencer Nadolsky
- Dr. Susan Davis