There is no F.D.A.-approved testosterone product for women. Insurance won’t cover it. Many doctors won’t prescribe it. It’s become a cultural phenomenon.
Spend enough time speaking to women who are taking testosterone — specifically, in very high doses — and you start to notice that they sound messianic. They’re often talking fast and intensely; they’re amped up; they’re describing what they clearly consider a miracle drug; and they have no intention of lowering their dose, despite the unknown risks or some problems with facial hair. After all, how can they worry about facial hair when they feel so alive? It’s nothing they can’t take care of with a quick waxing, which they now have the energy to do at the end of the day — right after they prepare a high-protein dinner for their family and before they put the finishing touches on their spreadsheets, close their laptops and light a few mood candles for the sex that they know will be great, maybe even better than the sex they had last night, even though they’re a day older.
“It’s changed my marriage,” Jessica Medina, a 41-year-old marketing consultant in Orange County, Calif., told me. With four kids in the house, and sex happening six times a week (up from “How about never?” pre-testosterone), she had to put a lock on the bedroom door. She and her husband had attended a “marriage growth” group at church for years, but it took testosterone for their relationship to be, as she put it, “100 times closer.” She was a little less emotional, a little less sentimental than she used to be, but she didn’t have time for that kind of thing, anyway. “It’s more like: Get stuff done, handle business, work out,” she said. “In order to do all that and still have time for our kids and their sports, there’s no time to whine about how hard it is.”
Catherine Lin, a single mother who ran a bicoastal fashion media company, went on testosterone in her early 40s to raise her energy. She got the boost she wanted, started lifting heavier weights, decided to pursue a degree in holistic nutrition and enjoyed an unexpected side effect: She started having orgasms for the first time in years.
If it’s not too invasive, can you describe what led to this? E.g. “I told my doctor I was experiencing []; she ordered tests of []; then we reviewed the results, discussed options [_], and she wrote me the script for testosterone cypionate.”
Takeaways From the Times Magazine Story on Testosterone and Sex Drive
Here’s when and why experts think testosterone should be prescribed to middle-aged women, and how it affects their lives.
Testosterone use has recently exploded among middle-aged women because the hormone can help revive libido. But many women are taking doses that are much higher than medical societies’ guidelines recommend. Increasingly, women in their 40s and beyond are experimenting with higher levels of the hormone than they produced naturally at any point in their lives; some are even approaching the levels of a teenage boy. These women report a dramatic return of their sex drives, as well as bursts of energy and improved muscle tone; but not everyone responds positively, and high doses can also have lingering side effects like hair loss.
Confusion about the hormone is rampant, and emotions about it run high — among both people who champion it and those who urge caution. “Testosterone is like a religion,” said Rachel Rubin, a urologist who specializes in sexual medicine. “People have very strong feelings about testosterone.”
For this story, I spoke with more than a dozen researchers and doctors in order to understand when experts believe testosterone should be prescribed, and how it affects women’s lives. Here are takeaways from the Magazine story.
It was in my BIEST sublingual for 7 years I’m pretty sure 1mg and after 7 years got blood drawn it was in the 220’s estrogen 557 - I don’t feel one bit different on or off HRT and those are high levels.
Please message me too. Lol. I’m currently on kisspeptin for peri menopause, BPC-157, TB-500, and GHK-Cu. I’m adding KPV soon, and eventually cjc-1295 w/ Ipamorelin (women are raving about this last one). HRT is my next step, if the kisspeptin doesn’t normalize my hormones.
Would testosterone boosting approaches such as boron, tangkat ali, clomid, enlomphine, etc. work equally well with women as men?
CGPT5 Response:
No — the effects, mechanisms, and safety profiles of testosterone-boosting agents differ sharply between men and women, mainly because of baseline hormone levels, gonadal feedback loops, and receptor distribution. Here’s how the key examples break down:
1. Boron
Mechanism (men): May transiently increase free testosterone by reducing SHBG and mild anti-inflammatory effects.
In women: SHBG reduction can raise free testosterone and estradiol slightly, but this often pushes androgen/estrogen ratios into unfavorable territory — e.g., oily skin, acne, or mild hirsutism.
Net: Small hormonal shifts, but rarely clinically meaningful or beneficial for women.
2. Tongkat Ali (Eurycoma longifolia)
Mechanism (men): May increase LH and testosterone via pituitary stimulation or cortisol suppression.
In women: LH stimulation can modestly raise androgen output from the ovaries/adrenals, but women’s endocrine balance depends heavily on estrogen/progesterone cycles.
Data: Limited and mixed; no robust female clinical trials. Some women report increased libido or energy, but risks include androgenic skin changes and menstrual irregularities.
Net: Mild adaptogenic effects possible, but not proven testosterone elevation in women.
3. Clomiphene (Clomid)
Mechanism: SERM (Selective Estrogen Receptor Modulator) that blocks estrogen feedback at the hypothalamus, increasing LH and FSH → higher gonadal steroid output.
Men: Often used off-label to raise testosterone in hypogonadal men with intact testes.
Women: Actually designed for women — used for ovulation induction (by increasing FSH and LH). It raises estrogen and androgens transiently but only during follicular stimulation cycles.
Net: Works in both sexes but for different endpoints — fertility induction in women, testosterone in men. Continuous “boosting” use in women would disrupt cycles and isn’t physiologically balanced.
4. Enclomiphene (active isomer of clomiphene)
Men: Raises LH/testosterone without major estrogenic side effects.
Women: Not studied for female hormonal optimization; same mechanism would overstimulate gonadotropins, possibly causing ovarian cysts or dysregulated ovulation.
Net: Not suitable for women outside specific fertility protocols.
Summary Table
Compound
Typical Goal (Men)
Typical Effect (Women)
Evidence in Women
Risk Profile (Women)
Boron
Mild ↑ free T
Slight ↑ free T/estradiol
Minimal
Acne, hair changes
Tongkat Ali
↑ LH, ↓ cortisol, ↑ T
Possible mild androgen rise
Very limited
Cycle irregularity, acne
Clomiphene
↑ LH/FSH → ↑ T
Used for ovulation (↑ FSH/LH)
Strong (fertility use)
Ovarian hyperstimulation if misused
Enclomiphene
↑ LH/testosterone
Not studied for use
None
Unknown; likely unsafe off-label
Bottom line
Women’s optimal testosterone range is 10–20× lower than men’s; “boosting” strategies that raise male T meaningfully can overshoot dangerously in women.
Tongkat and boron may have minor adaptogenic or libido-enhancing effects but not clinically significant testosterone boosting in females.
Clomiphene/enclomiphene absolutely can stimulate gonadotropins in women but are only safe in controlled fertility regimens.
If a woman’s testosterone is clinically low (postmenopausal or pituitary origin), the appropriate therapy is usually micro-dose transdermal testosterone under endocrinology supervision, not herbal or SERM manipulation.
I am on testosterone cream, its called Androfeme and its approved in several other countries (I get it shipped internationally). Dose is 5 mg QD. I am mainly on it for difficulty building muscle mass. I am postmenopausal and my free-testosterone was very low and SHBG was very high hence little bioavailable T for my cells to use. Not sure yet if I have more energy, a bit of higher sex drive but nothing crazy. This is a low dose that accepted by the medical community. I am also on HRT and have been since I was off birth control pills
Testosterone creams generally absorb around 10% compared to injections, so 5mg/day of cream is equivalent to 3.5mg per week of Testosterone Cypionate injection, which is a very low dose. The standard starting dose for female Testosterone Cypionate injections is 5mg/week and gets titrated up to a maximum of 20mg/week, backing off if hair loss on head or voice deepening shows up. Significant change in sex drive usually shows up for most women at 15mg/week (for Cypionate injections) according to reports in reddit threads.
Some women find they need to keep titrating well above 20mg/week, in order to get the benefits of male energy and sex drive, but most doctors will not go above 20mg/week. And since changes to voice are irreversible, you need to pay close attention and back off immediately if anyone notices any change.
This is very helpful, thank you for going into detail on the different types, dosing and how they compare. For me personally 18mg/week total via injection definitely feels like my upper limit and I have no desire to try going any higher. We need more guidance for women in this area imo.
It’s very interesting reading the articles on women taking testosterone because when I was in my 40s, I am now in my 80s, I started having injections from a lady doctor in Paphos Cyprus, and my sexual activity was amazing. Plus my energy levels were unbelievable. Since then I have been using the testosterone gel which I get from India. I don’t stick to any kind of routine. I just decide to take several drops after my shower three or four times a week. It has absolutely improved my sick life, because I really did not want any sexual activity at all until I started back on my testosterone. I have not noticed any hair growth or side effects however, after reading this article, I will concentrate more on how much testosterone I take because I think there is room for improvement. Thank you to the people who shared their experiences. Very encouraging.
Yes I started testosterone with a private gynaecologist as GPs here won’t generally prescribe for women ( I’m in Scotland). I was already on HRT.
I asked my GP to test my testosterone level a few years ago ( aged 57) and was told it was ‘normal’. Private testing indicated it was undetectable at age 58. But hard to know if that is considered ‘normal ‘ by current primary care clinical guidelines
Even privately, you can only get it for low libido. My main concerns were strength, cognitive health, muscle retention and energy and it does seem to have improved these (with running and strength training). Has also improved libido a bit, though I think this is impacted by the 100mg sertraline I am on.
Also taking a variety of supplements, dapagliflozin alternate weeks and Rapamycin 2 mg (with 1 ketoconazole tablet an hour before) fortnightly
No medical oversight for the above, sadly, but no side effects noted to date
My wife is also injecting. I think she is at 1x/week, I forgot her dose. I will ask later.
She reports that very few women inject, at least according to her doctor. She heard almost all women use a different technique (maybe pellets?). She says she is the only one in her doctor’s practice that is injecting. I don’t know if this is due to unusual elements of that particular medical practice or if that is typical.
I think all women should be in touch with medical professionals as they approach menopause, and consider taking HRT. I am too uninformed to say whether they should actually get it, but I think all of them should have a conversation about it and learn what their options are, and what are the pros and cons, and make an informed decision.
Women’s sexual health: desire, arousal, and orgasms, navigating perimenopause, and more
AI Summary:
Introduction to the Podcast
The podcast is hosted by Peter Aia, who welcomes listeners and introduces the guest, Sally, an OBGYN specializing in women’s sexual health.
The discussion aims to explore the importance of sexual health in the context of overall health and longevity, asserting that it is relevant to everyone, not just women.
The Importance of Sexual Health
Sally emphasizes that sexual health is a crucial aspect of overall health, linking it to performance and longevity.
She discusses how sexual activity contributes to various health benefits, including hormonal balance, sleep quality, and emotional well-being.
The conversation touches on how sexual health impacts life goals, such as maintaining an active lifestyle well into old age.
Health Benefits of Sexual Activity
Sally outlines that sexual activity can enhance sleep quality by activating the parasympathetic nervous system and releasing neurotransmitters like dopamine and oxytocin.
She mentions studies indicating that both men and women experience improved sleep quality after sexual activity, with a special focus on women experiencing orgasms.
Cardiovascular health is also discussed, noting that sexual activity can mimic exercise, providing metabolic benefits and calorie expenditure.
The importance of understanding individual sexual health needs and the variability of sexual desire among couples is highlighted.
Understanding Orgasm and Sexual Response
Sally explains the stages of a woman’s orgasm, including excitement, plateau, orgasm, and resolution, emphasizing the physiological changes that occur during each stage.
The average time to orgasm varies greatly, with women achieving orgasm faster when alone compared to with partners, highlighting the importance of foreplay.
The concept of the “orgasm gap” is introduced, illustrating disparities in orgasm frequency between men and women, with men reporting higher rates of orgasm during sexual encounters.
Impact of Sexual Health on Relationships
Sally discusses the significance of sexual desire discordance in relationships, where one partner desires sex more than the other, leading to potential relationship strain.
She emphasizes that communication and understanding each partner’s sexual needs are crucial for a healthy sexual relationship.
The discussion includes the role of sexual health in maintaining intimacy and connection between partners, suggesting that couples work together to enhance their sexual experiences.
The Role of Hormones in Sexual Health
The conversation shifts to the influence of hormones on sexual health, with Sally explaining how estrogen and testosterone affect sexual desire and function.
Sally notes the complexities surrounding hormone replacement therapy, particularly for menopausal women, and the importance of individualized treatment plans.
She discusses the impact of hormonal fluctuations throughout a woman’s life and how these changes can affect sexual health and desire.
Addressing Sexual Trauma and Its Effects
Sally addresses how adverse sexual experiences, including trauma, can negatively impact a woman’s sexual health and overall well-being.
She highlights the importance of therapy and support systems for survivors of sexual trauma, emphasizing the need for a trauma-informed approach in sexual health discussions.
Sally introduces the concept of sensate focus exercises as a therapeutic method to help individuals reconnect with their bodies and improve intimacy.
The Importance of Lubrication and Moisturization
Sally stresses the importance of lubrication in sexual activity, likening it to sunscreen for the vagina, to prevent discomfort and enhance pleasure.
She recommends silicone-based lubricants for their longevity and effectiveness compared to water-based options, which can lead to dryness.
The discussion includes the use of vaginal moisturizers and hormonal treatments to maintain vaginal health, particularly for women experiencing menopause or hormonal changes.
Conclusion and Call to Action
Sally concludes by encouraging women to take charge of their sexual health, advocating for open discussions about sexual needs and preferences with partners and healthcare providers.
Listeners are reminded that sexual health is a vital aspect of overall well-being and should be prioritized in health discussions.
The episode reinforces the idea that understanding one’s body and needs is essential for a fulfilling sexual life.
