Testosterone for women is a compounded, prescription-only hormone preparation of testosterone, an androgen that is naturally present and active in women, though at much lower levels than in men. It is prepared by a licensed pharmacy to the strength and form your provider orders rather than mass-produced, and it is available in several forms, including a topical cream, an anhydrous topical gel, a troche (a lozenge that dissolves in the mouth), and a rapid-dissolve tablet.
Providers may consider low-dose testosterone as part of a woman's hormone therapy when they determine it is appropriate. Doses used in women are a fraction of male replacement doses. Only a licensed provider can decide whether it is right for an individual. This is part of Bayview's women's hormone therapy range, alongside Bi-Est, progesterone, and combination preparations. Bayview compounds this as part of our hormone replacement therapy compounding line.
How does it work?
Testosterone is an androgen that women produce naturally in the ovaries and adrenal glands, and levels generally decline with age (StatPearls, physiology of testosterone). In women it contributes to areas such as libido, mood, and energy. When a provider identifies a role for it, low-dose testosterone may be added to hormone therapy. Because the appropriate amount for a woman is far lower than a male dose, the strength and form are matched to the individual by the prescriber, who sets the schedule and any adjustments.
What is it used for?
Providers may prescribe low-dose testosterone as part of a woman's hormone therapy when they determine it is appropriate. There are currently no FDA-approved testosterone products designed and dosed specifically for women, which is one reason a provider may turn to a compounded preparation, so the strength and dosage form can be tailored to a woman's much lower dose. Only a licensed provider can decide whether this formulation is right for an individual; Bayview Pharmacy does not provide consultations or determine appropriateness, and a valid prescription is required.
How do the forms compare?
Testosterone is compounded in several forms that differ mainly in how they are taken. The table below describes those differences for education only.
| Form | How it's taken | Notes |
|---|---|---|
| Topical cream | Applied to the skin | Absorbed through the skin; compounded at the low strengths used for women |
| Topical gel (anhydrous) | Applied to the skin | A water-free base applied to the skin |
| Troche | Dissolved in the mouth | Absorbed through the lining of the mouth |
| Rapid-dissolve tablet | Dissolves quickly in the mouth | A low-strength oral option |
Differences in form and route are described for education only and are not a statement that any option is better, stronger, or more effective. Topical forms carry a risk of transfer to others by skin contact. See the safety section below. Your provider determines which form and dose are appropriate for you.
How is it used?
Testosterone is used following the exact form, application site, technique, schedule, and dose set by your prescriber, who establishes your starting dose and any adjustments. Creams and gels are applied to the skin only where and as directed; troches and tablets are used in the mouth as directed. With topical forms, wash the application site before skin-to-skin contact and wash your hands after applying, to reduce the chance of transferring testosterone to another person, including a partner or child. Never change your dose on your own. If you are unsure about how to use it or about your dosing, contact your prescriber, and a Bayview pharmacist is available if you have questions about your prescription.
Side effects & safety
As with any medication, side effects are possible. Because testosterone is an androgen, too much of it in a woman can cause signs of virilization, such as unwanted or increased facial and body hair, acne, oily skin, voice deepening, or scalp hair thinning; some of these changes may not fully reverse, so report them to your provider promptly. Other reported effects can include application-site reactions with topical forms, mood changes, and changes in blood counts or cholesterol.
Seek medical care for signs of a serious problem, such as chest pain, shortness of breath, weakness or numbness on one side of the body, difficulty speaking, or swelling in the legs. Contact your provider about any reaction that concerns you.
Who should not use it?
Testosterone is not appropriate for everyone. It should not be used during pregnancy or breastfeeding, because androgen exposure can harm a developing baby, and it is generally avoided in women with known or suspected breast or other hormone-sensitive cancer, or with certain heart, liver, or kidney conditions, or a known sensitivity to the ingredients. Tell your provider about your full medical history and all medications you take so they can determine whether this formulation is appropriate for you.
How should it be stored?
Store exactly as directed on your label, away from heat, light, and moisture. Because testosterone is a controlled substance, keep it secured and out of the reach of children and others in the home, and do not share it with anyone. Avoid skin contact with topical forms by anyone the medication is not prescribed for. Do not use it after its expiration or beyond-use date, and dispose of unused medication as directed.
Why is this compounded?
Because there is no FDA-approved testosterone product dosed for women, compounding lets a licensed pharmacy prepare testosterone at the much lower strengths women need and in the dosage form a provider orders, for example a cream, an anhydrous gel, a troche, or a rapid-dissolve tablet. As a 503A compounding pharmacy, Bayview Pharmacy prepares each order in small batches under USP <795> standards using quality ingredients. Compounded preparations are not FDA-approved. Related hormone preparations include DHEA (Women), Bi-Est / Progesterone, Bi-Est, and Progesterone. The full list is in our compounded medications catalog.
Clinical details for prescribers
Controlled substance. Testosterone is a Schedule III controlled substance federally (Anabolic Steroids Control Act); certain states schedule it more strictly. Requires EPCS transmission and valid DEA registration; refill and quantity limits apply per federal and state law. Step-by-step: how to e-prescribe testosterone to Bayview →
Formulation (female dosing). Compounded as topical cream, anhydrous (VersaBase-type) gel, buccal/sublingual troche, and rapid-dissolve tablet at the low strengths used in women. Reported female dosing in the literature spans roughly 0.25 to 10 mg/day depending on route (e.g., transdermal cream/gel ~2 to 10 mg/day; sublingual ~0.25 to 0.75 mg). Strengths per the strengths table on this page; female androgen dosing is an order of magnitude below male replacement dosing. The goal is to keep serum testosterone within the physiologic premenopausal range and avoid supraphysiologic exposure.
Counseling points:
- Counsel on virilization signs (hirsutism, acne, voice change, alopecia) and that some may be irreversible; reduce dose or stop and reassess
- Secondary transfer risk: wash site before contact, cover application area, hand hygiene, virilization risk to children and other women
- Monitor per plan (e.g., total testosterone; consider baseline and follow-up levels to avoid supraphysiologic dosing)
- Contraindicated in pregnancy and breastfeeding; avoid in known/suspected hormone-sensitive cancer
Often prescribed alongside Bi-Est and progesterone in women's hormone therapy. Background: testosterone topical monograph; NASEM report on compounded BHRT.
This is a prescription-only compounded medication and is not FDA-approved. This information is educational and is not medical advice. Your provider determines whether it is appropriate and sets the formulation and dose.
