Testosterone is a women's hormone.

You know the feeling even if no one has named it. Desire that used to show up on its own doesn't show up at all. Your drive — at work, at the gym, in your relationship — feels like it's running on a dimmer switch. And when you finally bring it up at an appointment, you hear one of two things: "your labs are normal," or "we don't really do that here."

Here's what you deserve to know: testosterone is not a men's hormone that women borrow. Your ovaries and adrenal glands make it, and for much of adult life you have more circulating testosterone than estradiol. Levels decline gradually through the 40s and beyond — and treating that decline, in the right patient, is real medicine.

So why is it so hard to find a doctor who will?

Why so few doctors prescribe it

The honest answer is a training gap. Most physicians received little to no menopause education in residency — and testosterone for women is a step beyond even that. There is currently no FDA-approved testosterone product designed for women in the United States, which means prescribing it well requires comfort with off-label dosing, careful titration, and follow-up testing. That takes specific training and ongoing experience.

Providers who don't have that training tend to do one of two things: decline to offer testosterone at all, or offer exactly one delivery method to every patient who walks in the door. Neither is fair to you. Dismissing a treatable symptom isn't neutral — and neither is a one-size-fits-all protocol.

If a clinic only offers pellets, ask why

Testosterone pellets are implanted under the skin and release hormone for months. That convenience comes with a real trade-off: once a pellet is placed, it cannot be adjusted and it cannot be removed. Pellets frequently produce testosterone levels well above the normal female range, and if side effects appear — acne, hair changes, irritability — there is no way to turn the dose down. You wait it out.

Hormone therapy should be able to respond to how you actually feel. If pellets are the only option on a clinic's menu, that tells you something about the menu — not about what's right for your body. It's a fair question to ask out loud: "If this dose doesn't suit me, how do we adjust it?" Listen carefully to the answer.

How we prescribe testosterone at Wahine Health

We offer testosterone as a cream, a gel, an injection, or a troche — and which one you use is a conversation, not a default. Some women want something they apply once a day without thinking about it. Some would rather not deal with a topical at all. The route gets chosen around your life.

What all four have in common is the thing that matters most: the dose can be changed. We check baseline levels, recheck at about 8–10 weeks, and then adjust based on how you actually feel — not just a number on a lab report. If a dose isn't right, we change it. If a route isn't working for you, we switch it.

What the evidence actually says

The best-established indication for testosterone in women is hypoactive sexual desire disorder (HSDD) — low desire that genuinely bothers you — where global consensus guidelines support its use in menopausal women. Research on muscle, bone, and cognition is active and emerging, but not yet conclusive, and any clinic promising those benefits is ahead of the data. We'll always tell you what's established, what's emerging, and what's hype — because that honesty is what you're actually paying a physician for.

The point

You should not have to interview five providers to find one who can discuss your own hormone. You deserve a doctor who can say yes or no for real reasons — your history, your labs, your goals — not one whose training decided the answer before you finished your sentence.

Common questions

Why won't my doctor prescribe testosterone? There's no FDA-approved testosterone product for women in the U.S., so prescribing it means off-label dosing, titration, and follow-up labs. Many providers were never trained in it — so they either don't offer it, or offer only one method to everyone.

Is testosterone really a women's hormone? Yes. Women make it in the ovaries and adrenal glands, and for much of adult life circulating testosterone is more abundant than estradiol. It declines gradually through the 40s and beyond.

Are pellets a good option? Pellets can't be adjusted or removed once implanted and frequently push levels above the female physiologic range. Consensus guidance favors dosing that keeps levels in the normal female range — which an adjustable cream can do and a pellet cannot.

How do you prescribe it here? We offer cream, gel, injection, and troche. All four can be adjusted. We check baseline levels, recheck at 8–10 weeks, and change the dose or the route based on how you feel.