Patient guide
Testosterone for women: licensing, evidence and what to expect
In the UK, no testosterone product is licensed for women, yet NICE guidance says it can be considered for menopausal women with low sexual desire when HRT alone has not helped. That means prescribing is off-label, with particular responsibilities for the prescriber. This guide explains the position plainly.
Last checked: 2026-10-03
Key facts
At a glance.
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Licensing
There is no UK-licensed testosterone product for women. Prescribers use male products at reduced doses, which is off-label.
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NICE position
NICE guidance says to consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.
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Evidence
Trials show benefit for sexual desire in some women; evidence for other effects, such as mood or energy, is weaker.
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Monitoring
Blood levels and side effects are monitored to keep testosterone within the normal range for women.
Where testosterone fits
Women produce testosterone, and levels decline with age and after surgical menopause. Low sexual desire can have many causes, including relationship factors, medicines, mood, sleep, pain and oestrogen deficiency. Guidance suggests optimising oestrogen first, especially vaginal oestrogen for local symptoms, and addressing other factors. If distressing low desire persists, testosterone may be considered.
What off-label means
Off-label prescribing means using a medicine outside its licensed indication. This is lawful and common, but the prescriber takes responsibility for the decision, should explain that the product is not licensed for this use, and should document consent. The General Medical Council provides guidance on prescribing unlicensed and off-label medicines. NHS availability varies, and some GPs prefer specialist initiation.
What the evidence shows
Randomised trials and systematic reviews show that testosterone at doses that restore premenopausal levels can improve sexual desire, satisfaction and arousal for some postmenopausal women with distressing low desire. Results vary and effects on other symptoms are not established. Long-term safety data, particularly on breast and cardiovascular health, are limited, which is one reason for careful monitoring and review.
Safety and side effects
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Acne and increased facial or body hair are the most common side effects.
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Voice deepening and clitoral enlargement can occur at high doses and may not reverse.
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Scalp hair thinning is possible.
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Mood changes and irritability occur in some people.
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Blood tests monitor testosterone levels, and clinicians adjust to stay in the female range.
Typical process
A clinician takes a history, reviews oestrogen therapy, checks for other causes of low desire and measures baseline testosterone and other relevant bloods. If treatment is started, it is usually reviewed after a few months, with a trial period and a decision about stopping if there is no benefit. Cream or gel formulations are typically used at a fraction of the male dose. Pellets and unmonitored compounded products are not recommended.
Who should not use it
People who are pregnant or planning pregnancy, who have a hormone-sensitive cancer in their history without specialist advice, or who have liver disease or significant side effect risks should not use it without specialist advice. Testosterone is also not recommended for general energy or mood. Discuss expectations frankly with your clinician.
Questions to ask a prescriber
Ask what evidence supports testosterone for your situation, why other options such as vaginal oestrogen are or are not suitable first, which product will be used and how the dose compares with male doses. Ask how long you will trial it, what blood tests you will need, who will monitor you and what happens if it does not help. Ask whether your GP has agreed to continue prescribing. Written information on off-label use and the signs of excess dosing should be provided.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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Is testosterone approved for women in the UK?
No product is licensed for women. NICE guidance nonetheless supports considering it for low sexual desire after menopause in some circumstances.
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Will testosterone boost my energy?
Evidence for energy and mood is limited. It is mainly considered for sexual desire.
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Can I use male testosterone gel?
Clinicians sometimes use male products at much lower doses under supervision. Do not use products without medical guidance.
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How long until it works?
Some women notice change within a few months. If there is no benefit after a trial, it is usually stopped.
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Do I need blood tests?
Yes, to check baseline and monitor levels to keep them within the female range.
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Are there NHS prescriptions?
Practice varies. Some NHS clinics prescribe, and some GPs will under shared care.
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Is it safe long term?
Long-term safety data are limited, so reviews and monitoring are important.
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Can I take it without HRT?
Guidance describes using it when HRT alone is not effective, and for women who cannot take oestrogen specialist advice is needed.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NICE guideline NG23, Menopause: identification and management (nice.org.uk)
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British Menopause Society, patient and clinician consensus resources (thebms.org.uk)
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General Medical Council, Good practice in prescribing and managing medicines and devices (gmc-uk.org)
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MHRA drug safety updates and Yellow Card scheme information (gov.uk/mhra)