What it is
Your ovaries and adrenal glands make testosterone too. Levels drift down through your 40s and after menopause. For some women, that shows up as desire that has simply gone quiet.
Testosterone is not a first step. Dr. Mueller first works through the other causes: painful sex, poor sleep, medications, mood, relationship strain. It is considered when low desire is the distressing problem on its own.
No testosterone product is FDA-approved for women in the US. Following international guidelines, Dr. Mueller prescribes an FDA-approved gel off-label, at about one-tenth the male dose. Blood levels are checked. She does not use compounded creams or pellets.
Who it can help
- Postmenopausal women whose main complaint is low desire
- Desire that faded even though sex is comfortable
- Women already treated for dryness or pain, with libido still flat
- Women distressed by the change themselves, not only a partner
What starting it involves
- 1
Rule out causes
Sleep, mood, medications, and painful sex are addressed first.
- 2
Baseline labs
A blood test documents your testosterone level before starting.
- 3
Start low
A pea-sized dab of gel daily, about one-tenth the male dose.
- 4
Recheck levels
Labs at 8 to 12 weeks confirm you stay in the normal female range.
- 5
Judge at six months
If desire has not improved by then, the trial stops.
- 6
Yearly review
Dose and levels are rechecked at least once a year.
Questions people ask
- Will testosterone give me facial hair or a deeper voice?
- Kept in the normal female range, that is uncommon. Acne or a few extra hairs can happen and settle when the dose drops.
- Why not pellets?
- Pellets often push levels far above the female range and are hard to remove once placed. The Menopause Society advises against them.
- Is low libido just about hormones?
- Rarely. Sleep, stress, medications, and painful sex all lower desire. Dr. Mueller works through those first.
- How fast does it work?
- Slowly. Benefit builds over 8 to 12 weeks, and the trial is judged at six months.
- Does a blood test diagnose low libido?
- No. Testosterone levels do not predict desire. Testing is used to keep dosing safe, not to make the diagnosis.