A Patient's Guide to Understanding Testosterone Therapy

Demystifying Testosterone for Women

If you’ve ever felt like your hormone story was missing a piece, you’re not alone. For years, testosterone has been mislabeled as a “male hormone,” which means its crucial role in women’s health often gets overlooked.
The truth is, testosterone is just as essential for women — molecule for molecule, your body actually makes more testosterone than estrogen. It supports energy, mood, muscle tone, bone strength, and libido — all the things that help you feel like yourself.

At North Peak Hormone & Wellness, my goal is to help you understand what’s really going on in your body so you can make informed, confident decisions about your health. Let’s break it down together.

1. What Testosterone Does in Your Body

Before considering therapy, it helps to understand just how many systems depend on this single hormone.

Key roles of testosterone in women include:

• Sexual health: Supports libido, arousal, and orgasm.

• Physical strength: Helps maintain lean muscle and overall energy.

• Bone health: Protects against bone loss and supports density.

• Mood + motivation: Plays a role in confidence, drive, and emotional well-being.

Women make testosterone in three places — the ovaries, adrenal glands, and other tissues throughout the body. Because production happens in several areas, each woman’s experience with declining levels can look a little different. That’s why symptoms can range from subtle to significant as hormones shift with age, stress, or other health factors.

2. Should You Consider Testosterone Therapy?

Testosterone therapy isn’t about chasing a number — it’s about addressing how you feel. That said, it’s not a “magic fix” for every issue. Relationship strain, stress, or pain with intimacy may have different roots.
But if your symptoms point to low testosterone, therapy can be worth exploring.

Common signs of low testosterone may include:

• A drop in libido or sexual interest

• Less motivation or “drive”

• Declining muscle tone despite exercise

• Mood changes, irritability, or feeling “flat”

Medical vs. Functional Use

The only official medical diagnosis approved for testosterone therapy in women is Hypoactive Sexual Desire Disorder (HSDD) — a persistent lack of sexual desire for six months or more.
However, many women who don’t meet that strict definition still benefit when their testosterone levels are gently optimized. Research shows improvements in sexual satisfaction, mood, and energy when therapy is personalized and closely monitored.

The next step is to find out what’s really happening inside your body — and that starts with proper testing.

3. The Importance of Accurate Testing

No treatment should begin without knowing your baseline. Blood testing helps your provider see whether your symptoms line up with your lab results.

Key labs include:

TestWhy It MattersTotal TestosteroneMeasures everything in your bloodstream, both active and inactive.Free TestosteroneShows how much is available for your body to actually use.Sex Hormone Binding Globulin (SHBG)This protein carries testosterone; too much means less is “free.”

Ask about the testing method:
For women, the Mass Spectrometry (Mass Spec) method is the gold standard — it’s sensitive enough to detect the small amounts women produce. The Immunoassay method, still used by some labs, can be inaccurate for women and may underestimate true levels.
If possible, ask whether your test will be run via mass spec to ensure accuracy.

4. Treatment Options: Personalized + Compounded for Women

At North Peak Hormone & Wellness, I work exclusively with trusted compounding pharmacies to ensure that each patient’s testosterone therapy is customized to her unique needs. Compounded options allow for precise dosing, high-quality ingredients, and delivery methods that actually fit your lifestyle and comfort level — not a one-size-fits-all gel made for men.

Here are the most common forms we use:

1. Compounded Testosterone Cream or Gel

This is one of the most popular and flexible options. The pharmacy creates a bioidentical testosterone cream or gel in a strength customized just for you. Each “click” or pump delivers a specific dose — often 0.5 to 1 mg — making it easy to apply consistently.
The cream is typically applied to thin skin areas (like the inner wrist or thigh), and we’ll go over exactly how and where to apply it safely at your visit.

2. Vaginal Troches

Another great option, especially for women who also experience vaginal dryness or discomfort, are vaginal testosterone troches (pronounced troh-keys).
These small, dissolvable lozenges are inserted vaginally, where they slowly absorb through the mucosal tissue. This method supports both local tissue health and systemic benefits, often improving libido, arousal, and comfort with intimacy. They’re one of my favorite options for patients who prefer not to use a topical cream or gel.

3. Subcutaneous Injections

For women who prefer a “set it and forget it” approach, testosterone can also be compounded in a thin oil base (such as grapeseed or sesame oil) for tiny subcutaneous injections — meaning just under the skin rather than deep into the muscle.
These injections are usually done once or twice a week with a very small needle (similar to what’s used for insulin). This route provides steady absorption and is a good choice for women who want predictable, consistent levels without daily application.

Safety Note

Because testosterone can transfer through skin contact when applied topically, always wash your hands well after applying cream or gel, and allow it to fully dry before touching others — especially partners, children, or pets.
Injections and vaginal troches eliminate this concern entirely, which is another reason some patients prefer them.5. Side Effects: What to Watch For

When prescribed and monitored properly, side effects are uncommon. Most occur when the dose is too high.

Signs your dose may be too strong:

• Hair thinning on the scalp

• Acne along the jawline

• New facial hair growth

• Mood swings or irritability

In rare cases of excessive dosing, more serious changes (like voice deepening or clitoral enlargement) can occur — and those may not fully reverse.
That’s why your provider will start low and slow, adjusting based on both symptoms and follow-up labs.

6. Is Testosterone Right for You?

There’s no one-size-fits-all answer. Testosterone therapy should always fit within a broader plan for hormonal balance. For example, if estrogen is too low, testosterone alone may not feel right — your provider may address estrogen first to create balance before revisiting testosterone.

The best outcomes happen when you and your provider take a collaborative, personalized approach. You should never feel pressured into treatment — it’s about what aligns with your goals, values, and overall health.

The Bottom Line

Testosterone is not just a “male” hormone — it’s a vital part of women’s health and well-being. When properly assessed, monitored, and balanced, it can restore energy, confidence, and connection.
If you think low testosterone might be part of your story, start by asking your provider about testing options and the “mass spec” method. Knowledge is power — and understanding your hormones is the first step toward feeling like yourself again.