Key facts
- Women are increasingly using testosterone off-label for menopause symptoms like low sexual desire, fatigue, and loss of muscle strength.
- The rate of women receiving a testosterone prescription jumped 146% from January 2023 to July 2026, according to Truveta data.
- There is no U.S.-approved testosterone product specifically for women.
- Some pharmacies, including Amazon Pharmacy, have begun rejecting or delaying prescriptions for women's off-label testosterone use.
- Compounded testosterone can cost significantly more than commercially available versions.
- Over 30 trials studying testosterone use in women are underway or planned.
Women seeking testosterone therapy for menopause symptoms are encountering unexpected prescription delays and denials at pharmacies, according to interviews with healthcare providers and patients. While off-label use for low sexual desire is on the rise, and some clinicians are prescribing it for fatigue and loss of muscle strength, medical organizations like The Menopause Society only back its use for hypoactive sexual desire disorder.
Dr. Stephanie Faubion, director of Mayo Clinic's Center for Women's Health, stated that there is no evidence testosterone improves muscle mass, bone density, or mood in women, and that its purported benefits in the public sphere are not supported by data. The U.S. Food and Drug Administration (FDA) will hold a public workshop to review the evidence for testosterone use in menopausal women, noting that off-label uses have not been evaluated for safety, efficacy, or dosing.
With no U.S.-approved testosterone product for women, patients often use versions designed for men, sometimes requiring dose customization. Amazon Pharmacy has begun rejecting some testosterone prescriptions for women, citing a policy to ensure safe and compliant dispensing, and refers customers to compounding pharmacies. Compounded testosterone can be significantly more expensive than commercially available options, and most insurance companies do not cover it for women.
Issues with prescriptions, including at CVS and Walgreens, have worsened over the past year, according to nurse practitioner Magen Price. Pharmacist Kevin Schipper noted that pharmacies may decline prescriptions due to concerns over dosing accuracy, medication safety, and potential contamination if single-use packaging is reused, as testosterone is a controlled substance. Over 30 trials are underway or planned to study testosterone use in women, with some companies developing products specifically for this demographic.