If a woman has symptoms of high or low testosterone, it’s recommended that she visit a healthcare provider to get further testing and a diagnosis. High or low T levels in women may indicate an underlying medical condition, such as hirsutism, PCOS, tumors, or CAH. Typically, HRT supplements estrogen and progesterone (female hormones), but certain therapies can also deliver testosterone. Hormone replacement therapy provides women with hormones that are typically lost or reduced during menopause. There are currently no Food and Drug Administration (FDA)-approved testosterone medical treatments for women. In regard to therapies for women with low T levels, there is very limited research on the topic. Here’s a look at medical and non-medical, natural treatments for low testosterone in females. With respect to testosterone specifically, Grober et al. conducted an analysis of compounded testosterone creams/gels from 10 pharmacies in Toronto, Canada.410 Each pharmacy was given two prescriptions for 50 mg of testosterone, separated by 1 month to assess both intra-pharmacy and inter-pharmacy consistency. In 2001, the FDA performed an analysis of internet-purchased, compounded products following reports of contamination, poor compounding processes, and product toxicity.406, 407 Among 29 product samples analyzed, which included testosterone among multiple medications, 31% demonstrated sub-potency ranging from 59-89% below target dose. Considerable variation in dosages and in ingredients results. In contrast to commercial pharmaceutical manufacturing, which is regulated by the FDA, compounded medications are regulated by state laws and, therefore, vary significantly from one region to another.405 While testosterone gels and creams are the most commonly used forms of compounded testosterone therapies and are routinely less expensive than branded forms of testosterone, these preparations by individual pharmacies occur without direct FDA oversight and approval. Another meta-analysis by Calof et al.190 (2005) pooled data from 19 RCTs to determine the number of all-cause prostate events in men who were on exogenous testosterone treatment as compared to men who were on placebo. The other men in the study already had metastatic disease at the time of testosterone initiation. However, an analysis of Huggins' original paper reveals that this assumption was based on a single patient who was cancer and androgen therapy naïve at study onset. The controversy surrounding prostate cancer and testosterone stems from the work of Dr. Charles Huggins who discovered that treating metastatic prostate cancer patients with ADT resulted in cancer remission,341 suggesting that the presence of testosterone would lead to an increased likelihood of prostate cancer development. Increasing patient age and increasing duration of prior exogenous testosterone use both significantly reduced the likelihood of reaching the 5 million TMSC benchmark. Three Hone patients share a timeline of benefits and changes during the first year of TRT treatment. You can test your levels with an at-home kit or a blood test. You could fill a whole refrigerator with the variety of hormone-healthy foods you can add to your plate. Hone’s at-home hormone assessment can determine if you qualify for treatment. This is especially true in functional hypogonadism, where weight, sleep, metabolic health, and medication effects may influence the entire picture (Corona et al., Andrology, 2020). That is why good hormone care depends on more than a screenshot of a lab result. In transdermal therapy, timing matters differently. One reason lab conversations around TRT become confusing is that testosterone values are not independent of timing. In younger men, some authors have argued that a one-size-fits-all cutoff may miss clinically relevant low values when symptoms are present. Patients on topical gels, patches, and intranasal formulations should have their testosterone checked between two to four weeks after commencement of therapy. + FDA approved for use in males with hypogonadotropic hypogonadism and pediatric patients with cryptorchidism. Finally, hCG therapy alone or in combination with SERMs has been shown to facilitate recovery of testosterone production and spermatogenesis in men with a prior history of exogenous testosterone use333 or anabolic steroid abuse.334 Return of sperm to the ejaculate in these men can be highly variable, taking up to two years after cessation of exogenous testosterone in some cases, with some men never experiencing return of sperm.334 Clinicians should understand that of these agents, only hCG has been approved by the FDA for use in males, specifically to treat males with hypogonadotropic hypogonadism. While SERMs, hCG, and AIs are all categorized as "alternative therapies" to testosterone, they are actually a diverse group of agents. More recently, a study evaluating the amount of residual testosterone identified on laundered clothing from men using an axilla-applied testosterone liquid reported the presence of 13% of a single axilla dose on 10x10 cm clothing samples.393 After laundering the clothing with various other materials, as much as 5.8% of a standard dose of one axilla was transferred to other garments.
