People’s Pharmacy | Men Can Get Testosterone. Why Not Women?
More than a decade ago, the Food and Drug Administration warned doctors not to prescribe testosterone merely because an otherwise healthy man had “low T.” There were exceptions, though. Men with serious medical conditions that caused abnormally low testosterone levels could still receive hormone replacement therapy.
The FDA was concerned that treating age-related declines in testosterone might expose men to serious cardiovascular complications. The agency warned doctors and patients that testosterone treatment could increase the risk of heart attack, stroke or even death.
That caution was scary enough to discourage a lot of physicians from prescribing testosterone to men with low T levels. But on July 13, 2023, the results of a large clinical trial called TRAVERSE were published in the New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/37326322/ The outcome surprised a lot of healthcare professionals, including officials at the FDA. Testosterone replacement therapy (TRT) did not increase the risk for heart attacks, strokes or cardiovascular deaths.
In 2025, the FDA reversed course and asked drug companies to remove the black box warning it had previously required. On June 18, 2026, the Department of Health and Human Services went further and announced that the FDA would no longer warn doctors to resist prescribing testosterone for patients with low T.
What the FDA has not done, however, is consider the use of TRT for women. Most people do not realize that women require testosterone too. It is the precursor hormone for the creation of estradiol, the most active form of human estrogen.
Last year the FDA began easing cautions about menopausal hormone replacement therapy. Boxed warnings about cardiovascular disease and dementia were removed. But they only apply to estrogen and progesterone. FDA officials have not been willing even to consider testosterone for women.
There is evidence, however, that in low doses, testosterone can help ease menopausal symptoms, build strong bones and improve sexual health. Many readers have shared their experiences. One woman says: “It seems we are overlooked when it comes to low T, yet we could benefit just as much as men from testosterone therapy.”
Another offers this experience: “I have been using estrogen and testosterone for 18 years. I’m able to get both compounded into creams at a local pharmacy. All of my health indicators are great. I have no hot flashes, and I have a sex drive again.”
This woman is under careful medical supervision: “I had a post-menopausal decade of depression, low energy, no libido and creeping osteopenia [thinning bones]. Two weeks after starting bioidentical hormone replacement therapy—testosterone and estradiol pellets, plus a progesterone capsule—the sun came out. My doctor does blood work before every pellet refresh, about every 4 or 5 months, to make needed adjustments. She also takes into account how I’m feeling. My bones are now normal, sex drive is good, and I haven’t had a problem with testosterone side effects. I’ve been taking bioidentical HRT for 11 years and am 73 years old. To hell with the FDA! I’ll stop it when I’m dead.”
Not every man or woman needs hormone replacement therapy. Women who get too much testosterone may experience oily skin, acne, hair growth on the face or body, voice changes and hair thinning. But recent policy changes at the FDA are making access to HRT easier for both men and women.
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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.peoplespharmacy.com. Their newest book is Top Screwups Doctors Make and How to Avoid Them (Crown).