Testosterone prescriptions for women in the US surged nearly 390% between January 2018 and July 2026, according to healthcare analytics firm Truveta — yet no Health Canada-approved testosterone formulations exist for female use. The growing trend reflects both unmet clinical needs and a wave of misinformation, experts warn.

Randomized controlled trials, meta-analyses, and global guidelines — including those from the Society of Obstetricians and Gynecologists of Canada — support off-label transdermal testosterone as a treatment option, but only for hypoactive sexual desire disorder (HSDD). Experts stress that testosterone should not be promoted for mood, energy, brain fog, sleep, hot flashes, or pain, and that clinicians must rule out other contributing factors like depression, stress, anemia, or vaginal dryness before prescribing.

Key Takeaways:

• Low-dose transdermal testosterone (roughly one-tenth of a standard male dose) is the preferred method when no female-specific product is available
• Blood levels and symptoms should be checked ~6 weeks after starting treatment, then periodically thereafter
• If no meaningful benefit is seen after 6 months, treatment should be discontinued
• Pellet and oral formulations should be avoided due to dosing inconsistency and excessive testosterone exposure risks

Why it matters: With no approved female testosterone product on the market, clinicians are navigating a significant gap in care. Setting evidence-based expectations — and resisting patient and commercial pressure to overprescribe — is critical to safe, effective menopause management.