Testosterone Therapy for Women at Live Young Medical
Blending the latest evidence, two decades of hands-on experience, and insights from today’s leading menopause-care educators
Why testosterone matters in mid-life women
Research shows that endogenous testosterone peaks in the early 20 s and then drifts downward starting in their 30’s; by age 50 most women sit at about half their youthful level. Unlike estradiol, testosterone does not crash at menopause—so symptoms linked to low levels can emerge years before a woman’s final period. Well-conducted trials and consensus statements (Endocrine Society, ISSWSH, IMS, Menopause Society, SOGC) agree on one clear evidence-based indication: acquired, generalized hypoactive sexual desire disorder (HSDD) in post-menopausal women. Benefits are modest but clinically meaningful when physiologic transdermal doses keep serum T within the normal female range.
Additional, off label but potentially beneficial uses for testosterone are: as adjunctive therapy for persistent bladder symptoms and forms of vaginal pain in addition to localized estradiol or DHEA treatments for GSM; lean body mass support for both muscle and bone; and mental clarity- not all but some women will feel more focused and vital.
Side effects are rare when testosterone levels are kept in the physiological range. Even if in the normal range, oilier skin, break outs and worsening facial hair can occur; if bothersome testosterone can be discontinued or a dose reduction made.
Live Young Medical’s perspective
“Hormone optimisation is never ‘one size fits all.’ Over 20 years of prescribing menopause hormone therapy—including tailored testosterone—have taught me that the right dose, delivered with careful monitoring and integrated lifestyle support, can be transformative.”
— Dr Maureen Sweeney, MD, ABAARM
Since 2003 Dr Sweeney has combined board-certified age-management training with family-practice roots to build a whole-person model: metabolic screening, nutrition coaching, movement, sleep and stress interventions sit alongside precise hormonal support. In her experience:
- About one in five mid-life women who seek help for low libido or vitality ultimately benefit from a supervised testosterone add-on—after estrogen loss, thyroid issues, iron deficiency, genitourinary syndrome of menopause (GSM) and relationship factors are addressed.
- Physiologic dosing works. A 300 µg systemically delivered transdermal dose (e.g., AndroFeme® 1 % 0.5 mL or 1 % gel compounded to female strength) can improve desire without pushing serum T above 2 nmol/L.
- Monitoring is non-negotiable. Total T and SHBG at baseline and 6-week titration; discontinue if no symptomatic gain by six months and physiological levels are attained.
- Usual screening such as Pap, FIT, breast screening on schedule.
Voices that sharpen our practice
What they add | Dr Heather Hirsch, MD MS NCMP | Dr Rachel S. Rubin, MD |
Clinical focus | Internist & menopause specialist; founder, Menopause & Midlife Clinic, Brigham & Women’s Hospital (heatherhirschmd.com) | Fellowship-trained urologist/sexual-medicine physician; lead author, 2025 AUA / ISSWSH guideline on GSM (auanet.org) |
Key publications / platforms | Unlock Your Menopause Type (St Martin’s, 2023) – pragmatic algorithms for oestrogen, progesterone and testosterone (amazon.ca); Heather Hirsch Academy CME for clinicians (heatherhirschacademy.com) | Virtual Sexual-Medicine Collaborative; “Prescriber’s Pocket Guide to Local Vaginal Hormones” aligned with 2025 GSM guideline (rachelrubinmd.thinkific.com) |
Core testosterone message | “Keep dosing physiologic—testosterone is powerful medicine, not a bio-hack.” | “Sexual health is health; testosterone can help, but always as part of a biopsychosocial plan.” (urologytimes.com) |
How we apply it | Confirms our low-dose, lab-guided algorithm; her menopause-type framework helps stratify which Live Young patients might benefit most. | Reinforces comprehensive sexual-function work-up (pelvic floor, GSM, partner factors) before adding testosterone; her GSM guideline dovetails with our routine vaginal-oestrogen counselling. |
Our step-by-step care pathway
- Screen & contextualise – Decreased Sexual Desire Screener + full Age-Management intake to rule out thyroid, iron, medication, psychosocial and GSM contributors.
- Baseline labs – Total T, SHBG, E2, CBC.
- Shared decision-making – Discuss evidence, off-label status in Canada/US, expected benefit (~1 additional satisfying sexual event per month), and reversible androgenic side-effects.
- Physiologic transdermal start – 300 µg systemic daily; adjust at 6 weeks if serum T < 1 nmol/L and symptoms persist.
- Whole-health optimisation – Nutrition (protein adequacy, insulin sensitivity), resistance training, sleep hygiene and stress coaching—services embedded in every Live Young program.
- Ongoing monitoring – Labs at 6 weeks, 6 months, then annually; discontinue if no improvement by 6 months + serum T in upper normal female range.
- Research & education loop – Practice protocols updated annually based on new RCTs/ research, society statements, and insights from thought-leaders like Hirsch and Rubin.
The Live Young difference
Combining the rigour of current best evidence, 20 years of frontline hormone-therapy insight, and the teaching of today’s most respected menopause and sexual-health educators ensures patients receive care that is both grounded and progressive. Testosterone is never a stand-alone “fix”; it is one finely calibrated tool within a broader strategy to restore vitality, protect long-term health, and help women thrive through mid-life and beyond.