Updated March 2026

We wanted to highlight a recently published 2026 study examining the use of testosterone gel (Testogel) in women in a real-world setting.

This study included 24 women aged 40–65 who had already been using Testogel in the community for several months to manage low sexual desire. Around half were also using menopausal hormone therapy (MHT), and all were confirmed to be in the menopause transition.

Unlike controlled clinical trials, this study reflects how these products are actually being used in practice.

Participants were using approximately one pump of gel every 3–4 days, with dosing based on community prescribing rather than a standardised protocol. Researchers then performed detailed hormone profiling, measuring testosterone levels every two hours over a 10-hour period after application, and again at 24 hours.

The results showed marked variability in testosterone levels between individuals, ranging from undetectable levels (0 nmol/L) up to 24 nmol/L.

For context, typical testosterone levels in women are approximately 0.5–2 nmol/L. Levels above this range—particularly above 6–8 nmol/L—begin to overlap with the male physiological range.

In this study, some women reached levels well into that range, highlighting how difficult it is to achieve consistent and physiologically appropriate dosing when using products designed for men.

While some aspects of sexual function, such as arousal and satisfaction, were reported as reasonable, sexual desire itself remained lower. Importantly, the study was small and did not assess long-term safety outcomes.

This is clinically relevant, as persistently elevated testosterone levels in women may lead to side effects such as:

• acne 
• increased facial or body hair 
• scalp hair thinning 
• voice deepening 

Some of these effects may be irreversible.

The findings reinforce an ongoing concern: male-formulated testosterone gels can produce unpredictable and sometimes supraphysiological hormone levels in women.

In Australia and New Zealand, testosterone preparations specifically developed for women are available, such as Androfeme®. These products are designed to deliver lower, more consistent dosing aligned with female physiology.

Testosterone therapy in women should be:

• used only when clearly indicated (most commonly for hypoactive sexual desire disorder)
• prescribed at doses that maintain levels within the normal female range
• monitored with appropriate follow-up 

It is also important that other contributing factors to low sexual desire—such as psychological wellbeing, relationship dynamics, medication effects, and general health—are assessed and addressed as part of a comprehensive approach.

Some clinicians in New Zealand are using modified dosing strategies with Testogel (for example, ¼ pump daily), however these approaches remain unstudied and lack robust safety data.

Overall, this study provides useful real-world insight and supports current recommendations to use caution when prescribing testosterone products designed for men in women.

Reference:
https://pubmed.ncbi.nlm.nih.gov/41834026/

Policy and access context:
For a broader discussion on testosterone product availability, funding decisions, and formulation considerations in New Zealand, see our previous article here:
https://erhassociates.co.nz/opinions/what-does-the-funding-of-testogel-mean-for-women-and-menopause/

Note: we do not have funded affiliations with manufacturers or distributors of any of the  treatments mentioned above. This article simply reflects our view based on our clinical experience as endocrinologists, reviewing of the literature and communications with international colleagues.