Testosterone Prescribing Rises Among Women as Recorded Monitoring Remains Low
A study of 10,185 women found rising testosterone prescribing, few recorded blood tests, and limited documentation of an evidence-based indication.
Summary
Testosterone prescribing among women is increasing, but this study raises questions about treatment selection and monitoring. Researchers examined electronic health records for 10,185 adult women newly prescribed testosterone between 2016 and 2024. Only 17% had a recorded diagnosis of hypoactive sexual desire disorder, which the authors identify as the only evidence-based indication in postmenopausal women. New prescribing increased by an estimated 22% annually from 2022 to 2024. Blood testing was recorded for 16% before treatment and 10% during follow-up; among those tested afterward, 38% had testosterone levels above 70 ng/dL. Most received one prescription, while some continued beyond two years, where safety evidence is limited. These findings support reviewing treatment goals and monitoring, but incomplete records cannot establish inappropriate care or treatment-related harm. This summary uses the abstract only.
Detailed Summary
Testosterone use in women is attracting growing interest, but evidence does not support it as a general treatment for aging, energy, or wellness. According to this study, the only established indication is hypoactive sexual desire disorder in postmenopausal women. Understanding how prescribing compares with that evidence matters because prolonged treatment can extend beyond the available safety data.
Researchers analyzed electronic health records from the TriNetX network, identifying 10,185 adult women newly prescribed testosterone between 2016 and 2024. Their median age was 52 years. Women with gender incongruence were excluded. The study examined prescribing trends, recorded diagnoses, testosterone blood testing, and how long prescriptions continued. It did not test whether testosterone improved symptoms or caused adverse health outcomes.
Only 17% had a recorded diagnosis of hypoactive sexual desire disorder. New prescribing increased by an estimated 22% annually during 2022–2024. Testosterone testing appeared in 16% of records before treatment and 10% during days 60–180. Among women tested during follow-up, 38% had concentrations above 70 ng/dL. These measurements describe the tested subgroup, not all women receiving testosterone, and do not establish how frequently treatment caused harmful effects.
Most women, 59%, received just one prescription. Among those with at least two prescriptions, the estimated median time to discontinuation was 19.3 months. Some continued beyond two years, when safety evidence is limited. The findings support discussing the treatment indication, expected benefits, monitoring plan, and uncertainties before starting or continuing testosterone, especially when preexisting conditions complicate treatment decisions.
This summary is based on the abstract only. Missing diagnoses or blood tests in electronic records may reflect incomplete documentation or care outside the network, rather than absent clinical assessment. Prescriptions also do not prove medication use. Because this was an observational study without a comparison group, it cannot determine testosterone's benefits, harms, or effects on human longevity.
Key Findings
- Only 17% of 10,185 women starting testosterone had a recorded diagnosis of hypoactive sexual desire disorder.
- New testosterone prescribing increased an estimated 22% annually during 2022–2024, with a 95% confidence interval of 12%–29%.
- Testosterone testing was recorded in 16% at baseline and 10% during days 60–180; review monitoring plans with the prescribing clinician.
- Among women tested at follow-up, 38% had testosterone above 70 ng/dL; this percentage does not represent all treated women.
- Most received one prescription; among women receiving at least two, median time to discontinuation was 19.3 months.
Methodology
This retrospective new-user cohort study used de-identified TriNetX electronic health records for 10,185 adult women newly prescribed testosterone during 2016–2024, excluding women with gender incongruence. Researchers described patient characteristics, documented indications, prescribing trends, serum testosterone monitoring, and prescription persistence; the abstract reports no untreated comparison group.
Study Limitations
This summary is based on the abstract only; detailed methods, treatment formulations, doses, and discontinuation definitions were not available for assessment. Electronic records may miss diagnoses, prescriptions, or testing performed elsewhere, and prescriptions do not establish actual medication use. Selective follow-up testing limits interpretation of testosterone concentrations, and the observational design cannot determine treatment benefits or harms.
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