Why Testosterone for Women Was Hard to Get (And How That's Finally Changing)
I have been doing hormone replacement therapy for almost nine years. And the one thing that made the biggest difference for me was the one thing I was most scared to try: testosterone.
I had heard so many negative things about it. Too many side effects. Not enough research. And honestly, finding a doctor who actually knew what they were doing with testosterone for women felt almost impossible at the time. (If you want to hear from one of my favorite doctor's, Dr. Kelly Casperson, all about testosterone, click here).
Here is what I wish someone had told me sooner…
Women Produce Testosterone (And We Lose a Lot of It)
Testosterone is not just a male hormone. Women produce it naturally, just as men do, and we need it just as much. The problem is that when perimenopause hits, women can lose up to half of their natural testosterone levels, and that loss does not just affect sex drive.
Low testosterone in women shows up as:
- Persistent fatigue that does not respond to sleep or rest
- Brain fog and difficulty concentrating
- Difficulty building or maintaining muscle
- Reduced ability to use stored body fat as energy
- Low motivation and flattened mood
Sound familiar? A lot of women chalk these symptoms up to getting older. They are not inevitable. They are often hormonal, and they are addressable.
Why It Was So Hard to Get
For most of my early HRT journey, there was no testosterone that was specifically FDA-approved for women. None. Even though women produce testosterone and clearly need it, the only approved forms were designed for men, which meant trying to figure out the right fraction of a man's dose. It was not ideal. A lot of doctors were not comfortable prescribing it at all, and the ones who were often did not have enough clinical experience with women specifically to dial it in correctly.
That created a situation where millions of women were walking around with depleted testosterone, experiencing real symptoms, and being told everything looked fine on their lab work because no one was testing for it or taking it seriously.
What Has Changed
A 2026 PubMed review confirmed what many of us already suspected from experience: testosterone is a normal, biological hormone for women. It affects desire, energy, mood, cognition, bone density, and muscle. It also helps alleviate menopausal symptoms. The science has finally caught up to what women have been saying for years.
And now the access has started to catch up too.
How I Get Mine Through MIDI Health
MIDI Health is the telehealth company I use, and the reason I am proud to be affiliated with them is that they have been at the forefront of testosterone specifically formulated for women. No pellets, which I would avoid because if the dose is wrong you cannot adjust it once it is in. No trying to use a fraction of a men's formulation. There is now a gel specifically made for women's physiology, and MIDI has built a virtual care appointment around exactly this.
Their clinicians actually listen. You can walk into that appointment asking for a hormone panel, a DEXA scan, a thyroid panel, and a real conversation about whether testosterone is right for you. They work with almost all major insurance companies, which is genuinely rare in the hormone and longevity space where most care is entirely out of pocket.
Right now testosterone through MIDI is available in 25 states and they keep adding more. If you have been feeling like a dimmer version of yourself and you are wondering if your hormones are part of the reason, this is worth exploring before you assume anything else is the answer.
Book your appointment at chalene.com/midi.
Want to hear more? I chat about my testosterone experience in the beginning of this Chalene Show episode.
Love you, mean it.
Chalene
P.S. Full disclosure. I'm a paid partner with Midi Health. They're one of the few reputable telehealth services out there advocating for women. I use em and love em!
FAQ
Do women need testosterone?
Yes. Women produce testosterone naturally and need it for energy, mood, cognition, muscle maintenance, bone density, and libido. It is not just a male hormone.
What are the signs of low testosterone in women?
Fatigue, brain fog, difficulty building muscle, low libido, reduced motivation, and trouble losing body fat are among the most common signs.
Is testosterone FDA-approved for women?
Until recently, there was no FDA-approved testosterone specifically formulated for women. That has changed, and there are now options including a gel made specifically for women's physiology.
What is the best form of testosterone for women?
A gel specifically formulated for women tends to be preferred over pellets because the dose can be adjusted as needed. Pellets, once inserted, cannot be changed if the dose is off.
Where can women get testosterone prescribed?
MIDI Health offers virtual care appointments with clinicians who specialize in women's hormone health, including testosterone, and they work with most insurance.
