Testosterone Replacement Therapy for Men and Women

March 26, 2024

4 mins

When you think “testosterone” the image that comes to mind is probably of a man. Muscles, a deep voice, and a big sex drive are all traits associated with masculinity. It’s true that testosterone plays a role in all of those characteristics.

But, it may come as a surprise that women have testosterone, too. In fact, they need it for bone density and muscle mass, cognitive function, mood, sexual function, and energy. 

Low testosterone in both men and women can lead to various symptoms that affect mental and physical health. 

In this article, we’ll explore how testosterone affects both men and women and how TRT affects them. 

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What is TRT?

TRT – short for testosterone replacement therapy – is a medical treatment used to address low levels of testosterone in men. In some cases, healthcare providers may prescribe testosterone therapy to women, though it’s less common. 

TRT involves the administration of testosterone through various methods such as injections, patches, gels, or pellets implanted under the skin. The goal of TRT is to restore testosterone levels to within a normal range, alleviating symptoms associated with low testosterone, such as fatigue, decreased libido, erectile dysfunction, muscle weakness, and mood changes.

What Does TRT Do for Men?

TRT works by supplementing the body with exogenous testosterone (externally sourced T) to compensate for insufficient natural testosterone production. With T levels back to normal, certain physiological responses – such as high libido and sexual function, energy and mood boosts, muscle growth, metabolism regulation – begin functioning properly again. 

What Does TRT Do for Women?

In women, testosterone plays a role in sexual function, bone density, muscle mass, and overall well-being. Women with low testosterone levels may experience symptoms such as reduced libido, fatigue, decreased muscle mass, and mood changes. 

Low T levels in women may occur during menopause, as hormone imbalances occur naturally during menopause. 

Testosterone therapy for women is typically considered when other treatments have failed to address symptoms related to low testosterone and when testosterone levels are significantly below normal. 

However, prescribing testosterone to women requires careful consideration and monitoring due to potential side effects, such as acne, voice deepening, and changes in menstrual cycles.

Is TRT Administration Different for Men and Women?

Yes, the administration of TRT can differ between men and women due to differences in physiological needs and hormone levels.

For men:

TRT for men typically involves intramuscular injections, transdermal patches, topical gels, or implantable pellets placed under the skin. Intramuscular injections are commonly used and may be administered weekly or bi-weekly.

For women:

Testosterone therapy for women is less common than for men and is typically prescribed off-label. Administration methods may include transdermal patches, topical gels, or subcutaneous injections. Dosage and administration frequency are determined based on individual needs and response to treatment.

Is TRT Dosage Different for Men and Women?

Typically doses of TRT given to women are only about 10% of the amount given to men. This being said, doses are prescribed on an individual basis depending on blood work, symptoms, and other personal needs. 

For men:

Depending on the mode of administration (patch, gel, injection, etc.), TRT dosage can differ. In men, intramuscular injectables (cypionate) are typically prescribed at 50-300 mg every one to four weeks. Pellets dosage and frequency is around 150-450 mg every three to six months. Men are typically recommended to apply 50-100 mg of Androgel daily, while the transdermal patch Androderm is typically applied daily at 2-4 mg. 

For women: 

For injections, the recommended dosage for women by weight is:

• Up to 175 pounds: 10 mg every two weeks

• 176-200 pounds: 15 mg every two weeks

• Over 200 pounds: 20 mg every two weeks

The dosage of testosterone for women is typically lower than that for men and is carefully titrated to avoid virilization (development of male characteristics). Healthcare providers closely monitor testosterone levels and adjust dosage as needed.

Are the Side Effects of TRT Different for Men and Women?

Yes, the side effects of TRT can differ between men and women due to variations in hormone levels, physiological responses, and potential for virilization (development of male characteristics in women). Here's a comparison of potential side effects for both:

For men:

• Acne: TRT can lead to an increase in acne in some men due to the stimulation of sebaceous gland activity.

• Fluid retention: Some men may experience fluid retention, leading to swelling or bloating, particularly in the extremities.

• Increased red blood cell count: TRT can stimulate the production of red blood cells, leading to an increase in hematocrit levels. This may increase the risk of blood clots if levels become too high.

• Prostate enlargement: Testosterone can stimulate the growth of prostate tissue, potentially leading to benign prostatic hyperplasia (BPH) or exacerbating existing prostate conditions.

• Sleep apnea: TRT may worsen or exacerbate sleep apnea – a condition characterized by interrupted breathing during sleep.

• Infertility: TRT can suppress sperm production in the testes, leading to temporary infertility in some men. Fertility may return after discontinuing TRT or with additional treatment.

For women:

• Virilization: This is the development of male characteristics in women, such as voice deepening, increased body hair growth (hirsutism), clitoral enlargement, and male-pattern baldness. Virilization is a significant concern with testosterone therapy in women and requires careful monitoring to prevent and manage.

• Acne/oily skin: Similar to men, women may experience acne or oily skin as a side effect of TRT.

• Menstrual irregularities: Testosterone therapy can disrupt menstrual cycles in women, leading to irregular periods or cessation of menstruation (amenorrhea).

• Changes in libido: Some women may experience changes in libido – either an increase or decrease – as a result of testosterone therapy.

• Mood Changes: Mood swings or changes in mood may occur in both men and women undergoing TRT, although individual responses vary.

It's important to note that not all individuals will experience these side effects, and the severity and likelihood of side effects may vary based on factors such as dosage, administration method, individual response, and underlying health conditions. Close monitoring by a healthcare provider is essential to minimize risks and ensure safe and effective treatment.

Is TRT the Male Equivalent of HRT?

Yes, in many ways, TRT can be considered the male equivalent of hormone replacement therapy (HRT). Both TRT and HRT involve the administration of hormones to address deficiencies or imbalances in the body's natural hormone levels. However, there are some key differences between TRT and HRT:

Hormones involved: TRT specifically involves the replacement or supplementation of testosterone, the primary male sex hormone. In contrast, HRT typically refers to the administration of estrogen and progesterone (and sometimes testosterone) to address hormonal imbalances in women, particularly during menopause.

Indications: TRT is primarily used to treat low testosterone levels in men, a condition known as hypogonadism. HRT, on the other hand, is used in women to manage symptoms associated with menopause, such as hot flashes, vaginal dryness, and mood changes.

Effects and benefits: TRT aims to restore testosterone levels to within a normal range in men, leading to improvements in sexual function, mood, energy levels, muscle mass, bone density, and overall well-being. HRT in women aims to alleviate menopausal symptoms, protect against bone loss (osteoporosis), and reduce the risk of certain health conditions associated with hormonal changes, such as cardiovascular disease and cognitive decline.

Administration: TRT for men may involve various administration methods, including injections, patches, gels, or pellets implanted under the skin. HRT for women is typically administered through oral medications, transdermal patches, vaginal creams, or vaginal rings.

Despite these differences, both TRT and HRT share the common goal of restoring hormonal balance and improving quality of life for individuals experiencing hormone-related symptoms or deficiencies. It's important for individuals considering hormone replacement therapy to consult with a healthcare provider to determine the most appropriate treatment approach based on their individual needs and medical history.

How Rex MD Can Help

If you think that you may be experiencing low levels of testosterone, you may want to consider a blood test and find out if your levels are deficient or abnormal for your age. 

With the Rex MD TestoRx program, you’ll have access quality care from a team of licensed clinicians and testosterone replacement therapies (if clinically appropriate) and other testosterone solutions that can help you feel like yourself again.

To find out if the program is right for you, just answer some questions about your symptoms and medical history. Your provider will order lab work for you to help determine if you’re eligible for TRT or another testosterone solution available through the program.

Then, you’ll be able to schedule a virtual call with the Rex MD care team to further discuss your results, eligibility, and which treatment option would be most suitable for you, if any.

Get started today.