Testosterone can be considered in menopause care for persistent low sexual desire, after a full assessment and after HRT has been tried or reviewed where appropriate. Like any prescription medicine, it can cause side effects.
Many side effects are linked to too much testosterone exposure. That may happen if the dose is too high, if more is applied than prescribed, if a product is used more often than advised, if the application routine is misunderstood, or if testosterone accidentally transfers to another person.
Important: This article is general safety information. It does not replace your prescription label, product page, video guide, patient information leaflet or advice from LIVVE. Always follow the instructions for your prescribed product.
What side effects can testosterone cause?
At carefully prescribed female doses, side effects are usually uncommon and often mild. However, everyone responds differently, and some people are more sensitive to androgen-related effects.
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Acne or oilier skin
Testosterone can increase oil production in the skin. Some people notice mild acne, a change in skin texture or more oily skin, especially in the early months or if levels rise above the intended range.
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Facial or body hair
Some people notice increased hair growth, including facial hair or hair near the application site. Rotating sites where advised and avoiding over-application can help reduce local exposure.
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Scalp hair thinning
Hair thinning is less common but can be distressing. It may be more likely in people with a tendency to androgen-sensitive hair thinning or if testosterone exposure is too high.
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Application-site irritation
Redness, itching, dryness or irritation can occur where gel or cream is applied. This may relate to the product base, skin sensitivity or repeated use of the same area.
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Headache
Headaches can have many causes, but new or worsening headaches after starting treatment should be mentioned at review, especially if they are persistent or unusual for you.
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Mood or irritability changes
Some people report feeling more irritable, emotionally different or unsettled. Mood changes can also be caused by sleep, stress, HRT changes, life events or other medicines, so they should be reviewed in context.
Voice deepening and clitoral enlargement: uncommon but important
Voice deepening and clitoral enlargement are uncommon when testosterone is prescribed and monitored within the female physiological range, but they are important warning signs. They should never be dismissed as a normal adjustment effect.
Important warning
Contact LIVVE promptly if you notice a deeper voice, hoarseness that feels unusual for you, clitoral enlargement, marked new facial/body hair growth, rapidly worsening acne or scalp hair thinning.
Some androgenic changes may not fully reverse, particularly if high exposure continues for too long. This is why early reporting matters. Monitoring blood levels is important, but it does not replace telling your clinician what you are noticing in your body.
Warning
Do not change your dose on your own. If you are worried your dose is too high, too low or not working, contact LIVVE. Increasing, reducing or stopping treatment without advice can make interpretation harder and may increase side-effect risk.
How monitoring reduces risk
Monitoring is used to check whether testosterone is helping, whether side effects are appearing and whether levels remain within the female physiological range. The aim is not to raise testosterone as high as possible.
Blood tests are one part of monitoring. They cannot replace clinical review. LIVVE will also consider your symptoms, side effects, HRT, vaginal symptoms, application routine, other medicines and whether low desire is improving enough to justify continuing treatment.
Read more in Testosterone Blood Tests for Women.
What should I do if I notice a side effect?
| Symptom or concern | What to do | Why it matters |
|---|---|---|
| Mild acne, oilier skin or mild local irritation | Mention it at your review, or contact LIVVE sooner if it is worsening, painful or worrying you. | These symptoms may be manageable, but they can also suggest higher exposure or skin sensitivity. |
| New facial/body hair or scalp hair thinning | Contact LIVVE, especially if changes are progressing or distressing. | Hair-related changes can be dose-related and should be reviewed early. |
| Voice change, clitoral enlargement or marked virilising symptoms | Contact LIVVE promptly for advice. | These are uncommon but important warning signs and should not be treated as normal adjustment effects. |
| Severe allergic reaction, swelling of lips/face/tongue, breathing difficulty, chest pain or severe sudden illness | Seek urgent medical help. | These symptoms need immediate assessment and may not be related to testosterone. |
When might testosterone be reduced, paused or stopped?
A clinician may recommend changing the plan if side effects develop, blood levels are above the intended range, application is not practical, the medicine is transferring to someone else, or symptoms have not improved enough after an appropriate trial.
Stopping or adjusting treatment is not a failure. Testosterone is only helpful for some people, and ongoing treatment should be based on benefit, safety, tolerability and personal preference.
Could side effects happen because of transfer?
Yes. Testosterone gel or cream can transfer through skin contact before it has dried or if the application site is not covered when needed. Transfer can potentially affect partners, children, pets or anyone pregnant or who could become pregnant.
Wash your hands after applying, let the product dry, cover the area where advised and follow your product-specific instructions. If someone else has repeated contact with the application site and develops acne, hair growth or other unexpected symptoms, contact LIVVE for advice.
Read more in How to Use Testosterone Gel or Cream Safely.
When to contact LIVVE
Please contact LIVVE if you notice:
- new or worsening acne that is painful, persistent or distressing
- oilier skin that feels difficult to manage
- increased facial or body hair hair
- thinning or increased shedding from the scalp
- voice deepening, hoarseness or a change in voice quality
- clitoral enlargement or other marked androgenic symptoms
- ongoing irritation, redness, itching or rash at the application site
- new headaches, mood changes or irritability after starting or changing treatment
- suspected transfer to a partner, child, pet or someone pregnant or who could become pregnant
- any uncertainty about whether to continue, pause or change treatment
Worried about a testosterone side effect?
If you notice acne, hair changes, voice symptoms, irritation, mood changes or anything that feels unusual, contact LIVVE before changing your treatment. We can review your symptoms, application routine, blood results and next steps.
How this links to Androfeme, Tostran and Testogel
Androfeme, Tostran and Testogel can all require side-effect monitoring when prescribed in menopause care, but they are not used in the same way. This article explains side-effect principles only. Product-specific instructions should remain on the individual product pages, video guides and supplied medicine information.
Androfeme
Androfeme is a 1% testosterone cream licensed for use in women. It is supplied with a measuring applicator to help deliver small, consistent doses. Your clinician will advise whether Androfeme is the most appropriate option for you based on your individual assessment and product availability.
Tostran
Tostran is a 2% testosterone gel licensed for use in men but commonly prescribed off-label for women. Your clinician will advise the dose and application schedule that is appropriate for you, as women require much lower doses than men.
Testogel
Testogel is a testosterone gel supplied in 40.5 mg sachets. It is licensed for use in men but commonly prescribed off-label for women using a carefully measured female dose. Your clinician will advise exactly how much to use and how to apply it safely.
