Testosterone scripts for women rise, along with denials and delays
Sept 15 - Women increasingly turning to testosterone therapy to manage menopause symptoms are running into unexpected prescription delays and denials at pharmacies, according to interviews with more than half a dozen doctors, nurses and patients.
uncertain
Women → rise → doctors
There is no U.S.-approved testosterone product for women, although its off-label use is on the rise, primarily to treat persistently low sexual desire related to menopause, the only condition for which medical guidelines and evidence of efficacy currently exist.
asserted
guidelines → be → efficacy
Some clinicians are also prescribing it for menopause-related symptoms such as fatigue and loss of muscle strength, despite a lack of medical guidance for that use.
The Menopause Society and half a dozen other medical organizations only back testosterone use for hypoactive sexual desire disorder in menopausal women.
"We do not have any evidence in women that it will improve muscle mass or bone density or mood or well-being or really any other metric," said Dr. Stephanie Faubion, director of Mayo Clinic's Center for Women's Health and medical director of The Menopause Society.
asserted
Faubion → prescribe → Society
"What testosterone is being touted for in the lay public and on social media is not really what we have data for," she said.
asserted
she → tout → data
Testosterone's rise comes as more women turn to hormone therapy overall, also driven by social media and, more recently, by the FDA, which backed estrogen and progesterone use for menopause symptoms as safe and effective.
asserted
which → come → symptoms
Some clinicians prescribe testosterone alongside these therapies.
asserted
clinicians → prescribe → therapies
An exclusive data analysis for Reuters by healthcare analytics firm Truveta shows the rate of women receiving a testosterone prescription jumped 146%, nearly tripling, from January 2023 to July 2026.
asserted
rate → show → July
The U.S. Food and Drug Administration will hold a public workshop on Thursday to review evidence for testosterone use in menopausal women, which has been promoted by Health Secretary Robert F. Kennedy Jr. and Defense Secretary Pete Hegseth, who has made an issue of testosterone levels among the troops.
asserted
who → hold → troops
While healthcare providers can prescribe approved medicines any way they see fit, an FDA spokesperson said these off-label uses have not been evaluated by the agency for safety, efficacy or dosing.
asserted
uses → prescribe → safety
WORKAROUNDS FOR WOMEN
With no approved testosterone for women, patients must divide packaged versions designed for men often at many times the doses they're seeking.
Jennifer Lanoff, a women's health nurse practitioner in Washington, D.C., said Amazon Pharmacy rejected prescriptions from her practice for the first time this year.
asserted
Pharmacy → approve → time
"We've done (off-label testosterone prescriptions) forever.
asserted
We → do → prescriptions
It's clinical guidelines recommended.
asserted
It → recommend → ?
Amazon has not given us a problem before," she said.
asserted
she → give → problem
"I don't know exactly what happened or why they rejected.
asserted
they → know → ?
They say it was a new policy."
asserted
it → say → ?
Lanoff said she has had some success rewriting prescriptions under which patients discard leftover gel rather than splitting doses for later use.
asserted
patients → say → use
Amazon Pharmacy said it does not dispense some testosterone prescriptions that require women to customize doses in order to ensure safe and compliant dispensing.
asserted
that → say → dispensing
It added that the policy is not specific to testosterone or based on a patient's sex or gender identity.
asserted
policy → add → identity
The company said it refers customers to compounding pharmacies that mix ingredients for specialized doses.
asserted
that → say → doses
Compounded testosterone can cost about $100 for a three-month supply compared with $30 after discounts for a 10-month supply at a commercial pharmacy, Lanoff said.
asserted
Lanoff → cost → pharmacy
Most insurance companies do not cover testosterone for women, the doctors, nurses and patients said.
asserted
doctors → cover → women
Magen Price, a nurse practitioner and founder of Mystic Valley Sexual Wellness, said more than one-third of the 80 patients in her practice who currently use testosterone have encountered issues with their prescriptions, including at CVS and Walgreens pharmacies.
asserted
who → say → pharmacies
The issues that began last year have worsened, Price told Reuters.
asserted
Price → begin → Reuters
When Amy Swan, a 55-year-old graphic designer outside Boston, tried to fill her first testosterone gel prescription in March, she expected a simple pharmacy visit.
asserted
she → try → visit
Instead, she spent weeks trying to get a pharmacy to honor a GoodRx discount coupon that would reduce the cost by 25%.
asserted
that → spend → %
"Hours of my time were lost just being able to get this one prescription," Swan said.
asserted
Swan → lose → prescription
CVS said its pharmacies regularly fill prescriptions for topical testosterone gel for women.
asserted
pharmacies → say → women
Other retailers with large pharmacies including Walgreens, Costco and Walmart did not respond to requests for comment.
asserted
retailers → include → comment
Kroger declined to comment.
asserted
Kroger → decline → ?
Kevin Schipper, a pharmacist and director of product lifecycle management at consulting firm ProPharma, said pharmacies may decline prescriptions due to concerns over dosing accuracy and medication safety, as well as stability, storage and contamination if single-use packaging is opened and reused.
uncertain
packaging → consult → accuracy
Because it is a controlled substance — similar to aspirin with codeine — each state also has record-keeping requirements for the government.
asserted
state → control → government
TRIALS FOR SAFETY
Over 30 trials studying testosterone use for various health conditions in women are underway or planned, according to ClinicalTrials.gov, including a Marius Pharmaceuticals-sponsored sexual dysfunction trial due to start as soon as later this year.
uncertain
trials → study → year
Aviva Bio is developing a next-generation testosterone product that would address breast cancer risk associated with use of the hormone.
asserted
that → develop → hormone
Products currently used by women include branded and generic testosterone gels, such as AbbVie's AndroGel, Keenova Therapeutics' Testim and Upsher-Smith's Vogelxo.
asserted
Products → use → AndroGel
Upsher-Smith declined to comment on whether it plans to develop testosterone products specifically for women.
asserted
it → decline → women
AbbVie and Keenova did not respond to requests for comment.
asserted
AbbVie → respond → comment
Cynthia Stuenkel, a clinical professor of medicine at the University of California, San Diego, said she hopes the FDA will prioritize evaluating a testosterone product designed for women.
asserted
FDA → say → women
"This would certainly ease the ability of clinicians to more confidently prescribe testosterone and for women to more easily and confidently use testosterone specifically dosed for them," she said.
asserted
she → ease → them
The Aporia
