Women's testosterone replacement therapy (TRT) is a completely different animal from men's. The doses are smaller, the goals are different, and the risks are different. But the UK medical landscape makes it harder than it should be to access.
This guide cuts through the confusion and tells you what you actually need to know.
The most common mistake I see with female TRT is women using men's dosing guidelines. A client once told me her "wellness coach" had suggested 5 mg testosterone cream daily — five to ten times the standard female dose. At that level, virilisation becomes a real risk. The correct starting dose is 0.25-0.5 mg daily, which most private menopause clinics get right but unregulated practitioners often don't.
Why Female TRT Is Different From Men's
Men get TRT to bring testosterone from low (maybe 8–12 nmol/L) back to healthy male range (15–30 nmol/L).
Women get TRT to bring testosterone from low (maybe 0.5–1 nmol/L) back to healthy female range (1–3 nmol/L).
See the difference? The target ranges are entirely different. The doses scale with that.
Dosing: The Critical Difference
A man might take:
- 50–100 mg testosterone per week (intramuscular injection), or
- 200 mg testosterone per week (extreme/unsafe), or
- 5 grams of gel per day (roughly 50 mg testosterone).
A woman typically takes:
- 0.5–1 mg testosterone per day (cream or gel), or
- 2–4 mg per day at most.
That's a 50–100 times smaller dose. This is intentional. It's not that women's physiology is fragile, it's that you need far less to get back into healthy range.
How Female TRT Works in Practice
The Cream Format (Most Common)
Testosterone cream (Testogel or Androgel, used off-label in the UK) is applied daily, usually to the inner forearm or inner arm.
Typical protocol:
- Start with 0.25–0.5 mg daily
- Retest after 4–6 weeks
- Adjust up slowly if needed (max usually 1 mg daily)
- Retest every 3 months until stable
How you feel:
- Libido returns: Usually within 2–4 weeks
- Energy improves: Week 2–4
- Mood lifts: Week 3–6
- Muscle tone: Over weeks 8–12
It's not dramatic, but it's noticeable.
Cost: £30–60 per month if prescribed privately. NHS prescribing is rare.
Pellets (Rarer in the UK)
Testosterone pellets are tiny cylinders implanted under the skin, usually in the hip or buttock. They release testosterone slowly over 3–6 months.
Advantages: You don't have to think about it daily. Steady levels.
Disadvantages: Cost (usually £300–500 per insertion), harder to adjust if needed, requires a minor procedure.
Not widely used in the UK, but some private clinics offer it.
Patches (Also Possible)
Testosterone patches exist but are less commonly prescribed for women. They work similarly to cream but are more expensive and less flexible for dosing.
Virilisation: What You Should Actually Know
This is the concern that stops women from trying TRT: will you get a deep voice, facial hair, male-pattern baldness?
At therapeutic doses (0.5–1 mg/day): virilisation is rare. Your body already makes testosterone naturally. You're not adding something foreign, you're topping up what you're deficient in.
Virilisation typically happens at much higher doses, women who abuse anabolic steroids might use 10–50 mg per day or more. That's 10–100 times what a normal female TRT dose is.
If virilisation does start: It's usually reversible if caught early. Stop the medication and it reverses over weeks or months. Voice deepening and clitoral enlargement are the most common signs, and they reverse first.
Bottom line: If you're prescribed 0.5–1 mg daily and monitored properly, virilisation is not a realistic concern. If a clinician is recommending higher doses without clear justification, get a second opinion.
NICE Guidance and What It Actually Says
NICE (National Institute for Health and Care Excellence) updated its guidance on testosterone for women in 2023.
What it says:
- Testosterone can be considered for women with low sexual desire in perimenopause or menopause
- It should be prescribed as part of individualised hormone optimisation, not in isolation
- It should be prescribed by someone experienced in hormone therapy
- Monitoring is essential
What it doesn't say:
- That it's contraindicated (it's not)
- That you have to try other things first (nice to have, but not required)
- That you need a specific degree or qualification to prescribe it (the guidance expects clinical judgment)
The NHS rarely acts on this because GPs aren't trained in hormone therapy. But private clinics take NICE guidance seriously and use it to justify private prescribing.
Davis et al. - Global consensus position on testosterone for women
Testosterone therapy at physiological doses safely improves sexual desire, arousal, and orgasm frequency in postmenopausal women, with no significant increase in adverse events over 12 months.
NHS vs Private Access
Getting TRT on the NHS
Realistically: difficult. Your GP would need to:
- Test your testosterone (many won't)
- Interpret it correctly (many don't)
- Decide it's low enough to treat (rare)
- Prescribe testosterone (even rarer)
Some NHS menopause clinics (usually in major cities) might help, but most won't. Waiting lists are long.
If you want to try the NHS route: Book an appointment with your GP, bring printed NICE guidance, ask for testosterone testing, and see what happens. It might work. Often it doesn't.
Private Access (Much More Reliable)
Private clinics specialising in women's hormones can prescribe TRT easily. They have the training, the willingness, and the infrastructure.
UK Private Clinics for Female TRT
Newson Health (menopausedoctor.co.uk)
Founded by Dr Mendy Menopause, this is the biggest and most reputable menopause and hormone clinic in the UK.
What they do:
- Virtual consultations (no need to travel)
- Full hormone testing
- Individualised TRT prescriptions
- Regular monitoring and adjustment
- Straightforward, evidence-based approach
Cost: £200–300 for initial consultation, then £30–60/month for testosterone cream.
Timeline: Consultation → testing → prescription → retest in 4–6 weeks.
Vibe: Professional, no nonsense, actually listens.
Balance My Hormones (balancemyhormones.co.uk)
Another well-established private clinic specialising in hormone optimisation.
What they do:
- Consultations and testing
- TRT and other hormone prescriptions
- Ongoing monitoring
Cost: Similar to Newson Health.
Vibe: Equally professional, slightly more focused on the science.
Others
There are other private clinics (Harley Street Hormone Clinic, etc.), but Newson and Balance are the most established and reputable. They're where most knowledgeable women go.
Accessing Female TRT: The Step-by-Step
-
Decide you want to explore it. This guide probably means you already have.
-
Get tested beforehand. Use Medichecks (medichecks.com) to test total testosterone, free testosterone, and DHEA-S. Cost: £100–150. This gives you a baseline and helps the private clinic understand your starting point.
-
Book a consultation. Contact Newson Health or Balance My Hormones, book a virtual consultation. You'll pay £200–300.
-
Bring your test results (and if you've seen your GP, bring their notes too).
-
Discuss symptoms, dosing, and monitoring. The clinician will likely recommend starting with 0.25–0.5 mg daily cream.
-
Get a private prescription. They'll send it to a pharmacy, usually Superdrug Online Doctor or similar.
-
Retest in 4–6 weeks. The clinic will ask you to retest to see how you've responded.
-
Adjust if needed. If you feel better but bloods show room to go higher, they might increase. If you feel good, you stay put.
-
Ongoing monitoring. You'll retest every 3 months for the first year, then annually.
Total cost over first year: Roughly £500–800 (consultation, initial tests, repeat tests, cream). That sounds like a lot, but it's the same as many women spend on supplements with no real evidence behind them.
Side Effects: The Real Story
At therapeutic doses, side effects are minimal:
- Acne: Possible, usually mild. Often resolves as your body adjusts.
- Hair: Hair on face/body might increase slightly. Head hair might thin a bit (if predisposed). Reversible if you stop.
- Mood: Most women feel better, not worse. Aggression or irritability is very rare at low doses.
- Liver: Not a concern at cream doses. Oral testosterone carries liver risk; creams don't.
If side effects emerge: They're usually dose-related. Back off slightly, retest, and reassess.
The Bottom Line
Female TRT in the UK is not available on the NHS for most women, but it's easily accessible privately. The doses are small, safe when properly monitored, and can genuinely transform how you feel.
Start with testing via Medichecks. If your testosterone is genuinely low, book a consultation with Newson Health or Balance My Hormones. Be prepared to pay £500–800 for the first year, but consider it an investment in feeling like yourself again.
Female TRT is safe, effective, and accessible through UK private clinics at doses 50-100x smaller than men's — test first through Medichecks, then consult a specialist menopause clinic if levels are genuinely low.
The only real risk is not knowing your numbers and not being monitored. If you do the test, consult the clinic, and get retested, you're doing it right. This is evidence-based medicine, properly delivered. For more on why testosterone matters for women, see the female testosterone guide. If you're navigating perimenopause more broadly, the HRT menopause UK guide covers the full picture, and the female supplement stack covers what supplements can support alongside clinical treatment.
