Prescribed treatment: testosterone for women is used off-label or as a compounded product in most countries. Use only what your clinician has prescribed, with the amount and site they demonstrated. Don’t use a partner’s testosterone gel.
The short answer
- Where: the vestibule (entrance to the vagina) and inner labia, or the exact area your clinician marked; not deep inside the vagina unless told.
- How much: usually a pea-sized amount or a measured dose (for example 0.25–0.5 g of a low-strength cream), once or twice a day.
- Check-ups: watch for acne, extra hair, voice change or clitoral enlargement; blood testosterone levels are monitored if used long term.
Why vulvar testosterone is prescribed
The tissues of the vulva and vaginal entrance have receptors for both estrogen and androgens (such as testosterone). Some specialists prescribe topical testosterone, usually compounded at a low strength and often combined with estradiol, for:
- Vestibulodynia (provoked vestibular pain), particularly when linked to long-term hormonal contraception, or when estradiol alone hasn’t helped.
- Genitourinary syndrome of menopause (dryness, pain with sex) in selected cases, usually after vaginal estrogen has been tried.
Testosterone cream was once used for lichen sclerosus, but trials showed it was less effective than very potent steroid ointment (clobetasol), which is now the standard. Separately, licensed or compounded testosterone creams and gels are used on the skin of the thigh, buttock or abdomen to treat low sexual desire after menopause; that is a different use with different dosing. The international consensus (2019) supports testosterone in women only for hypoactive sexual desire disorder, at doses keeping blood levels in the normal female range.
How it’s usually applied
- Wash your hands and the area with water (no soap), and pat dry.
- Measure the prescribed amount: a pea-sized blob, a marked syringe or a dosing card.
- With a clean fingertip, gently apply a thin layer to the area shown, commonly the vestibule just outside the vaginal opening and the inner (minor) labia.
- Wash your hands afterwards.
- Avoid skin-to-skin contact with partners and children over the treated area until the cream has absorbed (about an hour), because testosterone transfers by touch.
| Topic |
Typical guidance (follow your prescription) |
| Frequency |
Once or twice daily, sometimes tapering to a few times a week |
| Time to effect |
Usually 6–12 weeks for vulvar pain conditions |
| Storage |
Room temperature; compounded creams have a use-by date |
| Sex |
Apply after, not before, to reduce transfer to a partner |
Side effects and monitoring
- Local: burning or irritation, especially at first; tell your clinician if it persists.
- Androgen effects: acne, oily skin, increased facial or body hair, scalp hair thinning, deepening voice, clitoral enlargement. Some may not fully reverse, so report them early.
- Blood tests: testosterone levels before and during longer-term treatment.
- Pregnancy: testosterone must not be used in pregnancy; use reliable contraception if relevant.
Other intimate treatments, including vaginal estrogen and metronidazole gel, are mentioned in the skin treatments guide.
Frequently asked questions
Can I use my partner’s testosterone gel on my labia?
No. Male products are many times stronger than vulvar doses and cause masculinising side effects. Use only a product prescribed for you.
How long until testosterone cream helps vestibulodynia?
Most specialists review progress after about 2–3 months. It’s often combined with pelvic floor physiotherapy and other treatments.
Is AndroFeme applied to the labia?
AndroFeme 1% (Australia) is a testosterone cream for low libido after menopause and is applied to the skin of the outer thigh or buttock, not the vulva, at a much higher dose than vulvar creams.
Sources and further reading
CanforaMedicine Guide
