Testosterone Side Effects

Testosterone therapy is becoming increasingly popular in perimenopause and menopause for women dealing with low libido, fatigue, brain fog, and reduced muscle mass. A once forgotten about hormone, is now viewed as essential by many menopause experts. While testosterone can be incredibly beneficial when used appropriately, it’s important to understand potential testosterone side effects and how to monitor for them. At Well North Functional Medicine, safety is always our priority and there is no one-size fits all approach and safety and risk/benefits are always discussed in detail. 

What Is Testosterone Therapy?

First let’s review. You can also read last weeks blog on Testosterone for Women HERE! Testosterone is not just a “male hormone,” it plays a key role in women’s hormone balance, supporting energy, mood, libido, bone density, and lean muscle mass. At Well North, low-dose bioidentical testosterone therapy may be prescribed when levels are suboptimal and symptoms are present. 

Common Testosterone Side Effects

When dosing is too high, or if a patient is particularly sensitive, side effects can occur. The most common testosterone side effects include:

• • Acne or oily skin: This is the most common side effect seen in some women. Increased sebum production can lead to breakouts, especially along the jawline and chin.
  • Hair changes: Some women notice increased facial or body hair (hirsutism) or, less commonly, scalp hair thinning.
  • Mood changes: Some women report irritability, anxiety, or feeling “on edge” if levels become too high.
  • Metabolic and Internal Effects: Beyond physical symptoms, testosterone therapy can influence cholesterol. Testosterone may lower HDL (“good”) cholesterol, so lipid panels should be monitored. Testosterone can also influence cholesterol positively in some! 
  • Red blood cell production: Elevated testosterone can increase hemoglobin and hematocrit, which may thicken the blood in some cases. That is why monitoring is essential. 

Less common side effects and typically occur as a result of supraphysiologic doses (ie: pellets) can include:

• • Voice changes: Deepening of the voice is rare but can be irreversible. This is associated with with high doses.
  • Clitoral enlargement: Also known as clitoromegaly, this is uncommon but associated with excessive dosing.
  • Liver function: Oral forms (this formulation is much less commonly used) may impact liver enzymes.

Long-Term Considerations

Research on long-term testosterone use in women is still evolving. This is why a personalized, root-cause approach with regular lab monitoring is essential.

How to Minimize Testosterone Side Effects

At Well North, we prioritize safety and precision:

• • Use low, physiologic dosing
  • Choose appropriate delivery methods (topical is preferred)
  • Monitor labs regularly (testosterone levels, lipids, CBC)
  • Adjust dosing based on symptoms + labs, not just numbers

Is Testosterone Therapy Right for You?

Testosterone can be a powerful tool for improving energy, libido, and body composition as natural levels decline as we age, but it is not one-size-fits-all. If you’re experiencing symptoms of hormone imbalance, a comprehensive evaluation can help determine whether testosterone therapy is right for you! Book a FREE Discovery call to learn more!