How Long for Testosterone Cream to Work for Women?

When women start using testosterone cream during menopause, one of the most common questions is how long it takes to feel a difference. In real-world care, changes don’t happen overnight. Many women notice a gradual shift over the first couple of months, with benefits becoming clearer as their body adjusts over time. What often matters just as much as when changes begin is how they show up in daily life, and what signs you can watch for while your care team fine-tunes your treatment.

What You'll Learn in This Article

How long for testosterone cream to work? Typical timeline from first application to peak effects

What changes should I expect? Sexual desire improvements vs. what doesn't usually change

What should I track? Specific signs that testosterone cream is working

What are the warning signs? When to call your doctor about side effects

When should I reassess? How to determine the duration of your testosterone treatment with you clinician

How Long Does Testosterone Cream Take to Work? The Complete Timeline

Weeks 2-4: The Subtle Beginning

In the first month of using testosterone cream, changes are subtle, and some women notice nothing at all. That's completely normal. The cream is building testosterone gradually in your system, and your body needs time to respond.

If you do notice something in these early weeks, it might be fleeting sexual thoughts that weren't there before, or a slight uptick in energy. Don't read too much into these early signals or their absence. Testosterone cream doesn't work instantly.

What to pay attention to during this phase: Are you thinking about sex more often, even briefly? Do you feel slightly more motivated or energetic? These aren't dramatic transformations, they're gentle shifts that may come and go.

Weeks 6-8: When Testosterone Cream Starts Working

This is when most women in clinical trials start to see meaningful improvement from testosterone cream. Sexual desire becomes more apparent: not just as passing thoughts, but as genuine interest or willingness to engage. Responsiveness during intimacy often improves, meaning arousal comes more easily and sex feels more satisfying.

A 2019 study on testosterone gel combined with estrogen found improvements in sexual function became noticeable around this timeframe, with continued benefit over the following weeks.

In terms of what improvement actually feels like at this stage, you might find yourself less actively avoiding intimacy. The distress about having no desire starts to fade. When your partner initiates, you're more likely to feel receptive rather than indifferent or resistant.

Months 3-6: Peak Effects of Testosterone Cream

Maximum therapeutic effect from testosterone cream is typically reached somewhere between three and six months. A 2025 comprehensive review in Obstetrics & Gynecology confirms this timeline. Most women see improvements in sexual desire, arousal, and sexual satisfaction generally peak by 12 weeks and remain stable.

This is the critical decision point: if you haven't noticed any meaningful change by six months of using testosterone cream, the therapy likely isn't working for you, and discontinuation is often recommended.

The key here is patience. Testosterone cream doesn't work overnight, and the timeline varies from person to person. Some women see improvements at eight weeks that continue to build. Others don't notice much until month four. If you're expecting immediate results from testosterone cream, you'll likely be disappointed. This is a therapy that requires time and careful attention to your body's response.

What Actually Improves (and Doesn’t) with Testosterone Cream

What Testosterone Cream IS Designed to Treat

Testosterone cream has one proven primary target: hypoactive sexual desire disorder (HSDD). HSDD is persistent, distressing low libido (interest or drive) and reduced sexual response (arousal, orgasism) in menopausal women. If this is your concern, here's what you should track:

Sexual desire and function:

• How often you think about sex
• Your interest in initiating or responding to intimacy
• How easily you become aroused
• Your level of satisfaction during sex
• How much distress you feel about your sex life

What this looks like in practice: Instead of actively avoiding intimacy or feeling absolutely nothing, you might find yourself thinking about sex more naturally after using testosterone cream. You might feel more responsive when your partner initiates. You may even feel more inclined to initiate intimacy yourself. The overwhelming sense of "I just don't care about sex anymore" starts to lift.

Clinical trials consistently show that testosterone cream (and other transdermal testosterone formulations like gels) improves frequency of sexually satisfying events, desire, arousal, and orgasmic function in postmenopausal women with HSDD. But it's a modest benefit, not a complete transformation.

How to Track Whether Testosterone Cream Is Working

Keep a Simple Symptom Log

Vague impressions won't help you or your provider figure out if testosterone cream is working. Track specific, measurable things from the start.

Weekly check-ins:

• How many times did you think about sex this week?
• On a scale of 1-10, how distressed do you feel about your low desire?
• How many times did you initiate or feel receptive to intimacy?
• When you did engage sexually, what was your satisfaction level?

Monthly monitoring:

• Any physical changes (skin texture, hair growth or loss, voice changes)
• Energy levels (keep this separate from sexual symptoms)
• Mood changes or irritability

This kind of tracking accomplishes two things: it helps you notice gradual changes from testosterone cream that might otherwise be overlooked in the rush of day-to-day life, and it gives you concrete data to discuss with your provider.

The Decision Points: How Long to Give Testosterone Cream

A 2026 systematic review on managing low sexual desire confirms that testosterone therapy at physiologic doses improves desire and sexual function, with benefits typically noticed by 6-8 weeks and peaking around 12 weeks, though long-term safety data remain limited.

At 6-8 Weeks Using Testosterone Cream

Check in with yourself honestly. Are you noticing any improvement in sexual desire or satisfaction? Even small changes suggest the cream may be working. If you're seeing absolutely nothing, that doesn't necessarily mean you should stop, but it's worth noting.

At 3 Months on Testosterone Cream

By three months, you should have a clearer picture of whether testosterone cream is working. If you're seeing continued improvement, stay the course. If nothing has changed at all, have a conversation with your provider about whether to continue. Some women are slow responders, but by this point, you should at least see a trend.

At 6 Months: The Critical Checkpoint

This is the critical decision point for testosterone cream therapy. Maximum benefit should be apparent by now. If there's been no meaningful change after six months of consistent use, discontinuation is often recommended. The research shows that if testosterone cream hasn't worked by this time, it's unlikely to start working later. There are other approaches to addressing your distress over your sexual health.

If you have had good results, this is the time to discuss your long-term monitoring plan with your provider. Long-term safety data for testosterone cream in women is still limited beyond about two years, so ongoing assessment is essential.

What "Working" Actually Means for Testosterone Cream

Let's be realistic about what success looks like with testosterone cream therapy. It's not:

• Returning to your libido in your 20s
• More libido and interest than you’ve ever had previous to your menopause symptoms
• Feeling constant, intense sexual desire

Success with testosterone cream is:

• Reduced distress about your sex life
• More natural interest in and responsiveness to intimacy
• Improved satisfaction when you do engage sexually
• Feeling more like yourself again in this aspect of your life

Why Testosterone Cream Dosing and Monitoring Matter

The Goldilocks Problem with Testosterone Cream

Getting the dose right is everything with testosterone cream therapy. Women need approximately one-tenth the dose men use. That means we're talking micrograms, not milligrams. More is not better. Benefits don't improve with higher doses of testosterone cream, but side effects definitely do.

In clinical studies, improvement often happens without significantly raising blood testosterone levels. Your provider is aiming to keep you in the female physiologic range, not to maximize your testosterone or push it as high as it will go. This is why it’s important to work with a clinician who is knowledgeable about testosterone, has the lab test and monitoring processes in place, and takes the time to listen to you and work with you on dosing. 

What Your Provider Should Be Monitoring

Regular monitoring isn't optional, it's essential for safe testosterone cream use:

• Testosterone blood levels (ensuring you stay in the female range)
• Symptom improvement based on your tracking
• Any adverse effects or concerning changes
• Regular re-evaluation of whether therapy should continue

If your provider isn't checking these things, ask why. Good monitoring protects you from potential complications and helps determine whether testosterone cream is actually working.

Forms of Testosterone: Why Cream or Gel Works Best

Recommended for women: Low-dose transdermal testosterone cream or gel is most common and preferred. It's easy to apply, easy to adjust if needed, and delivers consistent, low doses.

Generally discouraged: Testosterone pellets and injections carry too high a risk of overdosing. Once a pellet is implanted or an injection is given, you can't easily reverse it if your testosterone levels go too high. Oral testosterone is not recommended for women.

Clinical evidence specifically supports transdermal testosterone (cream and gel formulations) for treating HSDD in postmenopausal women. Research on testosterone cream in clinical trials demonstrates that doses around 1/10th of those used in men show the best balance of effectiveness and safety.

Most Asked Questions About Testosterone Therapy for Menopause

Will testosterone help with my hot flashes, night sweats, and brain fog? 

This is probably the #1 misconception. Women often come to testosterone therapy hoping it will be a cure-all for menopause symptoms. Testosterone is specifically for low sexual desire (HSDD), but can sometimes be prescribed to help with other symptoms.

What are the side effects? 

Becoming “masculinized” is the #1 fear, and it's legitimate but manageable. Women want to know about masculinizing effects: facial hair, voice deepening, hair loss. The key message: these are dose-dependent, most are reversible if caught early (although voice changes can be permanent quite quickly), so proper monitoring and open communication with a trusted clinician is critical. TCan I take testosterone if I've had breast cancer?

This is extremely common, especially since many women on aromatase inhibitors experience severe sexual side effects. The research shows vaginal testosterone has been studied in breast cancer survivors with some positive results, but systemic testosterone safety data is limited. This requires individual discussion with their oncologist.

How is testosterone different from estrogen? Can I take both?

Women are confused about hormone therapy options and often ask whether they need testosterone instead of estrogen, or whether they can/should combine them. They need clarification that in the area of sexual health and functioning, estrogen treats vaginal dryness and other genitourinary syndrome of menopause (GSM) symptoms, while testosterone treats sexual drive and response These two hormones work on different symptoms and can be complementary.

Is testosterone therapy safe long-term? Can I stay on it forever?

This comes up because most women with HSDD don't want a short-term fix: they want their libido back permanently. The honest answer creates anxiety: long-term safety data beyond two years is limited, there's no FDA-approved formulation for women in the US, and ongoing monitoring is essential. Women want reassurance that isn't yet fully supported by evidence. As more women use testosterone replacement therapy and for longer durations, the scientific research should catch up but for now, clinicians have limited studies on which to make evidence-based decisions about duration of treatment.

References

American Urological Association, Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, & American Urogynecologic Society. (2025). Genitourinary syndrome of menopause: AUA/SUFU/AUGS guideline. The Journal of Urology. https://www.auajournals.org/doi/10.1097/JU.0000000000004415

Chaikittisilpa, S., Soimongkol, K., & Jaisamrarn, U. (2019). Efficacy of oral estrogen plus testosterone gel to improve sexual function in postmenopausal women. Climacteric, 22(5), 460-464. https://doi.org/10.1080/13697137.2019.1589462

Fernandes, T., Costa-Paiva, L. H., & Pinto-Neto, A. M. (2014). Efficacy of vaginally applied estrogen, testosterone, or polyacrylic acid on sexual function in postmenopausal women: A randomized controlled trial. Journal of Sexual Medicine, 11(5), 1262-1270. https://doi.org/10.1111/jsm.12466

Kling, J. M., Kapoor, E., & Faubion, S. S. (2025). Testosterone for the treatment of hypoactive sexual desire disorder in perimenopausal and postmenopausal women. Obstetrics & Gynecology, 145(1), 28-37. https://doi.org/10.1097/AOG.0000000000005729

Rowen, T. S., Kling, J. M., & Hess, R. (2026). Evaluation and management of hypoactive sexual desire disorder. Sexual Medicine Reviews, 14(1), qeaf057. https://doi.org/10.1093/sxmrev/qeaf057