Women increasingly turning to testosterone therapy to manage menopause symptoms are encountering unexpected prescription delays and denials at pharmacies, according to interviews with more than half a dozen doctors, nurses and patients. No testosterone product for women has U.S. approval.

Testosterone use outside an approved label is rising primarily to treat persistently low sexual desire related to menopause, the only condition supported by current medical guidelines and evidence of efficacy. Some clinicians also prescribe it for fatigue and loss of muscle strength despite lacking medical guidance for those uses.

“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. “What testosterone is being touted for in the lay public and on social media is not really what we have data for,” she said.

The Menopause Society and six other medical organizations support testosterone only for hypoactive sexual desire disorder in menopausal women. Its growing use comes as more women pursue hormone therapy overall, a trend also driven by social media.

The FDA has backed estrogen and progesterone as safe and effective for menopause symptoms, and some clinicians prescribe testosterone alongside those therapies. A Truveta analysis for Reuters found that the rate of women receiving testosterone prescriptions jumped 146% from January 2023 to July 2026, nearly tripling.

The FDA plans to hold a public workshop to review evidence concerning testosterone use in menopausal women. The treatment has been promoted by Health Secretary Robert F. Kennedy Jr. and War Secretary Pete Hegseth, who has focused on testosterone levels among troops.

Healthcare providers may prescribe approved medicines as they consider appropriate. However, an FDA spokesperson said uses outside the approved label have not been evaluated by the agency for safety, efficacy or dosing.

Without an approved testosterone product for women, patients often must divide packaged versions designed for men that contain many times the doses they seek. That dosing problem has become a central source of pharmacy concern.

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. She has sometimes succeeded by rewriting prescriptions so patients discard leftover gel instead of saving divided doses.

Amazon Pharmacy said it does not dispense some prescriptions requiring women to customize doses, citing safe and compliant dispensing. The company said its policy is not specific to testosterone or based on a patient’s sex or gender identity, and it refers customers to compounding pharmacies.

Lanoff said compounded testosterone can cost about $100 for a supply lasting three months, compared with $30 after discounts for a commercial pharmacy supply lasting 10 months. Doctors, nurses and patients said most insurers do not cover testosterone for women.

Magen Price, a nurse practitioner and founder of Mystic Valley Sexual Wellness, said more than a third of the 80 testosterone patients in her practice have experienced prescription problems. Those issues, including difficulties at CVS and Walgreens pharmacies, began last year and have worsened.

Amy Swan, a 55 year old graphic designer outside Boston, spent weeks seeking a pharmacy that would honor a GoodRx coupon reducing her testosterone gel cost by 25%. “Hours of my time were lost just being able to get this one prescription,” Swan said.

CVS said its pharmacies regularly fill topical testosterone gel prescriptions for women. Walgreens, Costco and Walmart did not respond to requests for comment, while Kroger declined to comment.

Kevin Schipper, a pharmacist and director of product lifecycle management at ProPharma, said pharmacies may worry about dosing accuracy, safety, stability, storage and contamination when packaging is opened and reused. Testosterone is also a controlled substance with state record requirements.

More than 30 trials examining testosterone for health conditions in women are underway or planned, according to ClinicalTrials.gov. Cynthia Stuenkel, a clinical professor of medicine at the University of California, San Diego, said an FDA evaluated product specifically dosed for women would improve confidence among clinicians and patients.