SubQ Testosterone Therapy for Women and Muscle Health

Abstract

Testosterone is often thought of as a male hormone, but women naturally produce it in the ovaries and adrenal glands. It plays an important role in female sexual health and has biological effects on muscle, bone, the nervous system, and other tissues. For carefully selected women, testosterone treatment may be considered when distressing low sexual desire is present, especially after menopause. Subcutaneous testosterone injections deliver a small amount of hormone into the fatty tissue beneath the skin, where it is gradually absorbed into the bloodstream. However, the strongest clinical evidence in women remains with transdermal testosterone, not injections. This article explains subcutaneous testosterone therapy for women, its potential benefits and limitations, monitoring and safety, and how medical oversight, functional medicine, rehabilitation, and integrative chiropractic care can work together in a multidisciplinary model.

Testosterone Is Important in Women’s Health

Women naturally make testosterone throughout adult life. The ovaries and adrenal glands produce most of it, with additional hormone activity occurring through conversion in tissues. Testosterone levels generally decline with age and may fall more abruptly after removal of the ovaries (Davis et al., 2019).

Still, a low testosterone blood result by itself does not diagnose a testosterone-deficiency syndrome in women. Current international guidance states that no single blood-test cutoff can reliably identify women who will benefit from treatment. The strongest evidence supports testosterone therapy for hypoactive sexual desire disorder (HSDD) in postmenopausal women after other causes of low desire have been evaluated (Davis et al., 2019; Parish et al., 2021).

HSDD involves persistent or recurring low sexual desire that causes meaningful personal distress. Before prescribing testosterone, clinicians should consider other possible contributors, including sleep problems, depression or anxiety, medication effects, relationship concerns, painful intercourse, thyroid disorders, anemia, and other health conditions.

What Are Subcutaneous Testosterone Injections?

A subcutaneous, or SubQ, testosterone injection places testosterone into the layer of adipose, or fatty, tissue just beneath the skin rather than deep inside a muscle.

Once injected, the medication forms a small depot from which testosterone is gradually absorbed into the circulation. Compared with an intramuscular injection, a SubQ injection generally uses a shorter needle and does not require penetration into deeper muscle tissue. General hormone-injection resources describe the subcutaneous route as an established method of administering injectable hormones, although the dose and clinical target depend greatly on the reason for treatment (FOLX Health, 2023).

For women’s testosterone treatment, the concept is to administer a small, controlled amount and avoid pushing testosterone into male or supraphysiologic ranges.

The Medivant whitepaper emphasizes an important limitation: randomized efficacy studies in women have been conducted mainly with testosterone patches, creams, and gels. It describes subcutaneous injection as physiologically plausible and titratable but notes that there is no dedicated randomized efficacy trial of SubQ testosterone injections in women and no validated milligram-for-milligram conversion from transdermal therapy to an injection (Hatzilabrou, n.d.).

That distinction is important when discussing this therapy accurately.

Subcutaneous Testosterone Versus Transdermal Treatment

The greatest amount of evidence supporting testosterone treatment in women comes from transdermal therapy. Randomized studies involving postmenopausal women with HSDD have found improvements in sexual desire, arousal, orgasm, satisfaction, and sexual distress (Islam et al., 2019).

A major meta-analysis evaluated 36 randomized controlled trials involving 8,480 women and found meaningful improvements in several measures of sexual function. However, investigators did not find convincing benefits for body composition, cognitive function, or musculoskeletal outcomes, although fewer women contributed data to those outcomes (Islam et al., 2019).

The uploaded whitepaper summarizes the evidence by route:

• Transdermal patch, cream, or gel: strongest randomized evidence in women.
• Subcutaneous implant: limited evidence, including one small positive randomized trial.
• Subcutaneous injection: potentially titratable and convenient, but dedicated female efficacy trials are still lacking.
• Oral testosterone: generally avoided because oral administration may negatively affect lipid levels.
• Pellets: difficult to quickly adjust after implantation if testosterone exposure becomes excessive.

For this reason, SubQ testosterone should not be presented as proven superior to transdermal therapy.

What Benefits Does Testosterone Provide?

The best-supported clinical benefit is improvement in sexual desire and related sexual function in appropriately diagnosed women with HSDD. Current evidence supports a moderate benefit rather than a dramatic transformation for every patient (Davis et al., 2019; Islam et al., 2019).

Testosterone also has normal physiological activity in tissues throughout the body. Androgen receptors are found in muscle, bone, the brain, reproductive tissues, and other systems. This helps explain continuing research into possible relationships between testosterone and:

• muscle physiology and physical performance,
• bone remodeling,
• energy and well-being,
• mood and cognition,
• body composition,
• metabolic health.

However, biological importance does not automatically mean testosterone therapy has been proven to improve each of these areas. The Medivant whitepaper specifically notes that mood and well-being data are mixed, bone-density evidence is limited, and pooled studies have not established a consistent benefit for body composition or muscle outcomes.

Cedars-Sinai makes a similar distinction: testosterone may help appropriately selected women with HSDD, but evidence is not strong enough to promise improvements in energy, cognition, muscle strength, body composition, or other general menopause symptoms (Bieber, 2026).

Why “Restoring the Female Range” Matters

Women’s testosterone treatment uses an entirely different clinical goal than male testosterone replacement therapy.

The objective is to avoid creating male testosterone concentrations or pursuing the highest possible blood level. Instead, when treatment is appropriate, clinicians monitor testosterone so exposure remains within the physiologic premenopausal female range and signs of androgen excess do not develop (Parish et al., 2021).

The whitepaper describes the principle clearly: dose toward a physiologic range rather than continuing to increase testosterone simply because symptoms remain. It also recommends checking testosterone after treatment begins and after dosage changes rather than assuming that an injection amount borrowed from another route will produce the same blood concentration.

Possible signs of excessive androgen exposure include:

• acne or oily skin,
• increased facial or body hair,
• scalp hair thinning,
• voice changes,
• other signs of virilization.

Regular follow-up is therefore part of treatment, not an optional extra.

Monitoring and Safety Come First

Before treatment, the clinician should review medical history, medications, symptoms, cardiovascular risk, breast health, liver health, reproductive status, and other factors that may affect treatment decisions.

Clinicians commonly obtain a baseline testosterone measurement for monitoring. It should not be used alone to diagnose HSDD. Follow-up testing helps ensure treatment has not pushed testosterone above the physiologic female range (Davis et al., 2019; Parish et al., 2021).

The uploaded whitepaper recommends reassessing both symptoms and testosterone levels and monitoring for acne, increased hair growth, scalp hair loss, or voice changes. If meaningful improvement has not developed after an adequate therapeutic trial, guidelines favor discontinuing treatment instead of continually increasing exposure.

Long-term cardiovascular and breast-safety data remain incomplete. Short- and medium-term evidence at physiologic doses is reassuring, but that is not the same as having decades of safety information (Hatzilabrou, n.d.; Davis et al., 2019).

What About Compounded Subcutaneous Testosterone?

There is currently no FDA-approved testosterone product specifically indicated for women in the United States. As a result, testosterone treatment in women is generally off-label (Parish et al., 2021; Bieber, 2026).

Some practices use lower-concentration testosterone cypionate preparations because minimal doses may otherwise be difficult to measure accurately. Hone Health, for example, currently describes compounded lower-concentration testosterone preparations used for SubQ administration in women. Highland Longevity likewise describes SubQ testosterone as an approach that some clinicians use, while emphasizing individualized laboratory and clinical monitoring. These are clinical-practice resources, not randomized evidence establishing injections as the preferred female route.

Medivant currently describes Andrenyx as a prefilled compounded testosterone-cypionate product intended for subcutaneous use. Medivant also states that it is a compounded preparation from a 503B outsourcing facility and not an FDA-approved drug product.

The uploaded Medivant-associated whitepaper itself cautions that choosing compounded SubQ testosterone for women requires deliberate clinical extrapolation, individualized dosing, monitoring, and shared decision-making rather than assuming female efficacy has already been established.

Connecting Testosterone With Muscle and Chiropractic Care

Testosterone and chiropractic care address different parts of health.

Testosterone is a hormone. Chiropractic treatment does not replace testosterone therapy, does not correct an endocrine deficiency, and should not be described as directly increasing testosterone.

Instead, integrative chiropractic care can address the mechanical and functional side of musculoskeletal health.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, describes clinical observations in which hormone assessment is combined with evaluation of joint mobility, spinal mechanics, muscle balance, functional movement, nutrition, metabolic health, and progressive rehabilitation. His published approach emphasizes that chiropractic and rehabilitation may help a patient move and exercise more effectively while medical treatment addresses a separate hormonal problem when one is present.

A combined musculoskeletal program may therefore include chiropractic care together with:

• progressive resistance training,
• mobility and flexibility work,
• neuromuscular retraining,
• appropriate protein and nutrient intake,
• sleep and recovery strategies,
• management of pain that limits physical activity,
• cardiovascular and metabolic conditioning.

This is an important distinction because testosterone should not be prescribed simply as a muscle-building treatment for women. Randomized female data have not shown reliable improvements in muscle mass or musculoskeletal performance at physiologic treatment levels (Islam et al., 2019).

A Multidisciplinary Model in El Paso

At Injury Medical Clinic PA in El Paso, Texas, Dr. Jimenez works within a multidisciplinary model that combines chiropractic care, functional medicine, rehabilitation, personal injury care, and related medical services.

The practice identifies Dr. Maria Guadalupe Cardenas, MD, an internal medicine physician with more than four decades of clinical experience, as its Medical Director and Collaborative Physician. Public NPI records identify Dr. Cardenas as an internal medicine physician with NPI #1164426749 and Texas medical license #J2933. Injury Medical Clinic materials describe her as board-certified in internal medicine.

In this model, Dr. Cardenas provides medical direction and helps oversee medical evaluation, medication safety, contraindications, laboratory review, and complex medical concerns. Dr. Jimenez contributes his combined chiropractic and family nurse practitioner background to musculoskeletal evaluation, functional medicine, rehabilitation, biomechanics, and coordinated care.

This interdisciplinary structure can help keep responsibilities clear: hormone treatment requires medical evaluation and monitoring, while chiropractic and rehabilitation address movement, mechanical function, strength, and recovery.

Bringing the Pieces Together

Subcutaneous testosterone injections offer a practical way to place a small amount of testosterone into the fatty tissue beneath the skin for gradual systemic absorption. For some women, this route may offer convenience and precise dose adjustment under medical supervision.

But the evidence should remain at the center of the discussion. Testosterone therapy has its strongest support for postmenopausal women with distressing HSDD, and the best randomized evidence remains transdermal. Subcutaneous injection is a developing, off-label approach that requires careful prescribing, monitoring, informed consent, and realistic expectations.

An integrative plan can then address the rest of the patient—not by claiming chiropractic care changes hormone levels, but by combining appropriate medical oversight with movement restoration, strength training, rehabilitation, nutrition, functional medicine, and musculoskeletal care.

That creates a more complete goal: helping the patient function better while keeping hormone treatment firmly within an evidence-based and medically monitored framework.

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References

Bieber, A. (2026, April 9). Testosterone therapy for women. Cedars-Sinai.

Davis, S. R., Baber, R., Panay, N., et al. (2019). Global consensus position statement on the use of testosterone therapy for women. Journal of Clinical Endocrinology & Metabolism, 104(10), 4660–4666.

DeRosa, A. (2025). Testosterone therapy in women: Breaking myths and gaps. Medical Research Archives, 13(11).

FOLX Health. (2023). Steps to self-injecting HRT/GAHT for IM and SubQ injections.

Hatzilabrou, T. A. (n.d.). Testosterone therapy in women. Worldborne Medical/Medivant Healthcare.

Hone Health. (2026). Testosterone cypionate injection for women: Risks & benefits.

Islam, R. M., Bell, R. J., Green, S., Page, M. J., & Davis, S. R. (2019). Safety and efficacy of testosterone for women: A systematic review and meta-analysis of randomised controlled trial data. The Lancet Diabetes & Endocrinology, 7(10), 754–766.

Jimenez, A. (2026). Subcutaneous testosterone for hormone balance therapy guide. DrAlexJimenez.com.

Lindsley, J. (2026). Women’s testosterone dosing guide: How much should a woman inject per week?. Highland Longevity.

Medivant Healthcare. (2026). Andrenyx: Single-dose prefilled compounded testosterone syringe.

Parish, S. J., Simon, J. A., Davis, S. R., et al. (2021). International Society for the Study of Women’s Sexual Health clinical practice guideline for the use of systemic testosterone for hypoactive sexual desire disorder in women. Journal of Women’s Health, 30(4), 474–491.