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The delivery form decides how adjustable your dose is, and for women that matters more than it does for men. Here is how creams, injections and pellets actually compare on control, convenience and what happens when the dose turns out to be wrong.
When women research testosterone, most of the reading is about whether to take it. Far less is written about the choice you make immediately afterwards, which is how to take it, and that choice has more practical consequences than people expect.
The reason is dosing. Women need a small fraction of a male dose, and because no testosterone product is approved for women in the United States, every option involves either a compounded preparation or dividing down something made for someone else. The Global Consensus prefers a small dose of an approved men's transdermal product where possible. How easily you can adjust that dose, and how quickly you can undo it, is the real difference between the forms.
Two online services prescribe testosterone to women
Midi: 24 states and DC, a compounded cream, visits billable to most PPO plans (Medicare patients pay out of pocket). Hone Health: 33 states for women's hormone care, from $65 test, then $155/mo membership + medication. Compare them
The Midi link is not paid: we earn nothing if you choose Midi. The Hone Health link is a partner link: we may earn a commission, at no extra cost to you.
A cream or gel applied daily is the most common way women take testosterone, and the approach the evidence supports: the Global Consensus prefers a small dose of an approved men's gel, with compounded cream reserved for when that is not suitable.
What it does well. The dose is genuinely adjustable. You can move it up or down in small increments, and if something is not right you can change it this week rather than waiting for something to wear off. If side effects appear, stopping means the level falls away over days rather than months. For a medication where the correct dose is narrow and individual, that reversibility is the whole argument.
What it costs you. Daily application, every day, and absorption varies between people and between application sites. Two women on an identical prescription can end up with quite different blood levels, which is why measuring matters more with creams than most people are told. There is also transfer risk: testosterone can move to other people through skin contact, so application site and covering it matter, particularly around children.
Some women also find that hair grows finer and more noticeably where they apply it, which is a local effect rather than a systemic one and often improves by rotating sites.
Subcutaneous injections, usually weekly or twice weekly at very small volumes, are offered by some clinics, but the Global Consensus does not recommend injections for women, because they can push levels above the female range.
What it costs you. You have to be willing to inject, and more importantly the doses involved for women are very small, which makes accurate measurement genuinely fiddly. Drawing a fraction of what a syringe is marked for is a real skill and an easy place to make a mistake. Levels also peak and trough between doses rather than sitting flat, and some women feel that rhythm.
Two online services prescribe testosterone to women
Midi: 24 states and DC, a compounded cream, visits billable to most PPO plans (Medicare patients pay out of pocket). Hone Health: 33 states for women's hormone care, from $65 test, then $155/mo membership + medication. Compare them
The Midi link is not paid: we earn nothing if you choose Midi. The Hone Health link is a partner link: we may earn a commission, at no extra cost to you.
Pellets are inserted under the skin, usually in the hip, in a short in office procedure, and release testosterone over a period of months.
What it does well. Convenience, and nothing else comes close. You go in, it is done, and you do not think about it again for months. No daily cream, no injections, no routine to forget. Convenience does not outweigh the problems below, which is why pellets are not recommended.
What it costs you, and this is the important part. Once a pellet is in, the dose is set. If it turns out to be too high, you cannot turn it down. You wait. Depending on the pellet that can mean months of sitting with a dose you know is wrong, and the side effects that concern women most, particularly voice changes and clitoral enlargement, are precisely the dose related ones that may not fully reverse.
Pellet doses used in women are also frequently higher than what is needed to restore a normal female range, and blood levels above that range are where the persistent effects live. That combination, a dose you cannot retract and a tendency towards higher dosing, is why the Global Consensus does not recommend pellets for women, and why many menopause specialists avoid them even when they are comfortable with testosterone itself.
It is also worth knowing that pellet insertion is an in person procedure, so it is not something a telehealth service can provide. If you want pellets you are looking for a local clinic.
A reasonable way to think about it:
The general principle is to stay with something you can adjust. The less adjustable options, pellets and injections, are the ones the Global Consensus does not recommend.
Whichever form you choose, the thing that actually keeps it safe is checking a blood level rather than dosing by feel. The forms differ in how predictable they are, but none of them is predictable enough in women to skip measuring, and a provider who never checks is leaving the one real safety mechanism unused.
If you are earlier in the process than this, our guide to testosterone therapy for women covers whether it is likely to help you in the first place.
Get testosterone prescribed online
There is no FDA-approved testosterone product for women in the US, so it is prescribed off-label. The evidence supports it for one use: low sexual desire that bothers you (HSDD), after a clinician has assessed you. These online services prescribe it to women. Each covers different states, so check yours first.
Midi Health
A low-dose compounded testosterone cream from a virtual menopause clinic. Midi says most women have two video visits, with baseline blood tests, before a prescription, and only if a clinician decides it is appropriate.
The cream starts at $100 for a 90-day supply. Visits can be billed to insurance (Midi is in-network with most PPO plans) or cost $250 for the first visit self-pay; Medicare is self-pay only.
That evidence comes from trials of standardized, non-compounded testosterone used on the skin at doses that keep levels in the normal female range. The same international consensus does not recommend compounded testosterone, like Midi's cream, because its efficacy and safety have not been shown; it suggests small doses of an approved men's product instead, with blood levels checked. Ask any provider which product you would get and how your levels will be monitored.
Offered in 24 states and DC: AZ, CA, CO, DC, DE, FL, IA, IL, IN, KS, MA, MD, ME, NC, NJ, NM, NV, NY, OH, OR, PA, TX, UT, VA and WA.
Not a paid link: we earn nothing if you choose Midi.
Hone Health
Prescribes testosterone to women online, after a blood test.
From $65 test, then $155/mo membership + medication.
33 states for women's hormone care.
Partner link: we may earn a commission, at no extra cost to you.
Neither covers your state, or you would rather see someone in person? Find a clinic near you or compare online options.
Some links above are partnerships. If you start care through them, we may earn a commission at no extra cost to you. Partners we can earn from may be shown first in some lists, but commission never changes the facts we report about any provider.
The information on FindMyHRT is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have read on this website.
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