04/01/2026
Anytime I post about testosterone cream, it causes an emotional response in people, clinicians included.
âŠas if itâs the only tool in my toolbox.
I practice based on what my patients need. And if my patients respond very well to a minimal intervention, why wouldnât I use it?
I am not married to any therapy. If the testosterone cream works, itâs a keeper. If it doesnât do itâs job, we switch. Itâs that simple.
For those who want to argue that testosterone cream causes hair loss while other therapies are superior: Iâm sorry, I just have too much data to prove that all forms of testosterone can increase hair loss, and that the dose, the frequency, and individual physiology matter more than what we learn in textbooks.
Having said that, you can clearly see in this post from patient lab results (as an example) when the cream works, and when it doesnât.
Note regarding optimal ranges:
Many women feel their best outside of the standard range. Iâm not concerned that the total testosterone is outside of the optimal range (it usually will be much higher once we start supplementing with testosterone), unless it is causing negative side effects knowing that most of the benefits are coming from free testosterone.
One patient has been on the testosterone cream for years and is doing well. And another patient was on a testosterone cream and we didnât have great results with it. We switched to an injection and sheâs thriving.
Practicing personalized medicine means we give patients options, start with minimal intervention, test and check-in, and pivot as needed.
Iâve had patients who have transferred to me on a testosterone cream and it clearly was not working. Their total testosterone was in the 200 range and their free testosterone was nonexistent. But because the healthcare provider did not believe in any other form of testosterone therapy, they did not provide the patient with any other options.
Our job as clinicians is to do whatâs right for the patient. Our job as patients is to do our research and come prepared to the doctorâs visit knowing our options and being able to advocate for ourselves.