Testosterone therapy for women has become a controversial topic, with claims ranging from miraculous benefits to warnings of serious harm.
On this episode of the Sky Women’s Health Podcast, Dr. Carolyn Moyers brings together the worlds of evidence-based medicine and real-world patient concerns with her guest, Dr. Lindsey VanDyke, board-certified endocrinologist and expert in hormone therapy. Dr. Moyers opens the conversation with urgent questions about testosterone use, popular hormone clinics, and the “Wild West” of menopause care, inviting Dr. VanDyke to share not only the science but her firsthand clinical wisdom. Listeners are welcomed into a myth-busting, deeply practical discussion, anchored in the values of transparency, individualized medicine, and listening.
Hormone clinics vs. expert care
Dr. VanDyke warns:
“Hormone therapy clinics are everywhere. I’m seeing patients coming in with supra-physiologic testosterone levels, numbers in the male or transgender range, not normal for women. And the risks are real: voice deepening, irreversible clitoral enlargement, male pattern hair loss, and acne, without the promised improvements in libido or metabolism.”
She’s troubled by the shortcuts and lack of individualization found in many commercial clinics:
“If you’re going somewhere and the practitioner says they’re a hormone expert, that’s a clear sign they’re not an endocrinologist. They may have done a “certification” course in hormone pellet therapy, but they haven’t done a fellowship in endocrinology.”
Why dosing and monitoring matter
Dr. VanDyke insists on careful, physiologic dosing and a trial approach:
“When we dose testosterone carefully, staying in pre-menopausal physiologic ranges, we limit side effects. I usually do a three to six-month trial, if it isn’t working, we change course. No wasted time or unnecessary risks.”
She rejects the “blast and hope” philosophy:
“This idea of blasting women with a fire-hose of testosterone is not appropriate. Dosing of testosterone in women requires a delicate hand, and if it’s not giving us the results we need, we switch gears.”
Sex drive is multifactorial
Libido, Dr. VanDyke argues, is not fixed by one hormone:
“Women’s libido is incredibly multifactorial. Burnout, insomnia, chronic illness, stress, these all impact desire much more than simple hormone levels. It’s never just about testosterone.”
She emphasizes the importance of replacing all hormones appropriately and treating root causes:
“We need to address hot flashes, sleep, vaginal dryness, genitourinary changes, and only then look at testosterone if low desire persists.”
Individualized, patient-centered practice
Dr. VanDyke advocates for the direct care model:
“You cannot solve complex hormone issues in five or ten minutes. Patients need time, a relationship, and someone to listen. That’s how you avoid complications and truly improve lives.”
The search for better data
Dr. VanDyke is candid about limits in research:
“We clearly need more data on testosterone in women. Right now, the main indication is hypoactive sexual desire disorder, but even then, the solutions aren’t always straightforward. There simply is not enough research in this area, and there are no FDA approved treatments for this problem. Every patient’s care should be individualized.”
Applied wisdom
Her advice:
“If you’re considering hormone therapy, find a board-certified endocrinologist who listens and personalizes your care. Avoid cookie-cutter approaches. Look for someone willing to do a careful trial and adjust as needed.”
Dr. VanDyke offers personalized telehealth visits, making evidence-based, transparent, and compassionate care available across TX, OK, CO, WA, CA, NM, and OR.
Ready to move past myths and get real answers on hormones, menopause, or sexual health? Book your telehealth visit with Dr. VanDyke and experience medicine that truly listens, because your health deserves nuance, safety, and expertise.
Listen to the podcast here https://podcasts.apple.com/us/podcast/episode-202-testosterone-therapy-sexual-desire-insights/id1541657642?i=1000705147043