119: The Testosterone Access Gap No One's Talking About

We need to talk about the glaring inequity in Australian healthcare that's affecting millions of women. After 18 months on menopause hormone therapy, testosterone has transformed my life, restoring my vitality, sharpening my focus, lifting my mood, and reawakening my sexuality. Yet accessing this life-changing treatment reveals a troubling gender bias in our healthcare system.

While nine testosterone products for men are subsidised through the PBS, Androfeme - the only female-specific testosterone cream in Australia - remains unsubsidised, costing women over $100 per script. This forces many of us to use male-formulated alternatives that require daily careful self-measurement, an imprecise and frustrating workaround that no woman should have to endure.

The numbers are staggering: an estimated 1.34 million Australian midlife women experience Hypoactive Sexual Desire Dysfunction (HSDD), yet face significant barriers to diagnosis and treatment. 

Despite testosterone therapy being used safely and effectively for women since the 1940s, with Australian-made Androfemme recognised globally as a gold standard treatment, women continue to bear financial burdens that men don't face for essentially identical symptoms.

The solution is straightforward: include Androfemme on the PBS, just as other menopause treatments have recently been added.

Share this episode with friends, family, healthcare providers, and decision-makers. 

Together, we can amplify women's voices and demand the equal treatment we deserve. 

Women's health is not a luxury - it's time our healthcare system reflects that truth.

Links:

National Women's Health Advisory Council's Review

What is HSDD?

Australian Paper on HSDD

Testosterone has been treating women since 1940's

Testosterone for women: what you need to know

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Chapters

• 0:00 Welcome to Dear Menopause
• 0:50 Testosterone Therapy: My Personal Story
• 3:12 Gender Inequality in Healthcare Access
• 4:53 Understanding HSDD and Its Impacts
• 7:20 Time for Change: PBS Inclusion
• 9:47 Beyond Libido: Testosterone's Broader Benefits

Transcript

Sonya: 0:01

Welcome to the Dear Menopause podcast. I'm Sonya Lovell, your host Now. I've been bringing you conversations with amazing menopause experts for over two years now. If you have missed any of those conversations, now's the time to go back and listen, and you can always share them with anyone you think needs to hear them. This way, more people can find these amazing conversations, needs to hear them. This way, more people can find these amazing conversations.

Sonya: 0:27

Hello and welcome to this week's episode of Dear Menopause. I am so glad that you are here, and today I have something a little bit different for you. I am recording a solo episode. I don't do this very often it's actually something that I'm not super comfortable doing but I have been on my soapbox recently and I decided that it was time that I recorded a bit of a podcast about it. So today I'm going to talk to you about something that's both deeply personal and deeply political Access to testosterone therapy for women in Australia, and why I believe it's time to change.

Sonya: 1:07

So when I first started taking my menopause hormone therapy, which is about 18 months ago now, one of the most significant and transformative parts of my treatment has been testosterone. It has given me back a sense of vitality. It's absolutely improved my focus. It's definitely lifted my mood and, honestly, it helped reawaken a part of me that I thought was gone forever, and that was my sex life. But, like so many women across Australia, I very quickly discovered that accessing a testosterone product designed specifically for women is anything but straightforward or, more importantly, affordable. Now I use testosterone every day, but not the formulation that is made specifically for women by an Australian company. Why? Because the only female specific testosterone cream, which is called Androfeme, is expensive. It's not on the PBS, so it has to come on a private script, which means that it is over $100 per script and it's simply not sustainable long-term for many women, and that includes me. So instead I use a product that's designed for men. It's financially accessible because it's available on the PBS, but using a male-formulated product means that I have to carefully apportion a dose every day that's appropriate for my female body. Yep, every single time I use it, I have to self-measure how much I'm applying. It's not ideal and it's not what I would choose if cost wasn't a factor, but it's the reality that many others face.

Sonya: 2:58

So, as I said at the beginning, this isn't just my personal story. This is a systemic issue, because let's talk about what's really going on here. This is a case of gendered inequity. So the National Women's Health Advisory Council recently reviewed what so many of us already know, and that is that sex and gender imbalances in our healthcare system are ongoing and widespread, and testosterone access is just one prime example. Let this sit with you for a moment. Currently, there are nine testosterone products for men subsidized through the PBS Nine, and yet Androfem, the only TGA-approved testosterone therapy for women, remains excluded. The result it's a financial burden which is borne solely by women. It is, in my books, a textbook case of gender bias in healthcare policy.

Sonya: 4:03

Treatments for essentially the same symptoms low libido and related distress because they are the only symptoms that testosterone is approved to be prescribed to women for are funded for men but not for women. Honestly, the imbalance is indefensible and, frankly, it's infuriating. Indefensible and frankly, it's infuriating. So let's talk for a moment what I just mentioned there, which was that low libido and related stress are the only conditions that testosterone is approved to be prescribed for. It's actually a condition called HSDD, and let's talk about why it matters that women who do suffer from HSDD have equitable access to testosterone. So hypoactive sexual desire dysfunction is a diagnosable medical condition. It's marked by a persistently low libido that causes significant personal distress, and it impacts far more than just sex. It affects a woman's overall well-being, her mental health, her relationships and her self-esteem.

Sonya: 5:21

So I did a bit of digging and, using data from an Australian study on HSDD combined with some current ABS statistics, I did some math. And the results an estimated 1.34 million midlife Australian women are currently experiencing symptoms of HSDD. But here's the thing Based on the countless conversations I've had with friends, podcast listeners and clinicians, I truly believe that the real number is even higher. Study from 27,. Sorry, the study from 2017 reported 32.2% of midlife women were affected, but today I would argue that that is much closer to 50%. And yet, despite these numbers, very few women ever receive a formal diagnosis, let alone treatment. And why? Because of stigma, because of under-recognition of the condition and because of the significant cost barriers standing in the way.

Sonya: 6:39

Testosterone therapy has been used safely and effectively to treat low libido in women since the 1940s, and Androfeme, which is made right here in Australia, is globally recognized as a gold standard product specifically formulated for women. So why, in 2025, is Androfeme still not on the PBS? Australian women are being left behind in our own backyard. Now look, I'm not asking for special treatment. I'm asking for equal treatment. If testosterone is subsidized for men experiencing low libido, even when it doesn't meet the strict criteria of HSTD, then women deserve the same support for the same issue. Anything less is just another example of outdated patriarchal thinking that has played women's health for far too long Now.

Sonya: 7:46

I believe the solution here is simple. The Australian government must support the inclusion of androfem on the PBS, the same way that it has recently supported the inclusion of Prometrium and Estrogel, and Estrogel Pro and also Slinder. And when they support the inclusion of Androfeme, they will remove the financial barrier to treatment for hundreds of thousands of Australian women, and they'll also be supporting an Australian company that creates jobs and manufactures locally. They'll align our health policy with both evidence and international progress. And look, most importantly, it sends a really clear message that women's sexual health matters and it's worth funding. Women's health deserves equality. Our well-being is not a luxury.

Sonya: 8:45

Treatment of testosterone has changed my life for the better, but accessing it shouldn't require a male-oriented workaround. I also want to touch, before I wrap this up, on the fact that testosterone for women can also be prescribed for many symptoms of perimenopause and menopause that go beyond low libido and HSDD. I mentioned right at the very beginning that I have definitely benefited from impacts to my vitality, my cognitive clarity. I had a beautiful friend recently say that it was like it put the color back into her life. So, yes, testosterone is prescribed for HSDD, low libido and sexual desire, but it can also be prescribed for many other symptoms and side effects of perimenopause and menopause. It's time for the PBS to catch up with the reality of women's needs and to give us the equal access that we deserve. Thank you so much for listening. If this episode resonated with you or if you want to be a part of Pushing for Change, please share it with your friends, your family, your doctors and your networks. Let's make sure that women's voices are heard. Until next time, take care.