Subcutaneous Testosterone Injections for Women: Hormone, Muscle, and Integrative Chiropractic Health

Abstract

Testosterone is often called a "male hormone," but women naturally produce testosterone throughout life. It plays an important role in sexual function and also interacts with bone, muscle, mood, energy regulation, and overall physiology. In selected women, testosterone therapy may be considered when symptoms and a complete clinical evaluation support treatment. The strongest medical evidence is for postmenopausal women with hypoactive sexual desire disorder (HSDD), not simply for a low testosterone number on a blood test (Davis et al., 2019; Parish et al., 2021). Subcutaneous testosterone injections place a small amount of medication into fatty tissue beneath the skin, where it can be gradually absorbed. However, injectable testosterone therapy for women remains off-label in the United States, and the strongest randomized evidence still supports transdermal treatment. An integrative approach can combine appropriate medical oversight with chiropractic care, functional medicine, strength rehabilitation, nutrition, and movement therapy to address both hormonal health and musculoskeletal function.

Testosterone Is Important in the Female Body

Women produce testosterone mainly through the ovaries and adrenal glands. Levels generally change across adulthood and tend to decline with age. Surgical removal of the ovaries can cause a more sudden decline (Davis et al., 2019).

Testosterone affects several body systems. Its clearest treatment-related benefit in women is sexual health. Research shows that properly selected postmenopausal women with HSDD may experience improvements in sexual desire, arousal, pleasure, orgasm, and sexual satisfaction with physiologic testosterone therapy (Islam et al., 2019).

Testosterone also has biological relationships with:

• muscle tissue and muscle protein metabolism;
• bone metabolism;
• sexual motivation and arousal;
• red blood cell production;
• fat distribution and body composition;
• brain and nervous-system signaling.

These biological roles do not mean testosterone should automatically be prescribed to improve energy, mood, muscle mass, weight loss, or athletic performance in women. The international consensus statement concluded that HSDD is the only indication currently supported by strong evidence. Research on mood, cognition, body composition, and general well-being remains inconsistent (Davis et al., 2019).

The Medivant-supported white paper makes the same important distinction: sexual function has the strongest randomized evidence, while evidence for mood, cognition, metabolic effects, and body composition is much weaker or unproven.

What Are Subcutaneous Testosterone Injections?

A subcutaneous, or SubQ, injection places medication into fatty tissue just beneath the skin instead of deep inside a muscle.

With testosterone cypionate, the medication remains within this tissue and is gradually absorbed. SubQ administration can use smaller needles and may be easier for some patients to self-administer than an intramuscular, or IM, injection. FOLX Health describes the abdomen and fatty portions of the thigh or arm as common SubQ sites, while IM injections reach deeper muscle tissue and normally require a longer needle (FOLX Health, 2023).

The goal in a woman receiving testosterone treatment is not to create male testosterone levels. When therapy is medically appropriate, treatment should remain within the normal physiologic female range and avoid excessive exposure.

The Medivant white paper stresses an important limitation: dedicated randomized efficacy trials of subcutaneous testosterone injections in women are lacking. Most of the randomized evidence supporting testosterone therapy in women comes from transdermal patches, creams, or gels.

Therefore, SubQ testosterone should not be described as better proven than transdermal testosterone. It is an alternative delivery strategy that requires individualized prescribing, laboratory monitoring, and informed consent.

Low Testosterone Levels Do Not Tell the Whole Story

One of the most important points in women's testosterone care is that a blood test alone does not diagnose a condition requiring treatment.

Current expert guidelines recommend considering the full clinical picture. That includes sexual symptoms, medications, menopause status, relationship factors, sleep, mood, vaginal or genitourinary symptoms, and other medical conditions (Parish et al., 2021).

Blood testing still has an important role. It can help establish a baseline and, once therapy begins, help make sure testosterone does not rise above the normal female physiologic range.

The Medivant white paper summarizes this concept well: use the testosterone number to monitor exposure, rather than using one low value alone to diagnose HSDD.

What Benefits Can Testosterone Therapy Provide?

For an appropriately selected woman, the best-supported benefits are related to HSDD. Improvements can include greater sexual desire, better arousal and satisfaction, and reduced distress related to persistent loss of sexual interest (Islam et al., 2019).

Cedars-Sinai similarly notes that testosterone may benefit some women with HSDD while warning that evidence is not consistent enough to promise broad improvements in energy, cognition, mood, muscle, or general wellness (Cedars-Sinai, 2026).

Muscle and bone deserve special attention. Testosterone has anabolic biological actions, but female treatment studies do not justify presenting low-dose testosterone as a proven muscle-building therapy. A randomized dose-response trial evaluated body composition, muscle performance, and physical function in women, illustrating how dose and testosterone exposure can affect different outcomes, but it does not establish testosterone therapy as a routine treatment for female muscle weakness (Huang et al., 2014).

Likewise, the white paper notes one older trial showing increased bone density with testosterone added to estradiol, yet pooled evidence has not established testosterone as a treatment for osteoporosis or body-composition problems.

Why Chiropractic and Strength Rehabilitation Matter

This is where integrative chiropractic care can complement medically supervised hormone management.

Testosterone therapy does not correct restricted joints, poor movement patterns, spinal dysfunction, deconditioning, muscle imbalance, or an old injury. Likewise, chiropractic treatment does not replace a clinically indicated hormone.

They address different pieces of health.

Integrative chiropractic care may include:

• spinal and extremity evaluation to improve joint mobility and biomechanics;
• progressive resistance and stabilization exercises to build functional muscle strength;
• rehabilitation of weakened muscles following injury or inactivity;
• mobility, posture, balance, and movement training;
• nutrition, protein intake, sleep, and recovery support;
• monitoring of functional goals such as walking, lifting, exercise tolerance, and return to work or sports.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, has described a similar clinical approach in his published observations. His women's hormonal-health pathway looks beyond a hormone number and considers sleep, nutrition, musculoskeletal pain, movement, resistance training, mobility, rehabilitation, metabolic factors, and strength measurements alongside appropriate endocrine evaluation (Jimenez, 2026).

This creates an important distinction: testosterone may influence muscle physiology, while rehabilitation provides the mechanical stimulus needed to build functional strength.

Subcutaneous vs. Intramuscular Testosterone

Intramuscular testosterone is injected directly into muscle. Subcutaneous testosterone is delivered into fatty tissue.

Neither route should be confused with the goal of improving "intramuscular strength." The injection route simply describes where the medication is placed. Muscle strength comes from a combination of healthy muscle tissue, nervous-system control, resistance exercise, nutrition, recovery, and overall health.

SubQ injections may appeal to some women because the needle can be smaller and the treatment may be easier to self-administer. Hone Health currently provides low-concentration compounded preparations designed to make small SubQ doses easier to measure, which highlights the practical dosing problem created when male-concentration testosterone products are used for female-range dosing (Hone Health, 2026).

However, convenience is different from evidence. The Medivant white paper clearly states that no dedicated efficacy randomized controlled trial has established SubQ testosterone injections for women.

Medical Monitoring and Testosterone Safety

Female testosterone therapy requires careful monitoring because excessive testosterone increases the chance of androgen-related effects.

Possible effects include:

• acne or oily skin;
• increased facial or body hair;
• scalp hair thinning;
• changes in hematocrit;
• voice changes;
• clitoral enlargement at excessive exposure;
• other signs that testosterone has exceeded the intended female range.

Acne and excess hair growth are among the more common dose-related effects. Voice changes and other virilizing effects are less common but deserve prompt evaluation (Parish et al., 2021).

Long-term cardiovascular and breast safety also remain important research questions. Current short- and medium-term findings are reassuring in appropriately dosed patients, but adequately powered long-term trials extending over many years are lacking.

For that reason, testosterone should be treated as a prescription therapy requiring assessment, informed consent, appropriate laboratory testing, follow-up, and reassessment rather than as a general anti-aging supplement.

Medical and Chiropractic Integration in El Paso

At Injury Medical Clinic PA in El Paso, Texas, Dr. Jimenez's clinical model combines chiropractic and musculoskeletal care with medical oversight, functional medicine, personal injury care, rehabilitation, and related services.

The clinic's materials identify Dr. Maria Guadalupe Cardenas, MD, as a board-certified internal medicine physician with more than four decades of experience who serves as medical director and collaborative physician. Texas Medical License J2933 is documented through current Texas Medical Board licensing materials.

Dr. Cardenas can provide the internal medicine and medical oversight perspective, while Dr. Jimenez can focus on chiropractic biomechanics, functional assessment, rehabilitation, musculoskeletal health, and coordinated integrative care. Their clinic materials describe this as a multidisciplinary approach in which medical evaluation and chiropractic rehabilitation support different parts of the same patient's health plan.

For a woman considering testosterone therapy, this model allows the team to ask a broader question: not simply "Is testosterone low?" but rather, "What is affecting this patient's function, sexual health, strength, movement, sleep, recovery, and overall quality of life?"

A Careful, Whole-Body Approach

Subcutaneous testosterone injections can provide a convenient method of delivering a very small testosterone dose into tissue beneath the skin. For some women, they may be considered as part of individualized, medically supervised care.

But responsible treatment requires keeping the evidence in perspective. Testosterone therapy should not be presented as a cure for every symptom of menopause or as a shortcut to stronger muscles.

For appropriate candidates, hormone management can be combined with resistance exercise, adequate protein, healthy sleep, functional medicine strategies, chiropractic care, and rehabilitation. That combination addresses both physiology and function—the hormone environment on one side and the muscles, joints, movement patterns, and physical demands of daily life on the other.

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References

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

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: Strong enough for a man, but made for a woman. Medical Research Archives, 13(11).

FOLX Health. (2023). Estrogen and testosterone HRT/GAHT: Subcutaneous vs. intramuscular injections.

Hatzilabrou, T. A. (n.d.). Testosterone therapy in women. Worldborne Medical Clinical Frontiers: Androgen Series.

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

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

Huang, G., Basaria, S., Travison, T. G., et al. (2014). Testosterone dose-response relationships in hysterectomized women with or without oophorectomy. Menopause, 21(6), 612-623.

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). Women's hormonal health insights on testosterone deficiency. Injury Medical Clinic PA.

Medivant Healthcare. (2026). Medivant Healthcare sterile injectable products and testosterone formulations.

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 Sexual Medicine, 18(5), 849-867.

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The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and facilitate clinical collaboration with specialists across disciplines. Each specialist follows their professional scope of practice and the jurisdiction in which they are licensed. We utilize functional health and wellness protocols to treat and support care for musculoskeletal injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that directly or indirectly support our clinical scope of practice. Our office has made a reasonable effort to provide supportive citations and identify relevant research studies for our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

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Dr. Alex Jimenez, DC, MSACP, APRN, FNP-BC*, CCST, IFMCP, CFMP, ATN

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