@tamsenfadal's testosterone claims for menopause, fact-checked

What did @tamsenfadal actually say?

Tamsen Fadal posted a demonstration of her testosterone gel routine, noting she applies "just a little bit" — about "the top of a pencil head" — to her shoulders or thighs, lets it dry, and confirmed the product is FDA-approved. She also mentioned she switched from a compounded testosterone because she "was not really feeling it." That's the full scope of the medical claims here: dose size is tiny, application sites matter, drying is required, and FDA-approved differs from compounded.

To be clear, she's not giving a prescription guide. She's showing her personal routine. But with 550,000 views, personal routines become de facto health advice, so the details deserve scrutiny.

Does the science back this up?

Mostly, yes. Testosterone therapy for women, particularly in the menopausal transition, has a real evidence base, even if it remains underutilized and under-discussed. The application guidance she describes is also clinically sound.

The Global Consensus Position Statement on testosterone for women, published by Davis et al. (2019) in the Journal of Clinical Endocrinology and Metabolism, found that testosterone improves hypoactive sexual desire disorder in postmenopausal women and that physiological dosing — meaning doses that restore testosterone to normal premenopausal ranges rather than supraphysiological levels — appears safe in short-to-medium term studies. The "small amount" framing she uses tracks with this. Women's therapeutic testosterone doses are roughly one-tenth of what's used in men's TRT, which is likely what her doctor meant by "a tenth."

On application sites, the prescribing guidance for FDA-approved female testosterone gels specifies thighs as the primary site. Shoulders are used in male formulations. Her mention of both is worth a closer look.

What did they get wrong (or right)?

Let's start with what she got right: the dose framing is accurate. Female testosterone dosing is dramatically lower than male dosing, and the "pencil head" visual is an honest attempt to convey that. Letting the gel dry before contact with others is genuinely important; transfer to children or male partners is a documented safety concern flagged in FDA labeling.

The shoulder application site, though, deserves a flag. The one FDA-approved testosterone product currently indicated specifically for women, Androderm for women was discontinued, and as of this writing most women prescribed testosterone in the U.S. are either using male-labeled products off-label or compounded formulations. Shoulder application is standard in male gel products like AndroGel; some off-label female use follows the same instructions. This isn't wrong exactly, but it's context that viewers don't get from the video.

Her comment about switching from compounded testosterone because she "was not really feeling it" is honest and common. But viewers should not interpret this as evidence that compounded testosterone is inferior. Compounded and brand-name drugs are not equivalent by regulatory definition, and individual response varies for reasons that go beyond formulation alone.

What should you actually know?

Testosterone therapy for women is legal, used clinically, and supported by a growing body of evidence, but it remains largely off-label in the U.S. because no testosterone product is currently FDA-approved specifically for women. The FDA-approved products she references are almost certainly male-labeled gels used at reduced doses under physician supervision. That's a common and accepted clinical practice, but it means patients are navigating a product not designed for them.

Transfer risk is real. Testosterone gel on skin can transfer to partners or children through direct contact, and even brief exposure has caused virilization in children. The FDA added a black box warning about this in 2009. Letting the gel dry fully, covering the site, and washing hands are not optional steps.

Anyone watching this and thinking about testosterone therapy should know: blood levels need monitoring, dosing should be individualized, and "not feeling it" from one formulation does not automatically mean the next one will work better without clinical adjustment.

The bottom line

Fadal is not making wild claims. She's sharing a personal health routine in a way that is largely accurate and, frankly, fills a gap that mainstream media has ignored for decades. The menopausal testosterone conversation is one that doctors often avoid and patients often never hear. Her platform bringing it into view is not the problem.

The gap is context. Viewers do not learn that testosterone is off-label for women in the U.S., that transfer risk carries a black box warning, or that switching formulations without clinical guidance is not a simple swap. Those omissions matter at 550,000 views.