Testosterone Optimization
Testosterone isn't just a male hormone.
Women produce testosterone too — and when levels decline, the effects are significant: low energy, diminished libido, cognitive changes, loss of lean muscle mass. For men, the same decline drives fatigue, weight gain, mood changes, and poor recovery.
For Women
Testosterone for women: the most overlooked hormone in women's health.
Women produce testosterone in their ovaries and adrenal glands. Levels peak in the mid-20s and decline steadily with age — accelerating during perimenopause. This decline is rarely discussed in conventional women's health, and testosterone is almost never measured in a standard panel.
Low testosterone in women drives a distinct set of symptoms: persistent fatigue that doesn't respond to rest, decreased libido, difficulty building or maintaining muscle, cognitive changes (especially word-finding and focus), and decreased motivation. These symptoms are often attributed to depression, stress, or “just getting older.”
When testosterone is restored to optimal levels for women — not male reference ranges, but the levels appropriate for a woman's biology — the response is often dramatic. Patients describe it as feeling like themselves again: more energy, clearer thinking, renewed motivation.
For Men
Testosterone for men: what andropause actually looks like.
Unlike menopause, the hormonal transition in men is gradual — testosterone declines roughly 1–2% per year beginning in the 30s. By the 50s, many men have lost 20–30% of their peak testosterone. The syndrome that results — andropause — often goes unrecognized because it develops slowly.
The symptoms are recognizable: fatigue, especially in the afternoon, decreased motivation, weight gain (particularly abdominal fat), poor recovery from exercise, mood changes (irritability, low mood, reduced drive), and decreased sexual function. Often these are attributed to stress, aging, or lifestyle.
At Meliora, we measure testosterone properly — total and free levels, not just total — and evaluate results against optimal ranges. Many men are in the “normal” range for their age but well below what they'd need to feel well.
Treatment Options
Testosterone protocols at Meliora.
Testosterone Pellets
Subcutaneous pellets inserted in a brief in-office procedure. Deliver steady-state testosterone levels over 3–5 months (women) or 4–6 months (men). No daily administration. No peaks and troughs. Consistent levels — as close to the body's natural delivery as we can achieve.
Topical Testosterone
Compounded testosterone cream for patients who prefer not to use pellets, or for women where the starting dose is conservative. Applied to thin-skinned areas for absorption.
Who Benefits
Testosterone optimization is appropriate for more patients than most clinicians discuss.
Women with low libido, fatigue, or cognitive changes
Particularly after 35, or after starting estrogen therapy without testosterone. Estrogen without testosterone is incomplete for many women.
Women with low free testosterone on labs
Regardless of symptoms, low free testosterone should be addressed. Many women don't know what normal energy feels like until their testosterone is restored.
Men with documented low testosterone
Total testosterone below 400 ng/dL, or free testosterone below optimal, combined with symptoms. Men with borderline levels and significant symptoms are also candidates.
Men who haven't responded to lifestyle changes
If sleep, diet, and exercise haven't improved your energy or body composition, hormonal assessment is the next step.
Common questions.
Will testosterone therapy affect my voice or cause hair growth in women?
At the doses used for women, virilizing effects (voice changes, excessive hair growth) are uncommon. They are dose-dependent and monitored closely. If they occur, the protocol is adjusted.
Can testosterone therapy affect fertility?
Exogenous testosterone suppresses natural testosterone production and should not be used by men who are actively trying to conceive. For women, the clinical picture is more nuanced. Dr. Chua discusses fertility implications individually.
How long does it take to feel the effects?
Most patients notice changes within 4–6 weeks. Full effects — especially for energy and body composition — develop over 3–6 months as the protocol is optimized.
Do I need to be on other hormones to get testosterone therapy?
Not necessarily. Testosterone optimization can be done independently, but in most cases it's more effective in the context of a full hormonal assessment — because testosterone interacts with estrogen, thyroid, and adrenal function.
Testosterone affects far more than most patients realize.
Book a consultation. We'll measure your levels properly and build a protocol appropriate for your biology.