Testosterone is having a moment with women.

Maybe your wife has heard about it from a friend. Maybe she’s listening to Dr. Kelly Casperson or Dr. Rachel Rubin. Maybe someone sent her a podcast explaining why testosterone could help her libido, energy, strength or simply make her feel more like herself.

And now she wants your testosterone.

Not literally yours, hopefully.

But she wants to know why you’ve been able to talk openly about testosterone while the conversation for women has been very different.

It’s a fair question.

Women make testosterone too. Levels decline with age, and we have good evidence that testosterone can improve sexual desire in postmenopausal women with distressing low desire.

Beyond that, things get more interesting.

There is still no FDA-approved testosterone product specifically for women in the United States, and the strongest evidence remains around sexual desire. But no FDA approval isn’t the same thing as no legitimate use.

That’s where physicians like Kelly Casperson, Rachel Rubin and Mohit Khera are helping push the conversation forward. They’re looking at the evidence we have, years of clinical experience and what women themselves are reporting, and asking whether the traditional boundaries around testosterone are too narrow.

That’s a reasonable question.

For sexual desire, we have good data. For energy, mood, cognition, strength and some of the other benefits women report, the clinical conversation is moving faster than the quality of the evidence.

That distinction matters.

Off-label medicine isn’t unusual. We use medications off-label all the time. It simply requires an educated conversation about what we know, what we don’t, the potential risks and what someone should reasonably expect.

The FDA is now asking many of these same questions about testosterone in menopausal women. The discussion is changing quickly, and perhaps appropriately so.

Your wife isn’t wrong for asking.

And her doctor isn’t necessarily wrong for saying yes.

We may ultimately discover that testosterone does less for women than some advocates hope, or more than our current guidelines acknowledge.

Either way, women deserve the same thing I want for the men I treat: a thoughtful conversation, reasonable expectations and the opportunity to make an informed decision when the science isn’t perfectly settled.