Brazil — Leading Brazilian medical associations have issued a unified warning about the inappropriate use of testosterone in women, emphasising that the hormone should only be prescribed in highly specific clinical circumstances. The joint statement was released by three national organisations: the Brazilian Society of Endocrinology and Metabolism (SBEM), the Brazilian Federation of Gynaecology and Obstetrics Associations (Febrasgo), and the Brazilian Society of Cardiology (SBC).
According to the three bodies, testosterone therapy in women must be limited exclusively to cases of Hypoactive Sexual Desire Disorder (HSDD), and only after a comprehensive clinical evaluation. The organisations argue that prescribing the hormone for aesthetic enhancement, physical performance, improved vitality or general well-being lacks scientific justification and may result in substantial harm.
Health Risks Highlighted by Specialists
In the statement, the societies outline a broad range of adverse effects linked to non-indicated testosterone use in women. Documented consequences include virilising changes such as acne, hair loss, unwanted hair growth, enlargement of the clitoris and long-lasting vocal deepening. The associations also cite serious hepatic toxicity, including the potential for liver tumours, as well as notable psychological and psychiatric alterations.
The report further warns of fertility implications and a spectrum of possible cardiovascular risks, including hypertension, arrhythmias, embolic episodes, thrombosis, heart attack, stroke and increased mortality. Disturbances in laboratory parameters, particularly cholesterol and triglyceride levels, were also described as potential outcomes.
These risks are consistent with findings in existing scientific literature, which highlights the absence of long-term safety data for testosterone therapy in women and recurrent concerns about cardiovascular and metabolic complications (Davis & Braunstein, The Lancet Diabetes & Endocrinology).
Regulatory Position in Brazil
The statement also reiterates that Brazil’s national regulatory body, Anvisa, has not approved any testosterone formulation specifically for female use. The agency does not endorse the hormone for cosmetic purposes, anti-ageing protocols or body-composition enhancement. In practice, this means that off-label prescriptions fall outside formally recognised medical guidance, reinforcing the message of caution issued by the country’s clinical experts.
Call for Evidence-Based Prescribing
The Brazilian societies emphasise that clinical decisions must remain grounded in evidence and aligned with established guidelines, particularly when dealing with hormone therapies that carry meaningful physiological impact. Their alert serves as a reminder that testosterone is not a harmless supplement but a potent hormone capable of inducing significant systemic changes.
As demand for aesthetic or performance-driven treatments continues to rise globally, the statement from Brazil reinforces an international dialogue on the risks of non-therapeutic hormone use — especially in populations for whom safety data remains limited.