OBJECTIVES: The prevalence of sexual dysfunction in the United States (US) is approximately 31% in men and 41% in women. Current testosterone use in the US by males has been estimated, but the rate of use in females is unknown. Our purpose was to assess the personal characteristics and demographics of male and female testosterone users. METHODS: Characteristics of male and female testosterone users were retrieved from IMS LifeLink Plus for 2006-2013 and compared. On-label and off-label indications and contraindications were identified using validated ICD-9-CM codes. Demographics, prescriber and payer types, comorbidities, contraindications, and off-label and on-label use were compared between genders using Chi-square tests.  RESULTS: In total, 6187 females and 42306 males used testosterone. Female testosterone users were much younger than male users (46.0% vs. 40.5%, p<0.0001). The major provider speciality that prescribed testosterone was OB/GYN for females and general practitioner for males (22.5% vs. 10.2%, p<0.0001). Males were prescribed testosterone for a labeled indication more frequently (29.9% vs. 1.0%, p<0.0001), whereas females were prescribed testosterone off-label more commonly (22.9% vs. 15.9%, p<0.0001). The two populations differed significantly on most comorbidities, including a greater proportion of males previously experiencing cardiovascular events (6.3% vs. 3.0%, p<0.0001). Serum testosterone concentration (TC), were performed more frequently for males compared to females (76.0% vs. 40.2%, p<0.0001). Prostate specific antigen (PSA) test was performed in only 60% of men prior to testosterone use.  CONCLUSIONS: Characteristics of male and female testosterone users significantly differ in the cohort of commercially insured US population. Extensive off-label use of testosterone among females requires further investigation.