06/08/2026
Many menopausal women are taking testosterone these days. It's being sold as the elixir of life´, the missing link so to speak, but is it?
Check this article out by Dr Joanne Hobson
Testosterone at the menopause
by Dr Joanne Hobson, clinical lead director at The Menopause Consortium
IF YOU SPEND ANY TIME on social media, you could be forgiven for thinking that testosterone is the missing piece of every menopause treatment plan. It’s often promoted as a solution
for fatigue, brain fog, weight gain, muscle loss, joint pain and low libido.
But when we look at the clinical evidence rather than the headlines, the picture is far more nuanced.
Testosterone in women
Testosterone is produced by the ovaries, adrenal glands and in some other tissues and organs. It contributes to s*xual function, bone health, muscle maintenance and overall wellbeing. But
testosterone levels in women are naturally much lower than in men, vary considerably between individuals, and don’t reliably correlate with symptoms.
Research led by Professor Susan Davis has shown that testosterone decline is primarily age-related rather than menopause-related. Testosterone levels gradually reduce through midlife, reach their lowest point in the late 50s
and may rise slightly after that.
Natural menopause itself doesn’t appear to cause a significant drop in testosterone. The important exception is surgical menopause following removal of both ovaries, when
testosterone levels can fall abruptly. This challenges the increasingly common narrative that all menopausal women need testosterone replacement. that negatively affects quality of life and can’t be explained by other medical, psychological or relationship factors.
Clinical trials have shown that testosterone can improve s*xual desire, arousal and satisfaction in appropriately selected women with HSDD. Therefore, organisations including the International Menopause Society and the British Menopause Society support
testosterone prescribing for HSDD following careful assessment.
Low libido is rarely caused by low testosterone alone. Hormones, sleep quality, chronic pain, medicines, stress, depression, anxiety, body image, relationship dynamics and past experiences all play a role. A blood test alone can’t diagnose HSDD and
testosterone levels don’t reliably predict who will benefit from treatment. Many women ask whether testosterone helps with energy, brain fog, mood, weight management or joint pain. While anecdotal reports are common, current evidence doesn’t support prescribing testosterone specifically for these symptoms. Any
reported benefits may reflect placebo effects, using oestrogen replacement, treatment of vaginal symptoms, improvements in sleep or wider lifestyle changes while taking testosterone.
profoundly affect s*xual desire. If intimacy becomes associated with discomfort, it’s normal for desire to reduce.
Local vaginal oestrogen, moisturisers, lubricants and pelvic
health support are often far more important than testosterone.
Depression, anxiety, chronic stress, antidepressant medicines, unresolved relationship difficulties, caregiving responsibilities and past trauma can all contribute to reduced s*xual desire. Testosterone can’t resolve these issues.
Testosterone prescribing
Current international guidance doesn’t support the routine prescribing of testosterone for every woman. There’s only one evidence-based indication for testosterone therapy in postmenopausal women. This is hypoactive s*xual desire disorder (HSDD), which refers to persistent, distressing low s*xual desire The Menopause Exchange Holistic approach
Oestrogen remains the most effective treatment for many menopause symptoms, including hot flushes, sleep disturbance, mood changes, vaginal symptoms and musculoskeletal discomfort. Many symptoms often attributed to “low testosterone” improve significantly once oestrogen replacement is appropriately adjusted. Genitourinary syndrome of menopause (GSM), causing vaginal dryness, irritation and painful s*x, can
be carefully monitored.
Currently, no testosterone product is licensed specifically for women in the UK, so treatment is prescribed off-label
using low doses of formulations designed for men. The aim is to
maintain testosterone levels within the normal female physiological range, not to achieve male levels.
Ongoing monitoring should include symptom reviews, assessment of benefits, blood testing and evaluation for side effects such as acne, oily skin or unwanted hair growth. Most side effects are dose-related and uncommon when the testosterone treatment is prescribed correctly. Short-term safety data are reassuring, but long-term evidence beyond two years remains limited, so ongoing review is important.
For women who have gone through surgical menopause or experienced premature ovarian insufficiency (POI), testosterone may play a greater role because of more significant hormonal
changes. But even in these situations, careful assessment and optimisation of oestrogen remains essential.
About the author
Dr Joanne Hobson is a menopause and psychos*xual health specialist. She is clinical lead director of The Menopause
Consortium (TMC).
Issue 109, Summer 2026
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