Testosterone for women has narrow evidence in menopause care
Research supports carefully dosed testosterone for distressing low desire after menopause, while broader symptom claims and long-term risks remain unsettled.
By Tom Brennan · Health & Medicine Correspondent
3 min read
Interest in testosterone for women menopause care is rising, but the clearest clinical support is limited to a specific condition: persistent low sexual desire that causes distress after menopause. That condition, called hypoactive sexual desire disorder, or HSDD, is the only use in women for which international guidelines find sufficient evidence to recommend testosterone therapy, according to The Conversation.
The distinction matters as testosterone is promoted as a remedy for a wide range of menopause concerns. High-quality trial evidence has not established it as a treatment for low energy, mood changes, cognitive symptoms, bone health, muscle health or menopause symptoms generally, The Conversation reported.
Does testosterone help women during menopause?
A 2019 review of 36 randomized trials found that carefully dosed testosterone improved sexual desire and satisfaction for some postmenopausal women, according to The Conversation. HSDD means low desire that persists and causes personal distress; it does not describe every change in libido.
Sexual desire can also be affected by stress, tiredness, relationships, mental health, medicines and physical health. A hormone level alone cannot establish why someone has symptoms, and women’s low testosterone concentrations have historically been difficult for routine blood tests to measure reliably, the report said.
Women produce testosterone in the ovaries and adrenal glands, with other body tissues also contributing through hormone conversion. Their circulating levels are generally far lower than men’s, and they tend to fall gradually with age rather than dropping sharply at menopause, according to The Conversation.
What remains unproven?
A U.K. specialist-clinic study involving 510 women found participants reported better mood, cognition and libido after four months using testosterone gel. But the study could not show that testosterone caused those changes, The Conversation said.
National Geographic similarly reported that women’s testosterone levels fluctuate and that no established blood-test threshold defines a testosterone deficiency in women. It said available data do not support recommending testosterone for energy, vitality, mood, bone density or muscle health.
Why dosing and safety are still concerns
The United States has no approved testosterone product specifically for women, according to The Conversation. When male formulations are used in small amounts, accurately delivering a very low dose can be difficult. Excess exposure can lead to acne, oily skin, increased facial or body hair, and scalp hair loss.
Long-term safety evidence remains limited, particularly for heart disease, stroke and breast cancer, because trials have often been short and excluded women at higher risk for those conditions, The Conversation reported. Testosterone is also not a replacement for standard menopause hormone therapy; when prescribed, it is generally used alongside estrogen and sometimes progesterone.
U.S. regulators held a public workshop in September 2026 to examine evidence gaps and the need for drugs designed for women, according to The Conversation. The meeting reflects demand and unresolved research questions, rather than proof that testosterone benefits a broad range of menopause symptoms.
This story draws on original reporting from Medical Xpress.