Though often thought of as a “male” hormone, testosterone is important for women too. Produced mainly by the ovaries and adrenal glands, it helps support bone strength, mood, cognitive function, and sexual drive. Because testosterone has these roles, researchers and clinicians have explored whether supplementing it can ease symptoms that show up during the menopause transition.
From my perspective, the most relevant role of testosterone for women is its influence on sexual desire and arousal, but it also contributes to muscle maintenance and overall wellbeing. Testosterone levels usually peak in a woman’s twenties and then decline gradually; that decline becomes more noticeable during perimenopause and menopause. Certain medications, including some hormonal contraceptives and corticosteroids, can also lower testosterone levels.
Low testosterone in women may show up as reduced libido, low energy, loss of muscle mass, difficulty conceiving, vaginal dryness, mood changes such as anxiety or depression, thinning hair, dry skin, and sleep problems. A blood test is the only reliable way to confirm low testosterone, but these symptoms can help guide a conversation with a provider.
When it comes to therapy, the evidence is mixed. Some studies suggest testosterone can improve sexual wellbeing in postmenopausal women—helping desire, arousal, orgasm, and overall sexual satisfaction—but long-term safety data remain limited. For people with cardiovascular or liver disease, testosterone treatment may carry additional risks, so it’s not a one-size-fits-all solution.
Testosterone for menopause is used more routinely in some countries and is often prescribed off-label elsewhere. Typical delivery methods include prescription gels or creams that are absorbed through the skin. Clinicians who do prescribe testosterone usually monitor levels closely and weigh benefits against potential side effects.
Common side effects to be aware of include acne, increased facial or body hair, hair thinning on the scalp, weight changes, clitoral enlargement, voice deepening, and headaches. Because these effects can be permanent or difficult to reverse, careful discussion and monitoring are essential.
If you’re noticing symptoms that could be related to hormonal changes, the best first step is to talk with your healthcare provider. They can evaluate your symptoms, order appropriate blood work, and help you weigh the risks and benefits of testosterone alongside other treatment options tailored to your needs.
In short: testosterone can play a helpful role for some women during perimenopause, especially for sexual symptoms but it’s not universally appropriate, and safe use depends on individualized medical assessment and monitoring.
