Testosterone is often called a "male hormone," but that's not biologically accurate. Testosterone is a human hormone. Women and men both produce testosterone, and women need testosterone for normal biological functions throughout life.
What is changing is the conversation about what testosterone might be able to do for women during perimenopause and menopause.
Testosterone therapy has been studied most extensively for sexual health, particularly low sexual desire that causes distress. But testosterone also has biological effects in many other tissues, and researchers are increasingly studying whether testosterone therapy could have broader benefits for women, including effects on energy, mood, cognition, muscle, bone, genitourinary health and overall quality of life.
The evidence isn't complete. Some areas have encouraging findings, while others remain uncertain. Importantly, a lack of evidence is not the same thing as evidence that a treatment does not work.
That distinction matters because women's health has historically not been studied as extensively as many areas of men's health, while testosterone research has traditionally focused heavily on men. The result is a significant gap in what we know about testosterone in women.
Key Takeaways
- Testosterone is a human hormone, not a male hormone. Women produce testosterone throughout life, primarily in the ovaries and adrenal glands.
- Testosterone has roles throughout the body. It is involved in sexual function, muscle and physical function, bone biology, mood, cognition and other physiological processes.
- The strongest clinical evidence for testosterone therapy in women is for sexual function, particularly hypoactive sexual desire disorder (HSDD) in postmenopausal women.
- Research is expanding beyond sexual health. Scientists are studying testosterone's potential effects on energy, mood, cognition, muscle, bone, genitourinary health and menopause-related quality of life.
- Some newer research is encouraging. A 2026 study of 279 peri/menopausal women using HRT found significant improvement in multiple symptom categories after testosterone was added, although the study design cannot prove testosterone caused those improvements.
- Short-term safety data are generally reassuring when testosterone is used at physiologic female doses. Long-term safety data are still limited.
- Testosterone is not currently a standard treatment for most menopause symptoms. That reflects the current evidence and regulatory status, not proof that testosterone has no role in those symptoms.
- The FDA is now specifically examining testosterone use in menopausal women and has identified several areas where more research is needed.
What Is Testosterone?
Testosterone is an androgen, a group of hormones that includes testosterone and related hormones. Women produce testosterone throughout their lives. The ovaries and adrenal glands contribute to testosterone production, and the body can also convert other hormones into testosterone and testosterone into other active hormones.
Testosterone acts through androgen receptors in tissues throughout the body. It can also be converted into dihydrotestosterone (DHT) and estradiol, which means its effects are not limited to one organ or one biological process.
Testosterone levels change with age and across the reproductive lifespan. The relationship between testosterone levels and symptoms is complex, however, and there is no single testosterone blood level that can be used to diagnose a general "testosterone deficiency" in women.
Testosterone Is Not a "Male Hormone"
The phrase "male hormone" is commonly used to describe testosterone, but it can create a misleading picture of female biology.
Women produce testosterone. Women use testosterone. Women have androgen receptors throughout the body.
The difference between men and women is not whether testosterone exists. It is the amount produced, how it is produced, how it changes over time and how tissues respond to hormones.
That is why testosterone deserves to be discussed as part of women's health rather than as a hormone that somehow belongs exclusively to men.
What Does Testosterone Do in Women?
Testosterone is involved in more than sexual desire. Androgen signaling has physiological roles in multiple tissues and biological systems.
Research and physiology point to roles for testosterone and androgen signaling in areas including:
- Sexual desire, arousal, orgasm and sexual response
- Muscle mass, strength and physical function
- Bone biology and bone health
- Energy and physical wellbeing
- Mood and psychological wellbeing
- Cognitive function
- Reproductive and ovarian function
- Vulvovaginal and urogenital tissues
- Metabolic and other whole-body processes
There is an important distinction, though, between testosterone having a biological role in a system and testosterone therapy being proven to improve a symptom or prevent a disease in that system.
For example, testosterone is involved in muscle and bone physiology. That does not automatically mean testosterone therapy has been proven to prevent osteoporosis or build clinically meaningful muscle in every menopausal woman.
This distinction is one of the most important things to understand when reading about testosterone online.
How Does Testosterone Change During Midlife?
Testosterone production changes throughout a woman's life. Levels generally decline over the reproductive years, although the pattern varies considerably between women.
Menopause also changes the hormonal environment in which testosterone acts. Estrogen levels decline substantially, sex hormone-binding globulin (SHBG) can change, and ovarian and adrenal hormone production changes with age.
There is therefore no simple rule such as "every woman becomes testosterone deficient at age 30" or "low testosterone explains every symptom of menopause."
Instead, testosterone is one part of a much larger hormonal picture.
What Symptoms Are Associated With Testosterone Changes?
Women commonly associate testosterone with changes in libido, but testosterone-related symptoms can be much broader.
Symptoms that may occur alongside hormonal changes during midlife include:
- Reduced sexual desire or sexual response
- Changes in orgasm or sexual satisfaction
- Changes in energy or physical stamina
- Changes in muscle mass or strength
- Changes in mood or wellbeing
- Changes in cognitive function
- Changes in vaginal or vulvovaginal health
These symptoms do not establish that testosterone is low, however.
Menopause symptoms have multiple potential causes. Estrogen changes, sleep disruption, stress, medications, thyroid problems, iron deficiency, depression, anxiety, chronic illness and many other factors can produce similar symptoms.
That is why a symptom such as fatigue or brain fog should not automatically be labeled "low testosterone."
Testosterone and Sexual Health
This is currently the area where the evidence for testosterone therapy in women is strongest.
Clinical trials and systematic reviews have found that physiologic-dose testosterone can improve several aspects of sexual function in postmenopausal women with hypoactive sexual desire disorder (HSDD).
HSDD is more than simply having a lower sex drive than you once had. It involves persistently low or absent sexual desire that causes personal distress, after other contributing factors have been considered.
The Global Consensus Position Statement and the International Society for the Study of Women's Sexual Health (ISSWSH) support systemic testosterone therapy for appropriately evaluated postmenopausal women with HSDD.
A 2026 systematic review in the Journal of Sexual Medicine also found evidence supporting testosterone therapy for sexual function, with the strongest evidence in postmenopausal women. The authors emphasized that evidence is more limited and heterogeneous in premenopausal and perimenopausal women.
So HSDD remains an important part of the testosterone conversation. But it should not be confused with the statement that sexual function is the only thing testosterone does in women.
Could Testosterone Help Other Menopause Symptoms?
Testosterone therapy is already being prescribed off-label to some women for symptoms beyond sexual dysfunction. In the United States, this generally means a clinician is prescribing an FDA-approved testosterone product that is approved for men, but using it at a much lower dose appropriate for women. Off-label does not mean experimental or illegal. It means the FDA has not approved that particular product for that particular use or population.
Testosterone has biological effects in many tissues, so clinicians and researchers have been interested in whether treatment might help other aspects of menopause. The evidence is strongest for sexual function, while evidence for other symptoms is still developing. Here is what we know so far.
Energy and Physical Function
Testosterone is involved in muscle function, physical performance and energy-related processes. Some women who use testosterone report improvements in energy and physical wellbeing, and newer clinical research is beginning to investigate these effects more directly.
Testosterone is not currently a standard treatment for menopause-related fatigue, but energy and physical function are among the areas being explored in current testosterone research.
Muscle Mass and Strength
Testosterone has a role in maintaining muscle tissue and can influence lean body mass. Studies in women have found effects on body composition and muscle-related measures, although the clinical significance varies between studies.
This makes muscle health a particularly interesting area for women experiencing age-related loss of muscle mass and strength during midlife.
Bone Health
Testosterone is involved in bone biology and can also be converted to estradiol, which plays an important role in maintaining bone density.
Testosterone is therefore part of the hormonal environment that supports bone health. However, estrogen remains the better-established hormone treatment for prevention of menopausal bone loss, and testosterone is not currently a replacement for established osteoporosis treatments. Learn more about preventing osteoporosis and how to protect your bones in How Much Estrogen Do Your Bones Need?
Mood and Emotional Wellbeing
Androgen receptors are present in the brain, and testosterone can influence neurological pathways involved in mood and behavior. Some studies have reported improvements in mood-related measures with testosterone therapy, although results have not been consistent enough to establish testosterone as a general treatment for depression or menopause-related mood symptoms.
Cognitive Function
Testosterone also acts on the brain, making cognition another area of interest. Women experiencing menopause may notice changes in concentration, memory and mental clarity, and researchers are investigating whether testosterone has a role in these symptoms. At this point, testosterone is not an established treatment for cognitive impairment or menopause-related brain fog.
Vulvovaginal and Urogenital Health
Androgen receptors are found throughout the lower urinary and genital tract. Testosterone may therefore have effects on tissues of the vulva, vagina, bladder and urethra.
Some clinicians use testosterone alongside estrogen when treating women with persistent sexual or genitourinary symptoms, although vaginal estrogen and other local treatments remain important options for genitourinary syndrome of menopause.
Quality of Life
One of the most interesting questions is whether testosterone can improve overall menopause-related quality of life rather than a single symptom.
The NIHR-funded ESTEEM trial is specifically investigating this question in approximately 400 women, using the Menopause-Specific Quality of Life Questionnaire (MENQOL) as its primary outcome. The study reflects a growing interest in looking at testosterone's potential effects across multiple aspects of women's health rather than focusing exclusively on sexual function.
A 2026 Study Suggests Testosterone May Have Broader Effects
A newly published 2026 study adds an interesting piece to this evolving picture.
Researchers studied 279 peri/menopausal women who were already using standard HRT and evaluated symptoms before and three months after transdermal testosterone was added.
Fifteen of the 24 symptoms assessed showed statistically significant improvement. The improvements occurred across several symptom clusters, including energy, musculoskeletal symptoms, mood, cognition, genitourinary symptoms and endocrine symptoms.
The findings are encouraging, but the study needs to be interpreted carefully.
It was a retrospective cohort study from a single center and did not include a placebo or untreated control group. Some participants also had changes to their underlying HRT during the study period. The questionnaire used was not a standardized testosterone-specific outcome measure, and the study cannot establish that testosterone itself caused the improvements.
In other words, this is a signal worth investigating, not proof that testosterone treats 15 different menopause symptoms.
That distinction matters. The study adds to the evidence suggesting that testosterone may have broader therapeutic potential, while also showing why larger randomized controlled trials are needed.
Why Is There Still So Much We Don't Know?
It can be frustrating to read that testosterone has important biological roles in women but that research has not answered basic questions about how testosterone therapy might affect energy, mood, cognition, muscle, bone and overall wellbeing. Part of the problem is the history of medical research.
Women's health has not always received the same depth of research attention across all areas as men's health. Testosterone research in particular has historically been dominated by studies of men and male hypogonadism. This creates a problem when clinicians and researchers try to apply a largely male evidence base to women whose physiology, hormone concentrations and treatment goals are different.
The evidence gap does not prove that testosterone therapy works for every symptom women experience. But it also means that we should not mistake an absence of research for evidence of no biological effect.
Testosterone Research Is Expanding
There is reason to be hopeful about where the research is going.
The ESTEEM trial, funded by the National Institute for Health and Care Research (NIHR), is investigating the clinical and cost-effectiveness of testosterone for improving menopause-related quality of life. The study is designed to include approximately 400 women and uses the Menopause-Specific Quality of Life Questionnaire (MENQOL) as its primary outcome.
This is important because quality of life is broader than sexual function. Research like ESTEEM can help answer whether testosterone has meaningful effects on the broader experience of menopause rather than only one symptom domain. We do not have the results yet. But studies like this are exactly what is needed to move the conversation from anecdotal reports and biological theory toward stronger clinical evidence.
The FDA Is Examining Testosterone Use in Menopausal Women
The conversation has also reached the U.S. Food and Drug Administration.
On September 17, 2026, the FDA held a public workshop specifically focused on Testosterone Use in Menopausal Women. The agency identified critical knowledge gaps involving testosterone's potential role in sexual function, cognition, mood and musculoskeletal health, as well as challenges in measuring and interpreting testosterone levels and the lack of long-term safety data, particularly regarding cardiovascular and breast health.
The purpose of the workshop was to examine the existing scientific evidence and identify research needs that could inform future research and potential drug development.
This is significant.
The FDA examining these questions does not mean testosterone has been established as a treatment for every menopause symptom. It means the agency recognizes that testosterone use in menopausal women is an important area of clinical practice and research that needs better evidence.
There is currently no testosterone product specifically FDA-approved in the United States for women. Testosterone prescribed to women in the U.S. is therefore generally being used off-label. This regulatory situation is one reason women can encounter difficulty obtaining testosterone, even when a clinician believes it may be appropriate.
Why Are Women Already Using Testosterone?
Testosterone is already being prescribed to some women in menopause care, particularly for sexual symptoms. Menopause specialists in the United Kingdom, Australia and other countries have experience prescribing testosterone to women, and some clinicians have been advocating for broader research into its potential benefits.
The growing use of testosterone has also exposed practical problems: there are few female-specific testosterone products available in many countries, dosing can be difficult, and women may encounter pharmacies or healthcare systems that are unfamiliar with female testosterone prescribing. These real-world experiences are part of why better research and appropriate female-specific formulations matter.
Is Testosterone Currently a Standard Menopause Treatment?
Testosterone is not currently a standard treatment for most menopause symptoms. However, it does not mean testosterone has no role in women's health or that researchers have ruled out broader benefits. Current guidelines support testosterone therapy primarily for appropriately evaluated postmenopausal women with HSDD when other contributing factors have been considered and treatment is appropriate.
For symptoms such as fatigue, mood changes, cognitive complaints, muscle changes or general wellbeing, the hard evidence is still developing.
How Safe Is Testosterone for Women?
The safety picture is more reassuring than the lack of long-term data might suggest. Clinical studies of physiologic-dose transdermal testosterone in postmenopausal women have generally found that treatment is reasonably well tolerated over the short term. Studies have not demonstrated major adverse effects on blood pressure, liver or kidney function or blood cell indices, and short-term studies have not demonstrated an increased breast cancer risk.
At the same time, the available safety data have important limitations. Most randomized trials have been relatively short and long-term safety, particularly beyond two years, has not been adequately established. Women at high cardiometabolic risk were also often excluded from clinical trials, so trial findings cannot automatically be applied to every woman.
In other words, "long-term safety has not been established" does not mean "testosterone has been shown to be unsafe." It means that we need better long-term data.
What Side Effects Can Testosterone Cause?
When testosterone is prescribed at physiologic doses intended to maintain levels within the normal female range, the most commonly reported androgenic effects include:
- Acne or oily skin
- Increased facial or body hair
- Scalp hair thinning or loss
More pronounced androgenic effects, including voice deepening or clitoral enlargement, are less common but can occur, particularly when testosterone levels become excessive.
This is one reason appropriate dosing and monitoring matter. Testosterone therapy for women is intended to produce female physiologic testosterone levels, not male levels.
Can Testosterone Cause Weight Gain?
Weight and body composition are complicated during midlife. Changes in estrogen, muscle mass, physical activity, sleep, appetite, insulin sensitivity and aging can all influence body weight and fat distribution. Testosterone also affects muscle and body composition, which is why researchers continue to study its potential role in midlife weight and physical function.
However, testosterone should not currently be considered a general weight-loss treatment for menopause. If weight management is one of your concerns, MenoHello's Midlife Weight Management guide includes information on GLP-1 medications, telehealth providers, insurance and self-pay options.
How Is Testosterone Given to Women?
When testosterone is prescribed to women, transdermal therapy is generally preferred because it can deliver testosterone without the fluctuations associated with some other routes. Depending on the country and availability, transdermal testosterone may be supplied as a gel, cream, patch or other topical formulation.
In the United States, female-specific testosterone products are not currently FDA-approved, so clinicians may prescribe an FDA-approved male testosterone product off-label at a much lower dose that's appropriate for women.
Testosterone pellets and injectable or oral testosterone are generally not preferred for women because they can produce higher or less controllable testosterone exposure and may make dose adjustment more difficult.
What About Compounded Testosterone?
Compounded testosterone is sometimes used when an appropriate commercial formulation is unavailable or when a clinician believes a particular formulation is necessary.
Because these formulations are personalized, they are not FDA-approved and do not undergo the same testing or regulation as standardized products. However, the hormones used in compounding do contain FDA approved hormones that come from FDA-inspected and approved sources.
What About Testosterone Pellets?
Pellets are implanted under the skin and release testosterone over an extended period. The major concern with pellets is dose control. Once a pellet has been implanted, it cannot simply be removed if testosterone levels become too high or side effects occur. Pellets can also produce testosterone levels above the physiologic female range. For these reasons, major clinical guidance generally favors transdermal testosterone over pellets.
Do You Need a Testosterone Blood Test?
Testing testosterone in women is more complicated than many people realize. A testosterone level can be useful when considering treatment and for monitoring therapy, but a testosterone blood test cannot by itself diagnose testosterone deficiency in women. There is no universally accepted testosterone cutoff that identifies which women will have symptoms or which women will benefit from testosterone therapy.
When testosterone is prescribed, clinicians generally use total testosterone as the most practical measurement and may also evaluate SHBG and other relevant laboratory information depending on the clinical situation. Because testosterone levels are relatively low in women, laboratory methodology matters. Assays designed for the much higher testosterone concentrations found in men may not accurately measure the lower levels found in women.
What Is the Goal of Testosterone Treatment?
The goal is not to make testosterone levels as high as possible. When testosterone is prescribed for women, the objective is generally to use the lowest effective dose that maintains testosterone within the physiologic female range. Higher testosterone is not automatically better. Excess testosterone can increase androgenic side effects without providing additional benefit.
How Long Does Testosterone Take to Work?
The timeline depends on what is being treated. For sexual function, clinical guidance generally recommends evaluating response over several months rather than expecting an immediate change. For other potential outcomes such as energy, mood, cognition, muscle or general wellbeing, there is not enough evidence to establish a reliable treatment timeline.
This is another reason research matters. If testosterone eventually proves useful for broader menopause symptoms, studies will need to establish not only whether it works but also which women benefit, at what dose and how long treatment needs to continue.
Who Should Talk With a Healthcare Provider About Testosterone?
Testosterone therapy is a prescription treatment and should be discussed with a qualified healthcare professional who understands menopause care and female testosterone prescribing. A clinician may consider testosterone particularly when a woman has persistent low sexual desire that causes distress and other contributing factors have been evaluated.
For women interested in testosterone for other reasons, the conversation may be more individualized because the evidence is still developing. That does not mean you should be afraid to ask about testosterone. It means you deserve an honest discussion about what is known, what is uncertain and what other treatment options may be appropriate.
If your current provider doesn't feel comfortable prescribing or discussing testosterone, you can seek another opinion from a clinician with specific menopause expertise. MenoHello's Find a Menopause Specialist & Telehealth Providers directory can help you find providers and compare care options.
Questions to Ask About Testosterone
Before Your Appointment
☐ What symptoms are we trying to treat?
☐ Could something other than testosterone be contributing to these symptoms?
☐ Would testosterone be appropriate in my particular situation?
☐ What formulation would you recommend and why?
☐ What testosterone level will you use as my baseline?
☐ How will we monitor testosterone and side effects?
☐ What should I expect during the first few months?
☐ If you do not recommend testosterone, can you explain why and what alternatives you recommend?
Keep Track of Your Symptoms
If you're considering testosterone, documenting what you're actually experiencing can make your appointment much more useful. Track the symptoms you're hoping to change, including frequency, severity and how they affect your daily life. If you start treatment, continue tracking so you have something to compare over time.
MenoHello's Menopause Symptom Diary includes space to track physical symptoms, cognition, sleep, energy, sexual and urinary symptoms, skin and hair changes and mood. Keeping a record can also help you avoid attributing every change to testosterone. Symptoms naturally fluctuate, and tracking gives you a better way to see whether a change is consistent over time.
Have You Tried Testosterone?
Women are already having very different experiences with testosterone. Some have been prescribed it. Some have been told there isn't enough evidence. Some have had difficulty finding a provider willing to prescribe it. Others have been denied a prescription or encountered problems at the pharmacy.
Your experience is part of the larger conversation about women's health.
If you've tried testosterone, been denied testosterone, had trouble getting a prescription filled, or simply have questions about what happened when you asked for it, consider sharing your menopause story with MenoHello to share with our readers.
Women are particularly interested in hearing what others are experiencing in the real world as research and clinical guidance continue to evolve.
How Much Does Testosterone Cost?
Cost can vary significantly depending on the formulation, pharmacy, insurance coverage, whether the prescription is being used off-label and whether a compounded product is involved. If you're paying cash for hormone therapy, don't assume the first pharmacy price you see is the price you have to pay.
Use the MenoHello HRT Price Checker to compare medication prices and available discount options.
You can also check whether your menopause-related prescriptions or healthcare expenses may qualify for tax-advantaged spending through an FSA or HSA. See MenoHello's FSA & HSA Eligible Menopause Products guide for more information and always confirm eligibility with your plan administrator.
Testosterone, HRT and Other Hormones
Testosterone does not necessarily exist in isolation from other menopause hormones. Many women who use testosterone are also using estrogen, with or without progesterone. Estrogen can affect SHBG, which in turn influences how much testosterone is free and available to tissues. This is one reason hormone therapy needs to be considered as a whole rather than as a collection of unrelated hormones.
For a broader explanation of how estrogen, progesterone and testosterone interact during menopause, see MenoHello's Estrogen, Progesterone & Testosterone: How These Hormones Work Together in Menopause. You can also read The Role of Testosterone in Women During Menopause for a broader look at testosterone's role in female health.
What About Testosterone and Weight Management?
Testosterone is sometimes promoted online as a menopause weight-loss treatment. The evidence does not currently support that claim. Testosterone can affect muscle and body composition, but that is not the same thing as demonstrating that testosterone therapy is an effective treatment for menopause-related weight gain.
If weight management is one of your goals, MenoHello's Midlife Weight Management resources include information about GLP-1 medications and telehealth providers, including differences between insurance and self-pay options.
What We Know — and What We Still Need to Learn
| Area | What the Evidence Shows |
|---|---|
| Sexual function | Strongest evidence. Physiologic-dose testosterone can improve sexual function in appropriately selected postmenopausal women with HSDD. |
| Energy | Testosterone has biological roles related to physical function, but evidence is not sufficient to establish testosterone as a general treatment for menopause-related fatigue. |
| Muscle | Testosterone affects muscle biology. Research into clinically meaningful benefits for women is continuing. |
| Bone | Testosterone has biological effects on bone, but it is not established as a replacement for estrogen-based osteoporosis prevention or treatment. |
| Mood | Biologically plausible and actively studied, but not established as a general treatment for menopause-related depression or mood symptoms. |
| Cognition | An important research area, but current evidence does not establish testosterone as a treatment for cognitive symptoms. |
| Genitourinary health | Androgen receptors are present in urogenital tissues, but evidence for systemic testosterone treatment remains limited. |
| Long-term safety | Short-term data are generally reassuring at physiologic doses, but long-term cardiovascular and breast safety data remain limited. |
Frequently Asked Questions About Testosterone for Menopause
Is testosterone a male hormone?
No. Testosterone is a human hormone. Women and men both produce testosterone and use it for normal biological functions. The amount produced and the hormonal environment differ between sexes.
Can testosterone help menopause symptoms?
Testosterone therapy has the strongest evidence for improving sexual function in postmenopausal women with HSDD. Researchers are also investigating potential benefits involving energy, mood, cognition, muscle, bone, genitourinary health and quality of life, but evidence is not yet equally strong across these areas.
Is testosterone FDA-approved for menopause in the United States?
No. There is currently no testosterone product specifically FDA-approved for women or for menopause in the United States. Testosterone may nevertheless be prescribed off-label by a healthcare professional when clinically appropriate.
Why isn't testosterone a standard treatment for all menopause symptoms?
Because the clinical evidence has not yet established its effectiveness for most menopause symptoms. This is different from saying testosterone has no biological role in those symptoms. The FDA is currently examining the evidence and research gaps surrounding testosterone use in menopausal women.
Does testosterone help with low energy?
Testosterone has biological effects related to muscle and physical function, and energy is an active area of research. However, testosterone has not been established as a general treatment for menopause-related fatigue.
Can testosterone improve mood?
Testosterone interacts with neurological pathways and mood is being studied as a potential treatment area. Current evidence is not sufficient to recommend testosterone as a general treatment for depression or menopause-related mood symptoms.
Can testosterone improve brain fog?
Cognition is one of the areas researchers are studying, but current evidence does not establish testosterone as a treatment for menopause-related brain fog or cognitive impairment.
Does testosterone help build muscle?
Testosterone is involved in muscle biology, but testosterone therapy should not currently be viewed as a general muscle-building treatment for menopausal women. More research is needed to determine which women might benefit and what clinically meaningful outcomes occur.
Does testosterone protect bones?
Testosterone has biological effects on bone and can be converted to estradiol, which also affects bone. However, testosterone is not currently established as a replacement for estrogen-based therapy for prevention or treatment of osteoporosis.
Can women have low testosterone even if their blood test is normal?
Symptoms and testosterone levels do not have a simple one-to-one relationship in women. There is no universally accepted testosterone level that defines deficiency or predicts who will benefit from treatment. A blood test should therefore be interpreted in the context of symptoms, medical history and the reason testing was performed.
Is testosterone therapy safe for women?
Short-term studies of physiologic-dose transdermal testosterone have generally found a reassuring safety profile, with androgenic side effects such as acne and increased hair growth among the more common concerns. Long-term safety, particularly cardiovascular and breast safety, remains less certain because long-term data are limited.
Should women be afraid of testosterone?
There is no reason to treat testosterone as inherently dangerous simply because it is commonly associated with men. Testosterone is a normal human hormone. The more useful question is whether testosterone therapy is appropriate for a particular woman, at what dose, for what purpose and with what monitoring.
What should I do if my doctor refuses to prescribe testosterone?
Ask your provider to explain the specific reason. You can also seek a second opinion from a clinician with menopause expertise. MenoHello's Menopause Specialists & Telehealth Providers directory can help you find clinicians and services that focus on menopause care.
What if I have already tried testosterone?
Consider tracking what changed, what did not change and whether you experienced side effects. If you would like to share your experience, MenoHello invites women to share their menopause stories, including experiences with testosterone prescriptions, denials, pharmacy problems and treatment results.
Related MenoHello Resources
Prepare for a conversation about treatment:
- Find a Menopause Specialist & Telehealth Provider
- Menopause Symptom Tracking Diaries
- Share Your Menopause Story
Manage the practical side of menopause care:
- HRT Price Checker
- FSA & HSA Eligible Menopause Products
- Midlife Weight Management & GLP-1 Telehealth Providers
- MenoHello Menopause Resources, including Books Worth Reading
The Bottom Line
Testosterone is not a male hormone. It is a human hormone that women produce and need throughout life.
We know testosterone has important biological roles in sexual function, muscle, bone, brain function, mood and other tissues. We also have meaningful evidence that physiologic-dose testosterone therapy can improve sexual function in appropriately selected postmenopausal women with HSDD.
What we do not yet know is how much of testosterone's potential can be translated into meaningful clinical benefits for women experiencing other menopause symptoms. This question is now receiving more attention. New studies are examining testosterone's effects beyond sexual health, the ESTEEM trial is investigating menopause-related quality of life, and the FDA has specifically convened researchers and clinicians to examine testosterone use in menopausal women.
The goal isn't to declare testosterone a miracle hormone for menopause. It is to make sure women get the research needed to understand what this hormone can actually do for them.
This article is for informational and educational purposes only and does not constitute medical advice. The information provided should not be used as a substitute for professional medical consultation, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding hormone therapy, bone health, osteoporosis prevention, or any medical condition.
Symptom Relief
Managing menopause symptoms can feel overwhelming, especially when effective solutions seem hard to find. From unexpected skin changes to frustrating hot flashes, these shifts can impact daily life and overall well-being. Explore our Symptom Relief page to discover products that other women have found helpful in managing their symptoms of perimenopause and menopause.
If you’ve found a product that has made a difference for you, let us know through our contact form—we’d love to share it with others!
Explore More
Want to dive deeper into menopause and its symptoms? Visit our Resources page, where you’ll find a collection of studies, articles, and books from trusted experts. Whether you're looking for the latest research or practical insights, these resources can help you better understand your body and make informed decisions about your menopause journey.
Related Reading:
References
- U.S. Food and Drug Administration (2026). FDA Public Meeting: Testosterone Use in Menopausal Women.
- Hernandez BS, Boyne AM, Fleming B, et al. (2026). Improvement in multiple organ systems following testosterone replacement therapy in women previously on standard hormone replacement therapy. The Journal of Sexual Medicine. 23(9):qdag116. doi:10.1093/jsxmed/qdag116.
- Davis SR, Baber R, Panay N, et al. (2019). Global Consensus Position Statement on the Use of Testosterone Therapy for Women. Journal of Clinical Endocrinology & Metabolism. 104(10):4660–4666. doi:10.1080/13697137.2019.1637079.
- Achilli C, Pundir J, Ramanathan P, et al. (2017). Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis. Fertility and Sterility. 107(2):475–482.e15. doi:10.1016/j.fertnstert.2016.10.028.
- Islam RM, Bell RJ, Green S, et al. (2019). Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. The Lancet Diabetes & Endocrinology. 7(10):754–766. doi:10.1016/S2213-8587(19)30189-5.
- Parish SJ, Simon JA, Davis SR, et al. (2021). International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. The Journal of Sexual Medicine. 18(5):849–867.
- National Institute for Health and Care Excellence (NICE) (2024). Menopause: diagnosis and management. NICE Guideline NG23.
- Nachtigall L, Casson P, Lucas J, et al. (2011). Safety and tolerability of testosterone patch therapy for up to 4 years in surgically menopausal women receiving oral or transdermal oestrogen. Gynecological Endocrinology. 27(1):39–48. doi:10.3109/09513590.2010.487597.
- Glaser R, Dimitrakakis C. (2013). Testosterone therapy in women: myths and misconceptions. Maturitas. 74(3):230–234. doi:10.1016/j.maturitas.2013.01.003.
- Glynne S, Kamal A, Kamel AM, et al. (2024). Effect of transdermal testosterone therapy on mood and cognitive symptoms in peri- and postmenopausal women: a pilot study. Archives of Women's Mental Health. doi:10.1007/s00737-024-01513-6.
- Panay N. (2022). Testosterone replacement in menopause. Post Reproductive Health. doi:10.1177/20533691221104266.
- Hamoda H, Panay N, Arya R, Savvas M. (2020). The British Menopause Society & Women's Health Concern 2016 recommendations on hormone replacement therapy in menopausal women. Post Reproductive Health. 26(4):181–209.
- Testosterone therapy for female sexual dysfunction: a systematic review of the literature demonstrating outcomes in premenopausal and postmenopausal women (2026). The Journal of Sexual Medicine. 23(8):qdag206.
- ISRCTN Registry Evaluating the clinical and cost-effectiveness of testosterone to improve menopause-related quality of life (ESTEEM).
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