What testosterone does in women's bodies and how it changes in midlife.
Key Takeaways
- Testosterone Is a Women's Hormone Too: Before menopause, women produce three times as much testosterone as estrogen. Levels decline gradually with age, or abruptly after surgical removal of the ovaries.
- It Does More Than Drive Libido: Testosterone is involved in sexual function, muscle, bone, mood, cognition, and energy.
- It's Typically Added to HRT: When added to menopause hormone therapy that includes estrogen, testosterone can improve sexual function and overall wellbeing, and many women also notice better mood, concentration, motivation, and energy.
- Access Is Catching Up: No testosterone product is FDA-approved for women in the U.S., so it is prescribed off-label. That gap reflects years of under-studied women's health, and it is finally changing. For details, see our full testosterone guide.
Testosterone is often called a "male hormone," but that label isn't biologically accurate. Women produce testosterone throughout life, and tissues from muscle and bone to the brain and genital tract have receptors that respond to it.
This guide is your starting point: what testosterone does, how it changes in midlife, and how it can fit into menopause hormone therapy (MHT, also called HRT). When you're ready for the details on benefits, risks, testing, and treatment, our companion guide, Testosterone for Menopause: Benefits, Risks, Testing & What to Know, covers it all.
Not sure where you are in the transition? Start with our Am I in Menopause? Quiz.
What Does Testosterone Do in Women?
Testosterone is involved in far more than sexual desire. The same 2020 guide notes it can be important in women for bone density, muscle mass, cognitive function, mood, sexual function, and energy, and that adequate levels matter for musculoskeletal health and possibly vascular and brain function. Here's where it shows up:
| Area | What Testosterone Does |
|---|---|
| Sexual Function | Involved in sexual desire, arousal, orgasm, and sexual response. Adding testosterone to hormone therapy can improve sexual function in postmenopausal women. |
| Muscle & Physical Function | Helps maintain muscle tissue and supports musculoskeletal health. |
| Bone | Involved in bone density and can be converted to estradiol. The 2020 guide reports increased bone density when testosterone is combined with estrogen as part of HRT, while estrogen remains the foundation of bone protection. See How Much Estrogen Do Your Bones Need? |
| Energy | Plays a role in physical vitality. Many women report more energy after adding testosterone to their hormone therapy. |
| Mood | Androgen receptors are present in the brain. Many women report better mood, motivation, and concentration when testosterone is added to HRT. |
| Thinking & Memory | Acts on the brain and may support cognitive performance when combined with estrogen as part of HRT. |
| Vulvovaginal & Urinary Tissues | Androgen receptors are found throughout the lower urinary and genital tract, and urogenital symptoms have been reported to improve when testosterone is added to HRT. Vaginal estrogen and other local treatments remain important options for the genitourinary syndrome of menopause. |
In menopause care, testosterone is typically added to hormone therapy that includes estrogen. To see how the research looks area by area, check the "What We Know" table in our testosterone for menopause guide.
Testosterone Production and Natural Change in Midlife
In women, testosterone is produced mainly in the ovaries and adrenal glands. The body can also convert other hormones into testosterone, and convert testosterone into other active hormones, including estradiol. That means its effects aren't limited to one organ or one biological process.
According to a 2020 clinical guide in the British Journal of General Practice, women produce three times as much testosterone as estrogen before menopause. Levels then decline gradually with age, or abruptly after surgical removal of the ovaries (oophorectomy). Menopause also changes the hormonal environment testosterone works in: estrogen falls substantially, and ovarian and adrenal hormone production shifts with age.
Testosterone works alongside estrogen and progesterone, not instead of them. That's why it's typically considered as an add-on to menopause hormone therapy that includes estrogen. For the bigger view, see our guide to how estrogen, progesterone, and testosterone work together in menopause, or compare the hormones used in HRT side by side in HRT at a Glance.
Symptoms That May Be Linked to Testosterone Changes
Most women associate testosterone with libido, but the changes can be broader. These symptoms may occur alongside hormonal shifts in midlife:
- 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 concentration or memory
- Changes in vaginal or vulvovaginal health
If several of these sound familiar, especially alongside other menopause symptoms, it's worth raising with a menopause-informed clinician. If sexual changes are your main concern, our guide to sexual health during menopause covers the many factors that can play a role.
Testosterone Is Part of the Bigger Hormone Picture
These symptoms can also overlap with changes in estrogen and progesterone, sleep, stress, thyroid and iron levels, and mood. A menopause-informed clinician can look at the whole picture and help you decide whether adding testosterone to your hormone therapy makes sense for you.
Tracking what you're experiencing makes that conversation far more useful. Use the checklist below, or download our Menopause Symptom Diary to track patterns over time.
Sexual Health
☐ Less interest in sex than I used to have, and it bothers me
☐ Difficulty becoming aroused
☐ Changes in orgasm or sexual satisfaction
☐ Vaginal dryness or discomfort during sex
Energy & Physical Wellbeing
☐ Persistent low energy or exhaustion
☐ Less stamina during exercise or daily activities
☐ Noticeable loss of muscle tone or strength
Mood & Thinking
☐ Low mood or feeling flat
☐ Irritability or emotional ups and downs
☐ Trouble concentrating or brain fog
☐ Memory lapses
Hair & Body
☐ Thinning scalp hair
☐ Unexpected changes in weight or body composition
Can You Have Too Much Testosterone?
Yes, and it's one reason dosing and monitoring matter when testosterone is prescribed. Excess androgen effects can include:
- Acne or oily skin
- Increased facial or body hair
- Scalp hair thinning or loss
More pronounced effects, such as voice deepening or clitoral enlargement, are less common but can occur when levels become excessive. If you notice new acne, hair growth, or hair thinning, mention it to your clinician rather than assuming the cause.
Testosterone as Part of Menopause Hormone Therapy
For many women, testosterone works as an add-on. Clinicians typically prescribe it alongside estrogen as part of menopause hormone therapy (MHT/HRT), and guidance is increasingly supportive:
- Sexual function: UK guidelines from NICE say testosterone can be considered for menopausal women with low sexual desire when HRT alone isn't effective, and the British Menopause Society advises this can extend to women with low desire and tiredness. International guidelines also support testosterone for postmenopausal women with hypoactive sexual desire disorder (HSDD), which is persistently low sexual desire that causes distress.
- Beyond sexual health: The authors of the 2020 clinical guide report that adding testosterone to estrogen-based HRT has been shown to improve urogenital, psychological, and physical symptoms, bone density, and cognitive performance. Many women notice better mood, concentration, motivation, and energy. Research in these areas is still growing.
- Give it time: It can take several weeks or even months to notice the benefits. If you haven't noticed an improvement after about six months, testosterone is unlikely to help, and that's a good time to check in with your clinician.
- Why it's prescribed off-label: No testosterone product is FDA-approved for women in the U.S., so clinicians prescribe products made for men at much lower doses. That gap largely reflects how long women's health has been under-studied, and it's changing. The FDA held a public workshop on testosterone use in menopausal women on September 17, 2026, and the UK approved a testosterone cream for women with HSDD in August 2025. Read about the UK approval.
For everything else, including who may be a candidate, forms and delivery, testing, safety, side effects, and questions to ask your provider, read our full guide: Testosterone for Menopause: Benefits, Risks, Testing & What to Know.
Everyday Habits That Support How You Feel
There's no proven lifestyle "testosterone boost" for menopausal women, and evidence that diet or exercise meaningfully raises testosterone in women is limited. But these habits support muscle, bone, energy, and mood, the very areas many women worry about in midlife:
- Strength training: Supports muscle mass and bone health as estrogen declines.
- Nutrition: Adequate protein and a varied, nutrient-rich diet support muscle and overall wellbeing. If weight is a concern, our Midlife Weight Management guide covers GLP-1 medications, telehealth providers, and insurance and self-pay options.
- Sleep and stress management: Poor sleep and chronic stress can worsen fatigue, mood, and brain fog, the same symptoms often attributed to low testosterone.
Be cautious with "testosterone booster" supplements and DHEA, a precursor hormone the body can convert into other hormones. Supplements aren't reviewed by the FDA for effectiveness before they're sold, so talk with your clinician before starting any of them. Our guide to supplements for menopause symptom relief is a good place to start.
Take the Next Step
If you're curious about testosterone, you deserve an honest conversation with a clinician who understands menopause care. If your current provider isn't comfortable discussing it, seeking another opinion from a menopause specialist is reasonable. These tools can help:
- Am I in Menopause? Quiz: get a clearer picture of where you are in the transition.
- Find a Menopause Specialist & Telehealth Providers: locate clinicians who focus on menopause care.
- HRT Price Checker: compare medication prices and discount options.
- FSA & HSA Eligible Menopause Products: see what may qualify for tax-advantaged spending, and confirm eligibility with your plan administrator.
- Share Your Menopause Story: tried testosterone, been denied it, or hit a snag at the pharmacy? Other women want to hear from you.
Frequently Asked Questions About Testosterone in Menopause
Is testosterone a male hormone?
No. Testosterone is a human hormone. Women and men both produce it and use it for normal biological functions. The difference is in the amount produced and how tissues respond.
Does testosterone decline during menopause?
Testosterone levels decline gradually with age, or abruptly after surgical removal of the ovaries. Menopause also changes the hormonal environment testosterone works in, so the pattern varies from woman to woman.
Is testosterone taken on its own or with HRT?
In menopause care, testosterone is typically added to hormone therapy that includes estrogen. It works alongside estrogen and progesterone, not in place of them.
How do you know if your testosterone is low?
Most available tests aren't accurate or precise enough at the low concentrations found in women, so the normal range is difficult to define. That's why clinicians look at your symptoms and the whole hormonal picture, not just one number. Our full testosterone guide explains testing in more detail.
The Bottom Line
Testosterone is a human hormone that women produce and need throughout life. It plays important roles in sexual function, muscle, bone, brain function, mood, and energy, and clinicians are increasingly adding it to estrogen-based hormone therapy to help women feel better in midlife.
The system for prescribing it hasn't caught up: there is still no FDA-approved testosterone product for women. That reflects how long women's health has been under-studied, and it's changing. You don't need to be afraid to ask about testosterone. Track your symptoms, ask specific questions, and when you're ready to go deeper, our guide to testosterone for menopause has the details.
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 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.
Dive Deeper Into Menopause
References
- Scott A, Newson L. (2020). Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care. British Journal of General Practice. 70(693):203–204.
- 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.
- 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: identification and management. NICE Guideline NG23.
- 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.
- 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.
- Glaser R, Dimitrakakis C. (2013). Testosterone therapy in women: myths and misconceptions. Maturitas. 74(3):230–234.
- Panay N. (2022). Testosterone replacement in menopause. Post Reproductive Health.
- Furlan VA, Hammad MAM, Quesada S, Nguyen S, Yih J. (2026). 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.
- U.S. Food and Drug Administration. (2026). FDA Public Meeting: Testosterone Use in Menopausal Women.
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