Testosterone therapy for women: the missing piece in menopause care?

When women think of hormones linked to perimenopause and menopause, oestrogen and progesterone usually come to mind. And for good reason; these two are the headline acts of hormone replacement therapy (HRT). But there’s another hormone whose impact on the female body deserves attention, too: testosterone.

Although it’s often thought of, and referred to, as a “male hormone,” testosterone plays an important role in women’s health and wellbeing, influencing libido, mood, energy levels, and even mental clarity.¹ During perimenopause and menopause, when hormone levels naturally shift, many women notice symptoms that testosterone therapy could help to address.

So, what exactly is testosterone’s role in women’s health, and could testosterone therapy be the missing piece in your treatment plan?

What is testosterone?

Testosterone is part of a group of hormones called androgens. It’s actually the most common active hormone in women, and while it’s present in smaller amounts than in men, its effects are significantly impactful on the female body.

Produced mainly in the ovaries, testosterone peaks in women in their 20s and 30s and then begins to decline gradually with age.² By the time a woman reaches perimenopause or menopause between the ages of 45-55, reduced testosterone levels may cause noticeable symptoms.

Why does testosterone matter for women?

Testosterone can affect:¹

• Sexual health: supporting desire, arousal, pleasure, and orgasm.

• Mood: helping to regulate emotional wellbeing.

• Cognitive function: supporting focus, memory, and mental clarity.

• Energy: reducing fatigue and supporting motivation.

• Joint and muscular health: helping to relieve pain and discomfort in joints and muscles.

• Bladder health and function: reducing incontinence and improving overall bladder health.

Despite these benefits, testosterone has long been overlooked in women’s health, with declining libido, brain fog, and low energy often being brushed off as “part of getting older”, and not symptoms that can be treated.

The research could suggest a different picture, however. Studies have found that testosterone therapy in women has the potential to improve mood¹ and cognition,¹ sexual function,³ and even other more common menopausal side effects such as hot flushes and sleep problems.¹

How do women take testosterone?

Testosterone therapy can be used on its own or alongside oestrogen and progesterone as part of HRT. Dosage is carefully managed to keep testosterone levels within the normal female range.

Until recently, only products indicated for men were licensed in the UK, so testosterone therapy was only prescribed for women off label. However, advancements in testosterone therapy for women are on the horizon. In July 2025, the MHRA approved Androfeme cream (1%)⁵ as the first licensed testosterone product in the UK for postmenopausal women. It’s anticipated that this new, UK-approved product will be launched in 2026.

Busting the myths about testosterone therapy

As testosterone has been labelled a “male hormone” for so long, there are plenty of myths that can put women off from exploring treatment as a viable option to help with their symptoms. Let’s clear a few up:

• “It’s only for men.” False. Testosterone is an androgen that women naturally produce. Androgens play a key role in sexual function, bone and muscle health, energy, and psychological wellbeing.⁶

• “It will deepen my voice and make me more aggressive.” Voice changes are unlikely to happen if your testosterone levels are kept within the normal female range.³ Studies suggest that testosterone therapy decreases aggression, irritability and anxiety in over 90% of patients.¹

• “It isn’t safe for women.” When prescribed at the correct physiological dose for women, testosterone treatment and its risks can be effectively managed.³ 

Is testosterone therapy right for you?

Currently, testosterone therapy is generally only prescribed to women experiencing low libido and low sexual desire - also known as hyposexual desire disorder (HSDD) - that hasn’t improved with standard HRT or mental health support.⁷ If you want to understand whether testosterone therapy might be an option for you:

• Start with a blood test. Measuring your testosterone levels before treatment sets a baseline. Our perimenopause, menopause and female hormone blood tests measure testosterone as a key biomarker.

• Track your progress. We encourage re-taking your blood test after 3 months to monitor any changes in your testosterone levels. Our clinicians will be able to guide you through the process and make sense of your results.

• Expect gradual change. If you and your doctor decide that testosterone therapy is right for you, it may take 3-6 months for changes to occur.⁸ If you don’t notice benefits, or if your levels aren’t changing, your doctor will be able to advise you on alternative treatments for your symptoms.

It’s also worth noting that if your testosterone levels are low but you’re not experiencing uncomfortable symptoms, you may not need treatment at all.

The numan take

Perimenopause and menopause can affect every part of your life, from your sex drive to your mental clarity. While oestrogen and progesterone get most of the spotlight, testosterone could be the missing piece that helps you get your mojo back.

If you’re struggling with symptoms like low libido, brain fog, or changes in mood that aren’t improving with standard HRT, it might be time to get your testosterone levels checked. With the right knowledge, testing, and treatment, you can take back control and start feeling more like yourself again.

References

1. Glaser R, York AE, Dimitrakakis C. Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale (MRS). Maturitas. 2011 Apr;68(4):355–61.

2. Burger HG. Androgen production in women. Fertility and Sterility [Internet]. 2002 Apr 1;77:3–5. Available from: https://www.fertstert.org/article/S0015-0282(02)02985-0/fulltext

3. Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. The Lancet Diabetes & Endocrinology. 2019 Jul;7(10).

4. Scott A, Newson L. Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care. The British journal of general practice: the journal of the Royal College of General Practitioners. 2020;70(693): 203–204.

5. Venter M. MHRA approves testosterone cream for UK postmenopausal women. Lawley Pharmaceuticals Pty Ltd. 2025. [accessed 5 Sept 2025] Available from: https://www.lawleypharm.com.au/news/mhra-approves-testosterone-cream-for-uk-postmenopausal-women/

6. Bianchi VE, Bresciani E, Meanti R, Rizzi L, Omeljaniuk RJ, Torsello A. The role of androgens in women’s health and wellbeing. Pharmacological Research. 2021 Sep;171:105758.

7. Parish SJ, Simon JA, Davis SR, Giraldi A, Goldstein I, Goldstein SW, et al. 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. Journal of Women’s Health. 2021 Apr 1;30(4):474–91.

8. BRITISH MENOPAUSE SOCIETY Tool for clinicians Information for GPs and other health professionals.