Can testosterone help with menopause?

Declining levels of oestrogen and progesterone can cause a range of symptoms during menopause. But did you know that low testosterone levels could affect your health and wellbeing in menopause too?  

Despite being thought of as a male hormone, testosterone is also crucial for women’s health. Some evidence suggests that lower testosterone in menopause can affect your libido (sex drive) and mood.  

In this article, we look at why testosterone is important for women, the impact of declining testosterone levels during menopause, and what you can do about it. 
 
We cover: 

• What is the role of testosterone in women? 
• What happens to testosterone levels in menopause? 
• How can I increase my testosterone level during menopause? 
• How can I check my testosterone level? 
• Where can I find out more about menopause? 

What is the role of testosterone in women?
 

Testosterone helps regulate several processes in your body to keep everything running smoothly. The female body converts testosterone to oestrogen, and it’s important for reproduction, growth, and general health and wellbeing. 

Testosterone plays many roles in the female body, including:   

• Maintaining bone density  
• Maintaining muscle mass and strength  
• Regulating libido (sex drive) 
• Supporting energy levels 
• Regulating mood 
• Making red blood cells  

What is testosterone?  
 

Testosterone has an important role in the overall health of men and women. It's important for regulating mood, sex drive, and maintaining muscle and bone strength.  

So, although we often think of testosterone as a purely male hormone, this isn’t the case. Everybody makes testosterone — albeit women make much less than men. In males, testosterone is mainly made in the testes, while in women, it’s mostly produced in the ovaries. 

What happens to testosterone levels in menopause?
 

In the transition toward menopause (known as perimenopause), your testosterone level typically falls along with other hormones such as oestrogen and progesterone.  

This drop in testosterone occurs naturally as part of the ageing process in men and women. But in women, the fall in testosterone appears to be partly due to the loss of ovarian function in menopause.  

If you have an induced menopause, either surgically or medically, your testosterone level can drop very suddenly. This is because your ovaries produce most of the testosterone in your body. 

What are the symptoms of low testosterone in menopause?  
 

Lower testosterone levels in menopause can cause a wide range of symptoms. But it’s important to remember that every woman’s experience of menopause is unique, including the symptoms experienced and the effect they may have on health and wellbeing. 

Common symptoms of low testosterone in menopause include:  

• Loss of interest in sex (low libido)  
• Less pleasurable sex (reduced ability to get aroused and have an orgasm) 
• Tiredness  
• Lack of energy 
• Brain fog (including poor concentration and forgetfulness) 
• Headaches 
• Low mood 

According to the British Menopause Society (BMS), testosterone deficiency can lead to heightened menopausal symptoms [1]. In our Menopause Survey 2023, 67% of women reported experiencing reduced sex drive (libido) as a menopausal symptom.  

If you’re experiencing any menopausal symptoms and they’re affecting your daily life, we recommend you speak to your doctor for advice and support.  

How can I increase my testosterone level during menopause?
 

Your testosterone level can be increased with testosterone replacement therapy (TRT). TRT is generally available as gels or creams that can be applied to the skin.  

Awareness of the potential benefits of TRT was raised by what the media has termed the Davina McCall effect. The celebrity’s TV programme, Davina McCall: Sex, Myths, and Menopause, as well as her books and Instagram videos, discuss the impact of falling testosterone in menopause while singing the praises of TRT. 

Women are becoming more aware of the importance of testosterone, and according to data analysed by the Pharmaceutical Journal, there was a ten-fold increase in testosterone prescribing for women in the UK between 2015 and 2023. 

Our Menopause Survey 2023 found that 36% of women who had tried TRT rated it as invaluable as a menopause treatment — a similar percentage (44%) to that of women who considered conventional hormone replacement therapy (HRT) to be invaluable. 

However, experts have called for caution in portraying testosterone as a wonder drug for the complex issues women can go through during perimenopause.  

Although there’s evidence for testosterone treatment helping to improve distressing low libido (known as hypoactive sexual desire disorder or HSDD) in women, the BMS reports more research is needed in relation to its use for other menopausal symptoms. 

Can my GP prescribe testosterone for menopause?  
 

Testosterone treatments are currently unlicensed to treat menopausal symptoms in the UK. This means they may not always be available, and you may need to see a menopause specialist to be prescribed TRT.  

National Institute for Health and Care Excellence (NICE) menopause guidance and BMS recommend that a trial of conventional HRT (usually a combination of oestrogen and progesterone) is given before testosterone therapy is considered. So, your GP may see if HRT alleviates your menopausal symptoms, before considering TRT.  

When you visit your GP, they may:  

• Do further tests such as a blood test to rule out other conditions that could be causing menopause-like symptoms, such as a thyroid condition.  
• Refer you to a specialist such as a specialist menopause clinic run by gynaecologists or GPs with a specialist interest in menopause who can further investigate your hormones and symptoms. 

 

Should I take testosterone for menopause?   
 

In some cases, testosterone replacement therapy should be avoided or used with caution. These include:  

• Women with a history of hormone-sensitive breast cancer 
• Women with active liver disease 
• Competitive athletes – care must be taken to keep testosterone levels within the normal range for females 
• Women with upper normal or high baseline testosterone levels 

 

What are the side effects of taking testosterone as a woman?  
 

If you’re taking the right amount of testosterone and your level is maintained within the normal range for females, you’re unlikely to experience any side effects.  

Possible side effects of testosterone therapy include: 

• Excess hair growth on the face and chest 
• Oily skin or acne 
• Weight gain 

Side effects are normally reversible by reducing the dosage or stopping the treatment.  If you’re taking TRT, your doctor should arrange regular blood tests to monitor your testosterone level, so they can make sure the amount of testosterone you’re taking is right for you.

If you’re experiencing any side effects, discuss the dosage with your doctor, and never use more than the recommended amount.   

Can I improve low testosterone symptoms naturally?  
 

Lifestyle changes could help you manage some of the symptoms of low testosterone. For instance, doing gentle exercise and making sure you get a good night’s sleep could help with low mood and fatigue. 

Although there’s evidence that testosterone treatment can improve persistent low libido in menopause, it doesn’t work for everyone. Low libido is a complex issue and low testosterone is only one of many possible causes of a loss of interest in sex or less pleasurable sex. 

Other possible causes include relationship issues — this can be common if you’ve been in a relationship for a long time and become overfamiliar with your partner. Also, fatigue, stress, mental health issues such as depression and anxiety, and some medications such as SSRI antidepressants can all affect how you feel about sex.  

If you’re concerned about your libido, especially if you’re finding your reduced sex drive is distressing or affecting your relationship, we recommend you see your GP. They will be able to explore underlying causes and recommend appropriate treatments, which may include relationship counselling or a talking therapy like cognitive behavioural therapy (CBT) (you can also self-refer for CBT online). 

How can I check my testosterone level?
 

If you’re experiencing any symptoms of low or high testosterone, our home finger-prick Testosterone Blood Test could indicate whether your testosterone level is outside the normal range.   

If you’d like to check your testosterone level alongside key female hormones, try our at-home Female Hormone Blood Test, which includes nine key hormone health markers including:   

• Total and free testosterone (calculated)  
• Oestradiol  
• Follicle-stimulating hormone (FSH)   

These tests can provide insights that may help you to take action to improve your health and wellbeing.  
 
 

Where can I find out more about menopause?
 

Menopause is a natural phase of life. But unfortunately, there still seems to be a stigma around talking about this important female health topic. It’s not surprising that many women feel unprepared for the changes that happen around menopause and unsure how to manage their symptoms.   

If you’re experiencing menopausal symptoms, such as hot flushes, night sweats, mood swings, or irregular periods, you may want to check your menopausal status.  

Our Menopause Blood Test checks five hormones to assess your menopausal status, including thyroid hormones, as symptoms of a thyroid-related condition can be similar to those of menopause. 

The Menopause Charity and Women’s Health Concern are also great sources of information, advice, and support on menopause. 

 

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References 

1. British Menopause Society (2022) Testosterone replacement in menopause. Available at: https://thebms.org.uk/wp-content/uploads/2022/12/08-BMS-TfC-Testosterone-replacement-in-menopause-DEC2022-A.pdf (Accessed: 06 November 2023).