If your interest in sex seems to have quietly disappeared during menopause, you may have wondered whether testosterone could help.
Once thought of as a “male hormone”, testosterone is increasingly being discussed as part of menopause treatment. Prescriptions for women are rising, and social media is full of claims that it can restore everything from libido and energy to confidence, concentration and muscle strength.
But what does testosterone actually do for women—and does the evidence live up to the hype?
Women Have Testosterone Too
Testosterone is often associated with men, but women naturally produce it too. It is made by the ovaries and adrenal glands and is thought to play a part in sexual desire, arousal and general sexual wellbeing.
Testosterone levels gradually decline with age, beginning well before menopause. They can fall much more suddenly following surgery to remove the ovaries.
However, a low result on a blood test does not automatically explain why someone has lost interest in sex. Female desire is complicated and can be affected by hormones, relationships, stress, sleep, medication, body confidence, vaginal discomfort and numerous other factors.
This is why testosterone should never be presented as a magic solution for every woman experiencing low libido.
What Can Testosterone Help With?
The clearest evidence for testosterone treatment is for persistent, distressing low sexual desire associated with menopause—particularly when standard HRT has not helped enough.
NICE recommends that testosterone supplementation can be considered for low sexual desire associated with menopause if HRT alone has not been effective. The NHS also says that testosterone gel or cream may improve low libido for some women.
For women who respond well, possible improvements may include:
-
Feeling interested in sex more often
-
Becoming aroused more easily
-
Experiencing more satisfying sexual activity
-
Finding it easier to reach orgasm
-
Feeling less distressed by the loss of sexual desire
It isn’t about making someone want sex constantly. The aim is to help restore a level of desire that feels comfortable and normal for that individual.
Does Testosterone Help With Energy and Brain Fog?
This is where the conversation becomes less clear.
You may see testosterone promoted as a treatment for tiredness, low mood, poor concentration, reduced muscle strength, weight gain or loss of confidence. Some women taking it do report feeling more energetic or more like themselves.
However, there is not currently enough good-quality evidence to recommend testosterone specifically for brain fog, fatigue, mood, bone health, muscle strength or dementia prevention.
The British Menopause Society states that the current evidence-based reason for adding testosterone to standard HRT is persistent low libido after other contributing factors have been addressed.
That doesn’t mean women’s experiences should be dismissed. It means we need more research before broader claims can be made with confidence.
Low Desire Isn’t Always About Testosterone
Before prescribing testosterone, a healthcare professional should look at the wider picture.
Low libido during menopause may be connected to:
-
Vaginal dryness or painful sex
-
Poor sleep and exhaustion
-
Hot flushes and night sweats
-
Anxiety, low mood or depression
-
Stress and mental overload
-
Relationship difficulties
-
Body-image changes
-
Certain medications, including some antidepressants
-
Other health conditions
-
Inadequately controlled menopause symptoms
If sex has become uncomfortable, treating vaginal dryness may make a much greater difference than testosterone alone. Vaginal oestrogen, moisturisers and a suitable lubricant can all be worth discussing.
Likewise, if you are barely sleeping, feeling overwhelmed or experiencing relationship problems, those factors deserve attention too.
Loss of desire is real, but it is rarely as simple as one hormone being “too low”.
Do You Have to Be Taking HRT First?
UK guidance generally recommends optimising conventional HRT before considering testosterone.
Oestrogen can improve several problems that contribute to low desire, including flushes, sleep disruption, vaginal symptoms and discomfort. If these symptoms improve but distressing low libido remains, testosterone may then be considered.
Not every woman can or wants to take HRT, however. Treatment decisions should always be made individually with a suitably qualified healthcare professional.
How Is Testosterone Taken?
In the UK, testosterone is normally prescribed as a gel applied to the skin in a very small dose.
There is currently no testosterone product licensed specifically for women in the UK. This means products manufactured for men may be prescribed “off-label” at a much lower female dose.
Off-label does not mean that a treatment is automatically unsafe or experimental. It means the medicine is being used in a way that is not covered by its original UK licence. The prescriber should explain this and provide instructions on exactly how much to use.
It is important not to estimate your own dose or use someone else’s testosterone. Male preparations contain far more testosterone than a woman would usually require.
Depending on local NHS prescribing arrangements, testosterone may be prescribed by a GP, a clinician with a specialist interest in menopause or a menopause clinic.
How Long Does It Take to Work?
Testosterone is not an instant libido switch.
Some women notice a difference after several weeks, but it can take a few months to properly assess the effect. Your prescriber may suggest a trial period while monitoring your symptoms and blood-test results.
If there has been no meaningful improvement after around six months, treatment would usually be reviewed and may be stopped.
Keeping a simple symptom diary can help. Rather than concentrating only on how frequently you have sex, consider whether your interest, arousal, enjoyment or distress around the issue has changed.
Will You Need a Blood Test?
Blood tests may be taken before treatment to establish a baseline and ensure your testosterone level is not already high.
Further tests are normally used to check that treatment is keeping testosterone within the expected female range. They are not a simple test of whether you “need” testosterone, nor can a particular number reliably predict whether treatment will improve your libido.
Your symptoms, medical history, response to treatment and blood results all need to be considered together.
What Are the Possible Side Effects?
When testosterone is prescribed at an appropriate female dose and properly monitored, side effects are generally uncommon.
Possible effects can include:
-
Acne or oily skin
-
Increased facial or body hair
-
Hair thinning
-
Irritation where the gel is applied
-
Weight gain
Using too much testosterone can cause more significant changes, including a deeper voice, enlargement of the clitoris and male-pattern hair loss. Some of these changes could be irreversible, which is why correct dosing and regular monitoring matter.
You should contact your prescriber if you develop unwanted side effects rather than altering the dose yourself.
Is Testosterone Safe?
Available evidence is reassuring when testosterone is used at female doses under medical supervision, but information about very long-term use remains limited.
Women’s Health Concern notes that studies covering up to five years have not shown adverse effects in healthy postmenopausal women, while also acknowledging the lack of longer-term safety data.
Your personal medical history still matters. Anyone with a history of hormone-sensitive cancer, liver disease or another significant health condition should receive individual specialist advice.
How to Ask Your GP About Testosterone
You could start the conversation by saying:
“My other menopause symptoms are being treated, but I’m still experiencing a persistent loss of sexual desire and it is affecting my wellbeing. Could we discuss whether testosterone might be appropriate?”
It may help to explain:
-
When the change began
-
Whether it is causing you distress
-
Whether you can still become aroused or reach orgasm
-
Whether sex is painful or uncomfortable
-
Which HRT or other treatments you have already tried
-
Any medication you are currently taking
-
How the problem is affecting you or your relationship
If your GP does not prescribe testosterone, you can ask whether there is a local menopause service or clinician to whom you could be referred. Availability and prescribing arrangements can differ between NHS areas.
The Bottom Line
Testosterone can be genuinely helpful for some menopausal women experiencing persistent, distressing low sexual desire—especially when standard HRT has not solved the problem.
But it is not the missing third component of HRT for every woman, and it has not yet been proven to treat the full list of symptoms sometimes attributed to it online.
The best approach is a properly informed conversation that considers hormones, physical comfort, sleep, medication, emotional wellbeing and relationships—not simply a blood-test number.
And if your desire has changed, you are not shallow, broken or failing your partner. Sexual wellbeing is part of your overall health, and it is entirely reasonable to ask for help.
This article is for general information only and is not a substitute for personalised medical advice. Speak to your GP, pharmacist or a suitably qualified menopause specialist before starting or changing any treatment.
