Testosterone and Menopause : What Women Need to Know
Article written by Dr Mari Walling, British Menopause Society Registered Specialist, GP, Co-founder of Lemala Health, November 2025 This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance.
Testosterone is often less talked about than oestrogen and progesterone, but it can play an important role in how some women feel during menopause.For some, it can be the missing piece when symptoms such as low libido or low energy persist despite treatment.
This guide explains who may benefit, how it works, and what to expect.
What happens to testosterone during menopause?
As women age, testosterone levels naturally decline. Many women will not notice these changes, while others may experience symptoms that affect daily life.
For some, testosterone can be the final missing piece of the jigsaw in menopause management. It appears to be particularly important in women with:
Symptoms of low testosterone in menopause
Low testosterone levels can lead to a variety of symptoms including:
Low sex drive
Decreased sexual satisfaction
A lack of energy or feeling tired
Vaginal dryness
Mood changes, including depression and anxiety
Hair thinning
Loss of muscle strength and tone
Sleep issues, such as insomnia and disrupted sleep
Should you take Testosterone for Menopause?
Many women with low testosterone do not have symptoms, and treatment is not usually needed unless symptoms are affecting quality of life.
Testosterone is also not typically recommended as a first-line treatment for menopause symptoms.
Current guidance suggests:
Testosterone may be considered if low libido persists despite adequate oestrogen
It can be used safely alongside HRT and vaginal oestrogen
Some women report improvements in energy, mood and concentration, but evidence is not yet strong enough for routine use for these symptoms
It is also important to note that:
Oral oestrogen can increase sex hormone binding globulin (SHBG)
This may reduce free testosterone levels and worsen symptoms
Switching to transdermal oestrogen (patch, gel or spray) may help
Do I need a blood test?
Before starting testosterone, levels should be checked with a blood test.
After starting treatment:
Levels are usually rechecked at 3 to 6 months
Then monitored yearly
This helps ensure levels remain within the normal female range and reduces the risk of side effects.
Explore our blood test options.
Types of testosterone used in menopause
Testosterone is usually prescribed as a gel or cream applied to the skin (transdermal testosterone).
Common options include:
Testogel (male-licensed, used off label for women)
Androfeme (formulated specifically for women)
Both are body-identical, meaning they contain testosterone with the same structure as that naturally produced in the body.
Androfeme update
In August 2025, Androfeme, a testosterone cream, formulated specifically for women, was approved by the UK regulator, the Medicines and Healthcare products Regulator (MHRA).
Until now, Androfeme has only been available through private clinics, under a special import licence. This approval means a UK-licensed version is expected to be available in 2026. NHS availability will depend on a future NICE appraisal, so for now women can still access AndroFeme privately with a prescription.
AndroFeme must not be used by anyone with an almond allergy.
How do I use testosterone cream or gel ?
Apply to clean, dry skin on the upper outer thigh, buttock, lower tummy or inner forearm.
Rotate application sites regularly to minimise hair growth.
Rub in thoroughly and wash hands immediately.
Allow 30 seconds to dry before dressing
Wait 30 minutes before bathing, or applying other creams
Apply at the same time each day for best results.
How long does testosterone take to work?
Response to testosterone treatments differs in each person.
Some women notice improvement immediately, some report a few months for the full effects. When we monitor your blood levels, your dose can be adjusted if needed.
Testosterone does not work in everybody. If you show no response by 6 months, we may recommend you stop treatment, and we explore other causes for your symptoms.
Side effects of testosterone
Side effects are uncommon when used at low doses and monitored appropriately.
Possible side effects include:
Increased hair growth at the application site
Greasy skin or acne
Rare side effects:
Facial hair
Voice deepening
Weight gain
Clitoral enlargement
What are the risks of testosterone?
Short-term studies up to five years show no increased risk of breast cancer, heart disease, or stroke in healthy postmenopausal women.
Long-term data are limited, so ongoing monitoring is important.
Summary
Testosterone can be a safe and helpful treatment for some women, especially for persistent low sexual desire during or after menopause. Treatment is low dose, monitored carefully, and usually well tolerated.
A specialist consultation ensures treatment is suitable, safe, and tailored to your individual needs.