Why Are Women Taking Testosterone for Menopause—and What Happens When They Try to Get It?

On social media, testosterone is increasingly presented as the missing hormone in menopause care. Women describe waking with more energy, thinking more clearly, recovering their motivation and feeling interested in sex for the first time in years. Some call it the final piece of their HRT; others say they had to find a private clinic after their GP refused to prescribe it.

The enthusiasm has collided with a much narrower medical position. Testosterone is a hormone produced naturally by women as well as men, and there is evidence that treatment can help some postmenopausal women experiencing persistently low sexual desire that causes distress. There is not yet good evidence that it routinely treats the much wider collection of symptoms for which it is promoted online, including brain fog, fatigue, low mood, weak muscles and poor general wellbeing.

This leaves women in a confusing position. Their own experiences may be compelling, yet the benefits they report can extend far beyond those recognised in clinical guidance.

What is testosterone being prescribed for?

NICE recommends considering testosterone for low sexual desire associated with menopause where standard HRT has not been effective. The British Menopause Society takes a similar position: testosterone should primarily be considered for women experiencing distressing low sexual desire after other possible causes have been explored.

That distinction matters. A woman may have little interest in sex because intercourse is painful, she is exhausted, a medicine is affecting her libido, her relationship is under strain or she is experiencing depression or anxiety. Vaginal dryness and pain may respond better to vaginal oestrogen or another treatment directed at the genitourinary symptoms of menopause.

Testosterone is not intended to turn every woman into a more sexual version of herself. Treatment is usually considered where the loss of desire is persistent, acquired, troubling to the woman and not better explained by another factor.

The NHS says testosterone gel or cream can improve low libido for some women and may be available on prescription, sometimes through a menopause specialist.

What about energy, mood and brain fog?

This is where the medical evidence and online conversation separate.

Women taking testosterone sometimes report improvements in energy, concentration, confidence, mood, strength and motivation. Those experiences should not be dismissed; they are one reason further research is needed. However, individual reports cannot establish whether testosterone caused the improvement, whether another part of HRT was responsible or whether the same result can be expected across a larger population.

The British Menopause Society’s 2026 guidance says randomised controlled trials have not demonstrated benefits for cognition, mood, energy or musculoskeletal health. It notes that some individuals report improvements but says better-designed studies are needed before treatment can be recommended for these broader purposes.

A UK trial called ESTEEM is now examining whether testosterone improves menopause-related quality of life in 400 women. Until that and other research provides clearer answers, the established indication remains low sexual desire following a wider assessment.

The gap between evidence and experience does not mean one side must be lying. A clinical trial asks whether a treatment produces a reliable benefit across a defined group. A testimonial describes what happened to one person. Both can be worth hearing, but they answer different questions.

What happens when a woman asks her GP?

The response can vary considerably.

A GP may ask about the nature of the libido change, whether it causes distress and whether there are other physical, psychological, medication-related or relationship factors. They may review the woman’s existing HRT and ensure that symptoms such as vaginal dryness or painful sex are being treated.

NICE and the British Menopause Society recommend trying conventional HRT before adding testosterone. For some women taking oral oestrogen, switching to transdermal oestrogen through a patch or gel may also be considered because oral oestrogen can affect the amount of testosterone available to the body.

Some GPs are comfortable initiating and monitoring treatment. Others may seek advice from or refer the woman to a menopause or gynaecology service. Local prescribing policies, clinical experience and medicine availability can all influence what happens next, which helps explain why one woman may receive testosterone through her GP while another is told that it cannot be prescribed.

That variation can feel arbitrary, especially when women compare experiences online. A refusal may reflect the clinician’s view that the indication has not been met, uncertainty about prescribing or a local pathway requiring specialist initiation. Women can reasonably ask which of those applies and what referral or review option is available.

Is testosterone licensed for women in the UK?

The position has recently begun to change. For years, there was no testosterone product licensed specifically for women in the UK, so clinicians commonly prescribed a much smaller amount of a gel licensed for men. This was an accepted form of off-label prescribing where the clinician judged it appropriate and took responsibility for monitoring.

A 1% testosterone cream designed for women, AndroFeme, has since received UK regulatory approval, although availability and NHS formulary access may still vary. British Menopause Society guidance published in May 2026 said full UK authorisation had been granted subject to an appropriate pump presentation becoming available.

A licensed product may make dosing easier and increase clinician confidence, but it does not broaden the evidence automatically. Approval of a female formulation does not mean testosterone is established as a treatment for every symptom attributed to menopause.

Compounded testosterone products are different again. The British Menopause Society does not recommend compounded bioidentical testosterone where an appropriate regulated alternative is available, because quality, consistency and dosing may be less certain.

Does a blood test show whether a woman “needs” testosterone?

Not on its own.

Women naturally have much lower testosterone concentrations than men, and levels gradually decline with age. However, a low blood result does not necessarily correspond with symptoms. Many women with low circulating levels do not experience distressing low libido, while a woman’s sexual desire is influenced by biological, psychological and social factors.

The British Menopause Society advises that treatment should not be given simply to correct a low number. A blood test is usually taken before treatment to make sure the level is not already high and to create a baseline for monitoring. The aim is then to keep concentrations within the normal physiological range for women, not to pursue an arbitrary “optimal” level promoted online.

Levels may be checked again after treatment begins and then every six to 12 months. Clinical response and signs of excessive androgen exposure are also important. If there is no meaningful improvement after an adequate trial—often around three to six months—continuing indefinitely may not be justified.

What are the possible side effects?

At doses that keep testosterone within the physiological female range, side effects are generally uncommon. The most frequently reported include acne, increased facial or body hair and weight gain, which are usually reversible if the dose is reduced or treatment is stopped.

Scalp hair loss, deepening of the voice and enlargement of the clitoris are considered rare at physiological doses, but the possibility reinforces why careful dosing and monitoring matter. Long-term evidence relating to breast and cardiovascular outcomes remains limited, although shorter-term trial data have been reassuring.

Testosterone gel can also transfer to somebody else through skin contact. The application area should be allowed to dry, hands should be washed and close skin contact with children or partners should be avoided until it is safe. The MHRA has warned of harm to children following repeated accidental exposure to topical testosterone, including early puberty-related changes.

Testosterone is generally avoided during pregnancy and breastfeeding and requires additional caution in some women, including those with active liver disease, high baseline testosterone or a history of hormone-sensitive cancer.

Why has testosterone become so emotionally charged?

For many women, the argument is not only about one hormone. It is about whether their accounts of exhaustion, cognitive change, loss of desire and diminished identity are being heard.

Online testimonials can feel validating after an unsatisfactory medical appointment. But they can also oversell certainty, turning testosterone into a cure for almost every difficulty of midlife. The medical response can create the opposite problem if it acknowledges only libido and refuses to engage seriously with the broader symptoms women are reporting.

The fairest position lies between the two. Testosterone is neither a miracle hormone that every menopausal woman is missing nor a fringe treatment without a legitimate role. It has evidence for a specific problem, appears to help some women substantially and deserves further research into its wider effects.

A woman asking about testosterone should receive more than an automatic yes or no. She should be offered an honest discussion about what she wants to improve, what the evidence supports, what other causes may be contributing and how treatment would be prescribed and monitored safely.

Medical disclaimer: This article is for general information only and is not a substitute for individual medical advice, diagnosis or treatment. Testosterone is a prescription medicine and should only be used under the care of an appropriately qualified healthcare professional. Do not use another person’s medication or change your HRT without medical advice.

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