When you think of testosterone, you might picture muscle-bound men and aggressive gym energy—but women make testosterone too, and it plays a critical role in health and vitality, especially during and after menopause.
What Does Testosterone Do in Women?
Testosterone is produced by the ovaries and adrenal glands and contributes to:
- Sexual desire and arousal
- Energy and motivation
- Mood regulation
- Muscle mass and strength
- Cognitive sharpness
- Overall sense of vitality
During perimenopause and menopause, testosterone levels decline, often significantly—yet many women are never told this might be contributing to their symptoms.
Who Might Benefit from Testosterone Therapy?
Women who experience:
- Low libido
- Difficulty with arousal or orgasm
- Persistent fatigue
- Low motivation or “flat” mood
- Declining muscle strength or stamina
—despite optimal estrogen levels—may benefit from carefully prescribed testosterone therapy.
It’s especially helpful when vaginal estrogen and systemic hormone therapy aren’t enough to address sexual desire concerns.
Is It FDA-Approved?
In the U.S., no testosterone product is FDA-approved for women, but it’s still prescribed off-label by trained clinicians. It can be compounded or prescribed at low doses using products originally developed for men, adjusted for female physiology.
Australia and the UK do have testosterone formulations approved for women, and the evidence base supporting use in selected cases is growing.
Is It Safe?
When used correctly and monitored regularly, testosterone therapy is considered safe for midlife women. Potential side effects (like acne or hair growth) are rare when dosed appropriately. More serious side effects, such as enlargement of the clitoris and deepening of the voice tend to be seen when women are treated with high-dose pellets instead of testosterone through the skin. You’ll be monitored for symptoms, blood levels, and any changes over time.
What Results Can I Expect?
Improvements in libido and sexual satisfaction are the most well-studied outcomes. Some women also notice:
- Increased energy
- Better mood
- More drive or motivation
- Improved muscle tone
But it’s not a miracle drug—and it’s not for everyone. The key is a personalized approach, with expert guidance.
The Bottom Line
Testosterone is not just a “male hormone.” For some women, it’s the missing piece in their midlife health puzzle. If you’ve addressed estrogen and progesterone and still feel off—testosterone may be worth exploring.
👉 Low energy? Zero libido? Testosterone might be the missing piece. If you’re wondering whether it’s right for you, let’s talk through your options.
Need support or want to learn more about treatment options? Schedule a free 15-minute call to see how we can work together.
Dr. Aoife O’Sullivan is a family physician, board certified by the American Board of Family Physicians and a menopause specialist, certified by the North American Menopause Society, dedicated to empowering women through their midlife health journeys. She is the founder of Portland Menopause Doc, co-founder of the Portland Menopause Collective, podcaster on The Dusty Muffins, and an expert speaker, frequent podcast guest and active contributor to midlife women’s health research.
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