Testosterone for women in menopause: what it helps, what it doesn't, and where it is approved

Name: Testosterone for women in menopause: what it helps, what it doesn't, and where it is approved
Creator: MenoWoman

Testosterone for women in menopause has good evidence for one use only: low sexual desire that causes distress after menopause. It is not proven to help energy, mood, brain fog, muscle or bone, and no product is approved for women in the US.

Researched by the MenoWoman team. Edited by Marcela Sat. Updated 7 November 2026. We may earn from links.

See a doctor if you notice new facial hair, acne, scalp hair loss, a deepening voice or clitoral enlargement while using testosterone, or if you could be pregnant. Low desire that comes on suddenly, or with pain, low mood or relationship strain, also deserves a full check first.

What the evidence supports

In 2019, experts from menopause and endocrine societies worldwide agreed a Global Consensus Position Statement on testosterone for women. It was endorsed by groups including the International Menopause Society, The Endocrine Society and the Royal College of Obstetricians and Gynaecologists.¹

The statement found one evidence-based use. That is hypoactive sexual desire disorder (HSDD) in postmenopausal women, meaning low desire that causes distress. It should be diagnosed after a full check of physical, emotional and relationship factors.¹

The benefit is moderate. In trials, testosterone in the normal female range added about one satisfying sexual event a month compared with a placebo.¹ A blood test alone should not be used to diagnose low desire.¹

What it does not help

Testosterone is widely promoted online for energy, muscle, bone and brain health. The consensus statement found no benefit for general wellbeing or depressed mood. It also found no effect on bone density, muscle mass or strength, and no support for protecting memory or thinking.¹

The British Menopause Society said in 2026 that current trials do not show benefits for mood, cognition, energy or muscles and bones. Larger trials are still running.⁴ At the September 2026 FDA workshop, a UCLA specialist said evidence supports only HSDD after menopause.²

There is too little evidence to recommend it for women before menopause.¹ For more on causes of low desire, see low libido.

Side effects and safety

At doses in the normal female range, the main side effects were mild acne and extra body or facial hair in some women.¹ The common effects usually settle if the dose is lowered or treatment stops.⁴ Scalp hair loss, voice deepening and clitoral enlargement are rare at doses in the female range.⁴ In a small case series, mostly of women using pellets, voice changes did not fully recover and may be permanent.⁶

Testosterone taken by mouth worsened cholesterol in trials, so it is not recommended. Skin products did not show this short-term effect.¹ Short-term studies did not raise breast density or breast cancer risk, but long-term data are lacking.¹

Safety data beyond about two years are missing.¹ The FDA named heart disease, breast cancer and longer-term safety as the main gaps.³ It is generally not advised after hormone-sensitive breast cancer, in pregnancy or breastfeeding, or with active liver disease.^2,4 Pregnancy is still possible in perimenopause, so tell your doctor if you could become pregnant.

Approval status by country

United States: No testosterone product is FDA-approved for women. Doctors may prescribe it off-label, often using men's products at lower amounts or compounded mixes.² Off-label means the product is not approved for this use. Men's products hold far more testosterone than women need, so only a prescriber should judge the amount.⁴ On September 17, 2026, the FDA held a public workshop on testosterone in menopausal women. It urged companies to run trials that could support approval, and the comment period closed on October 19, 2026.³

UK: A testosterone cream made for women (AndroFeme) has been granted a UK marketing authorization. Until it is widely supplied, it is imported privately under a special license, and most testosterone products remain off-label for women.⁴ Primary care can prescribe and monitor, with input from a menopause specialist where needed. UK guidance suggests trying standard HRT first.⁴

Australia, New Zealand and South Africa: A testosterone cream for women (AndroFeme) is licensed in these countries, for HSDD after menopause.^3,4 In New Zealand, AndroFeme is not government-funded.⁵

Compounded products, pellets and questions to ask

Menopause societies do not recommend compounded testosterone, because doses are not standardized.^1,4 Pellets and injections can push levels well above the female range.^1,3 Once a pellet is in place, its effects cannot be quickly reversed if side effects appear.³ See compounded bioidentical hormones.

Useful questions for a doctor include: Could something else explain my low desire? Is my estrogen treatment suitable? What product would you use, and how will we check it is safe and working?⁴

Decisions about starting or stopping testosterone should be made with a doctor.

What it is used for: evidence rated

Option	Evidence	What the research shows
Low sexual desire with distress (HSDD) after menopause	Strong evidence	Supported by the 2019 Global Consensus Position Statement; the effect in trials was moderate.¹
Energy and fatigue	Weak evidence	Points to no benefit: not shown in trials, according to the British Menopause Society; promoted mainly on social media.^2,4
Mood and wellbeing	Weak evidence	Points to no benefit: trials found none for general wellbeing or depressed mood.¹
Brain fog and memory	Weak evidence	Points to no benefit: the consensus statement found no support for use to protect or improve thinking.¹
Bone and muscle	Weak evidence	Points to no benefit: trials showed no effect on bone density at 12 months and no gain in muscle mass or strength.¹

Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.