Can Testosterone Help Menopausal Symptoms?

Testosterone in women declines with age; by the time we’re 40 years old our levels are half of what they were in our 20’s. Could this be responsible for some of the symptoms reported around menopause?

Though primarily thought of as a male hormone, testosterone is also a critical hormone in women with a role in maintaining libido, energy, mood and muscle mass so it makes sense that these things will be impacted by lower testosterone levels around midlife.

There’s a lot of talk about testosterone in the media currently, with plenty of speculation about a multitude of potential benefits in menopausal women. Whilst it certainly has been proven beneficial for some issues, evidence of effectiveness for a wider range of symptoms is still lacking (but underway!).

How does Testosterone help Women?

Cardiovascular health. In women – especially postmenopausal women – low testosterone may be associated with higher risk of cardiovascular disease due to reduced muscle mass, increased fat accumulation and metabolic changes. However excessive testosterone (such as from supplementation) may also raise risks by affecting cholesterol levels and blood pressure.

Some smaller research studies show that lower levels of testosterone post-menopause are associated with higher cardiovascular risk. Women over 70 years with higher testosterone levels also seem to have higher HDL (“good” cholesterol) and lower trigylerides, which puts them at lower risk of cardiovascular disease.

Mood. In menopausal women, declining testosterone levels can contribute to mood changes such as irritability, anxiety, depression and low motivation. Testosterone influences neurotransmitters like serotonin and dopamine, which regulate mood and emotional well-being. While there’s not a lot of good research evidence, anecdotally some women report feeling “better” with testosterone therapy.

It’s important to discuss any mood issues with your doctor to identify the possible causes and contributors, as treatment may involve multiple approaches.

Cognition. Testosterone influences neurotransmitters like dopamine and acetylcholine, which play key roles in cognitive function.

Some research suggests testosterone therapy may help reduce brain fog and improve verbal memory and processing speed. It may also have neuroprotective effects, potentially lowering the risk of dementia or cognitive decline. However solid research evidence is lacking and more studies are needed to confirm its long-term impact on brain health in menopausal women.

For more information about the impact of our changing hormones on brain function we recommend “The Menopause Brain” book by Dr Lisa Mosconi, and “Save Your Brain” by Dr Ginni Mansberg. We also have great on-demand free webinars about Dementia Risk and Brain Glitches, and ADHD Around Menopause.

Bones and Muscles. Testosterone plays a crucial role in maintaining bone density and muscle mass in menopausal women. Bone loss increases as estrogen and testosterone decline with age, increasing the risk of osteoporosis and fractures. Testosterone helps stimulate bone formation and support calcium retention, contributing to stronger bones.

Testosterone also helps maintain muscle mass, strength and metabolism. Low levels can lead to muscle weakness, increased fat accumulation and reduced physical performance. There are important studies currently underway to try to prove whether supplementing with testosterone can improve muscle and bone mass… watch this space!

Vulva, vagina and libido. As testosterone and estrogen decline women may experience vaginal dryness, thinning tissues, decreased blood flow and reduced sensitivity; these can result in discomfort, irritation, painful intercourse and poor sexual responsiveness.

Testosterone therapy is proven to be effective for diagnosed Hypoactive Sexual Desire Disorder (HSDD) in postmenopausal women. It can improve vaginal lubrication, tissue thickness and sexual sensitivity, especially when combined with estrogen. However treatment must be initiated by a doctor and carefully monitored, as too much testosterone can cause unwanted and sometimes irreversible side effects: weight gain, acne, hair loss, excess body hair, voice deepening or clitoral enlargement. Also, increasing T dose above what’s needed can actually cause reduced sexual effectiveness.

Can I Get Testosterone for my Menopausal Symptoms?

Currently Australia is one of the only countries to have an approved prescribed testosterone product for women, which is medically indicated for the treatment of a diagnosed hyposexuality disorder (poor sexual responsiveness and libido).

Its primary role is therefore to improve sexual function in postmenopausal women; using it for any other purpose, or in pre-menopausal women, is called “off label” use. Your doctor may still prescribe it for you if they think there is a good chance of benefit and a low risk of harm, but you must accept that there’s no proven benefit it that scenario.

Most importantly, DO NOT buy unregulated products online, or used products designed for men. There is huge potential for harm, so only use with individualised medical supervision.

Should Women have Testosterone Blood Tests?

It is normal for women to have low testosterone, so in most cases testing is simply to establish a pre-treatment baseline.

One challenge with testosterone treatment is that there’s no perfect test to measure how much testosterone is active inside the cells where it works (like the brain). Blood tests help guide treatment, but they aren’t the whole story. Doctors aim to keep testosterone levels within the high-normal range for women, but the most important thing is how you feel, not just what the numbers say.

How Long does Testosterone Take To Work for Symptoms in Women?

If testosterone is going to help, most women start noticing improvements between 4 and 8 weeks after starting, with the best results usually seen around 3 months. A trial period of around 6 months is often recommended to see if the treatment is working well for you. It’s also good to know that we don’t yet have long-term safety data beyond 2 years of use.

Who Should Avoid Testosterone Treatment?

Testosterone treatment is not recommended if you:

• Have breast cancer or any hormone-dependent cancer (either active or in remission)
• Have cancers that are stimulated by androgens (male hormones)
• Are pregnant, breastfeeding, or planning to become pregnant
• Are under 18 years old
• Have certain health conditions like nephrotic syndrome, a history of unwanted blood clots or high calcium levels
• Are allergic to testosterone, almond oil (commonly used in some preparations), or any other ingredients in the product

If you’re an athlete, testosterone use can have implications for competition rules and regulations, so make sure you consult with a doctor who knows the regulations for your sport.

The Bottom Line:

Testosterone therapy can be a helpful option for some women, but it needs to be carefully monitored and tailored to your specific needs. Always discuss your goals, medical history, other treatment options and concerns with your medical practitioner, and only use approved prescribed products under medical supervision.

What is WellFemme About?

If you can’t find the professional help you need for your menopause or perimenopausal symptoms then book a Telehealth consultation with an expert WellFemme menopause doctor.

WellFemme is Australia’s first dedicated Telehealth menopause clinic, servicing locations nationwide including: Melbourne, Sydney, Adelaide, Darwin, Perth, Hobart, Brisbane, Dubbo, Bendigo, Broken Hill, Broome, Alice Springs, Launceston, Cairns, Mildura, Lightning Ridge, Kalgoorlie, Albany, Toowoomba, Charleville, Port Headland, Katherine, Ballarat, Coober Pedy, Bourke, Albury… and your place!