Could testosterone be the missing piece in managing your menopause symptoms? For some women, it might hold the key to addressing low libido, fatigue, and brain fog. But testosterone replacement isn’t a one-size-fits-all solution. By understanding its role, benefits, and potential risks, you can make informed decisions with your healthcare provider about whether it’s the right option for you.
As women approach menopause, hormone levels—including testosterone—begin to decline. While often associated with men, testosterone plays an essential role in women’s health, influencing libido, mood, energy levels, bone and muscle strength, and overall well-being.
In this guide, we’ll explore how testosterone replacement therapy (TRT) works for women, guided by the latest NICE and British Menopause Society (BMS) guidelines.
What Is Hormone Replacement Therapy (HRT)?
HRT is a treatment used to alleviate symptoms caused by declining hormone levels in women during perimenopause and beyond. These symptoms can include:
- Hot flushes and night sweats
- Mood changes and brain fog
- Joint pain and fatigue
- Vaginal dryness and low libido
While HRT typically focuses on replenishing oestrogen and progesterone, testosterone replacement is sometimes added to address specific symptoms like low libido that persist despite standard HRT.
The Role of Testosterone in Women’s Health
Though testosterone is often linked to men’s health, it’s a crucial hormone for women as well. Produced in the ovaries and adrenal glands, testosterone helps regulate:
- Sexual Desire and Arousal: Supporting libido and sexual satisfaction
- Energy Levels: Combating fatigue and low motivation
- Mood and Cognitive Function: Enhancing concentration, memory, and overall well-being
- Muscle and Bone Health: Contributing to strength and stability
From the mid-30s, testosterone levels in women naturally decline, with a sharper drop during menopause. This can contribute to symptoms like reduced sexual desire, mood swings, and fatigue.
Testosterone Therapy for Women: What the Evidence Says
According to NICE and BMS guidelines, testosterone therapy can be considered for postmenopausal women experiencing low sexual desire that doesn’t improve with oestrogen and progesterone HRT alone.
Key Findings from Research:
- Testosterone therapy can improve libido, sexual satisfaction, and even mood for some women.
- Treatment aims to restore testosterone levels to the normal female range, avoiding excessive levels.
However, not all women benefit equally, and the effectiveness of testosterone therapy depends on individual symptoms and needs.
Types of Testosterone Therapy Available
NHS Options
In the UK, there are no testosterone products specifically licensed for women on the NHS. However, testosterone gels and creams designed for men can be prescribed off-licence at much lower doses for women. These products are typically applied daily to the inner thigh or abdomen, with the dosage carefully adjusted.
Private Options
Privately, women can access Androfeme 1% cream, a product specifically licensed for women in Australia. A pea-sized amount is applied daily to the lower abdomen, upper outer thigh, or buttock, rotating the application site.
- Key Considerations:
- Each 50ml tube lasts around 100 days.
- Avoid showering or swimming for four hours after application.
- Regular monitoring ensures safe and effective treatment.
Dosage and Monitoring
Testosterone therapy for women is highly individualised, with doses much lower than those used for men.
What to Expect:
- Before Treatment: A blood test will establish your baseline testosterone levels.
- Monitoring: NICE guidelines recommend follow-ups every 3–6 months initially, then annually once stable.
- Adjustments: Dosages are adjusted to alleviate symptoms while avoiding side effects from excessive testosterone levels.
Who Should Consider Testosterone Therapy?
Testosterone therapy may be suitable for women who:
- Experience persistent low libido or hypoactive sexual desire disorder (HSDD) despite standard HRT.
- Struggle with low energy, mood changes, or brain fog that doesn’t improve with oestrogen and progesterone alone.
The decision to start therapy should be made in consultation with a healthcare professional, tailored to your unique symptoms and health goals.
Potential Risks and Side Effects
While side effects are uncommon when testosterone levels are kept within the female range, they can occur. These may include:
- Acne or oily skin
- Excessive or unwanted hair growth
- Voice deepening (rare)
- Changes in cholesterol levels
Regular monitoring and careful dosing minimise these risks.
Alternatives and Additional Therapies
Testosterone is just one piece of the puzzle for managing menopause symptoms. A holistic approach often yields the best results.
Complementary Options:
- Lifestyle Adjustments: Nutrition, exercise, stress management, and sleep hygiene.
- Vaginal Oestrogen: Local treatments for vaginal dryness and discomfort.
- Non-Hormonal Therapies: Psychological support or cognitive-behavioural therapy (CBT).
- Adjusting HRT: Tailoring oestrogen and progesterone doses to better suit your needs.
In Summary
Testosterone replacement therapy can be a valuable option for women experiencing symptoms of low testosterone during perimenopause and menopause. It has the potential to improve libido, energy levels, and mood, especially when standard HRT isn’t enough.
However, it’s not a universal solution and must be tailored to each individual. Regular monitoring ensures treatment remains safe and effective, addressing your unique needs.
If you’re struggling with symptoms that could be linked to low testosterone, speak with your healthcare provider or contact us at The Menopause Company. Together, we’ll create a personalised plan to help you feel your best during this transformative stage of life.