Testosterone is an increasingly common menopause treatment, used alongside standard hormone replacement therapy, particularly for women with reduced sex drive.

Although menopause doesn’t directly cause a reduction in testosterone, low levels can coincide with this time in your life and can contribute to some menopause symptoms.

In most countries, testosterone is not licensed as a treatment for women but you may be able to get a prescription from a specialist doctor by talking to your GP.

You can also buy some testosterone products from online pharmacies after taking a test or having a consultation.

Testosterone usually comes as a gel or cream that you rub into your skin. The dosage you’re given will be much lower than that for men.

As well as helping some women to increase their libido, testosterone may also have benefits for vaginal, bone and muscle health, mood, focus and energy.

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Why is testosterone important for women?

Although testosterone is commonly thought of as a ‘male’ sex hormone, it’s important for women too. In fact, before menopause women produce three times more testosterone than they do oestrogen, mostly in their ovaries.

One way that your body uses testosterone is by turning it into oestrogen. But testosterone itself also plays significant roles in many other areas, including your sex drive, maintaining vaginal and breast tissue, mood, brain function and the health of your bones, muscles and blood vessels.

Do testosterone levels change during menopause?

In most cases, menopause isn’t directly linked to reduced testosterone levels and your ovaries keep producing it in significant amounts after menopause.

However, testosterone production does gradually slow as you get older, from your mid-30s onwards. That’s why low testosterone levels can coincide with menopause and may contribute to some of the symptoms.

If you have an early menopause due to having both your ovaries surgically removed – known as an oophorectomy – or because of other medical treatments, your testosterone levels can drop much more quickly.

Signs of low testosterone in women

Common symptoms of low testosterone for women can include:

• reduced sex drive
• tiredness or lack of energy
• low mood
• difficulty concentrating
• headaches
• a reduced sense of general well-being

However, for many women low levels of testosterone don’t cause symptoms, which is why doctors are advised not to prescribe testosterone replacement therapy on the basis of a blood test alone.

Can your doctor prescribe testosterone for menopause on the NHS?

In the UK, your GP can prescribe testosterone themselves or refer you to a specialist menopause doctor who may decide to prescribe it. They’ll usually only prescribe it if you’ve passed menopause, have low sex drive and if standard HRT hasn’t helped.

Once you’ve found the right dose and your symptoms have improved, you’ll be able to get your testosterone prescription via your GP and your local pharmacy.

However, testosterone is not actually licensed as a treatment for women in the UK, the US or elsewhere, apart from in Australia. In most countries, it’s only licenced for men with reduced libido, not women.

That means it hasn’t been through clinical trials designed specifically to look at its safety and effectiveness for women. However, the NHS says there is evidence that it does work for women with low sex drive during menopause so allows doctors to prescribe it.

The British Menopause Society also believes testosterone therapy should be licensed for women.

Testosterone therapy, oestrogen and other hormones

If your doctor prescribes testosterone treatment for menopause symptoms, they will usually do so together with standard hormone replacement therapy (HRT), which includes oestrogen and often progesterone, another reproductive hormone.

This combination generally works better and can reduce potential side effects like increased acne and hair growth, although these are relatively rare. HRT can be taken in many forms, but if you’re using testosterone, you’ll generally be given oestrogen HRT as a gel because oestrogen taken orally can reduce the effects of testosterone.

Another treatment for certain menopause symptoms is a medication called Prasterone. Prasterone is a synthetic but biologically identical form of a hormone called dehydroepiandrosterone (DHEA), which your body converts into testosterone and oestrogen.  

Prasterone is used to treat vaginal atrophy – the thinning of the vaginal walls – and comes as a pessary that you insert into your vagina.

Although testosterone treatments can help many women, it’s important to be aware that it may be weeks or even months before you notice the benefits, and testosterone doesn’t work for everyone.

Testosterone gels, creams and patches

The most common form of testosterone therapy for menopause is a gel that you rub it into your skin and is absorbed into your bloodstream. In some countries, the gel may be delivered via a skin patch. Testosterone taken orally tends to be linked to more side effects than gels.

In the UK, there are two main products you could be prescribed:

• Tostran^® 2%: This gel comes in a pump and is normally used three times a week.
• Testogel^®: This gel comes in sachets. One sachet lasts a week and you use some of it each day.

Other products that are sometimes available in the UK, or can be imported, include:

• Testim^® gel: A tube of gel that you use daily.
• AndroFeme^® cream: In Australia, this cream is licensed for daily use for women.

Your doctor will tell you where on your body to apply the gel. You should avoid contact with anyone else until it’s dry, which takes about 10 minutes, and shouldn’t wash the area for 3 hours to give it time to be properly absorbed.

Because the testosterone products you will usually be prescribed in the UK are designed for men, you should follow the instructions your doctor gives you, not those that come with the product.

Dosage

Women using testosterone will generally take a tenth or less of the dosage for men.

Again, your doctor will tell you exactly how much you should take but testosterone replacement gels and creams designed for women usually recommend a starting dose of 0.5 millilitres (ml) / 5 milligrams (mg) per day.

Where can I buy testosterone for menopause?

You can buy testosterone gel products like Testogel^® from online pharmacies in the UK, provided that you:

• are between the ages of 40 and 70
• are perimenopausal or postmenopausal
• have been using a standard HRT gel or patch for at least 3 months
• have low sex drive

Before you can buy Testogel^®, you’ll also need to buy a testosterone test kit to take to make sure it’s safe for you. 

The testosterone cream AndroFeme^®, which is licensed for use by women in Australia, is available via an online pharmacy in the UK too. However, it’s much more expensive than an NHS prescription.

A doctor will decide whether to prescribe it to you after an online consultation.

Benefits of testosterone for menopause

Depending on the cause, testosterone therapy could help with a number of menopause symptoms, as well as improving your overall well-being.

• Sex drive: Testosterone is mainly prescribed for menopausal women alongside HRT to increase sex drive and your ability to reach orgasm. Clinical trials have shown that it can be very effective.
• Vaginal health: Prasterone / DHEA taken as a pessary can also help with vaginal atrophy and related symptoms such as dryness and painful sex. Vaginal testosterone may improve these symptoms too but more research is needed.
• Energy levels: According to the UK’s Menopause Charity, taking testosterone can improve both physical and mental energy levels and stamina.
• Mood and cognitive function: Similarly, many women report that testosterone therapy improves their mood, concentration and general motivation.
• Bone and muscle health: Having enough testosterone is important for maintaining bone density and muscle mass, both of which can be reduced during menopause.

For extra support with some of these aspects of your health during menopause, try The Better Gut probiotic supplements.

Does testosterone therapy have side effects?

Testosterone prescribed by a doctor rarely has side effects because you’ll only take enough to get your levels back within a normal range for women.

However, occasional side effects include:

• increased body or facial hair
• acne or greasy skin
• weight gain

Even rarer side effects, that can happen if you take a large dose of testosterone, include:

• your voice becoming deeper
• pattern hair loss/alopecia
• an enlarged clitoris

Side effects of testosterone therapy can usually be reversed by reducing your dosage or stopping the treatment.

Summary

Testosterone is an important hormone for women, with roles in sexual health, mood, cognitive function and bone and muscle health. In fact, prior to menopause your body produces three times more testosterone than oestrogen.

Although menopause doesn’t cause low testosterone, your levels drop as you get older. Many women don’t notice any signs of low testosterone but for some it can contribute to menopause symptoms like reduced sex drive, tiredness, low mood and difficulty concentrating.

Despite testosterone not being licensed to treat women in most countries, you may be able to get it on prescription if your doctor thinks it could help. It usually comes as a gel and will generally be prescribed together with standard HRT. Women need much less testosterone than men, with daily doses often around 5 mg.

You may also be able to buy testosterone gels or creams through an online pharmacy.

Testosterone doesn’t work for all women but it can boost sex drive for many, and may also improve vaginal health, bone density, muscle mass, energy levels, mood, focus and overall well-being.

Side effects are rare but can include increased hair growth, acne, weight gain and occasionally other symptoms.

For help with a whole range of perimenopause and menopause symptoms, including better vaginal health, mood, bone health and sleep, try The Better Gut probiotic supplements.

To get 10% off your first order, use the discount code WELCOME10.