Testosterone for the menopause

Expert reviewer Dr Samantha Wild, Bupa Clinics GP
Next review due December 2023

Testosterone for the menopause can help to ease some sexual symptoms such as a reduced sex drive. It’s usually offered to women in addition to hormone replacement therapy (HRT), especially women who have reached menopause prematurely or due to surgery.

A woman reading on her sofa

About testosterone

You may think of testosterone as a hormone that only men produce, but women produce it too. In fact, your body makes three or four times more testosterone than oestrogen. It affects many different things, from your mood and thinking through to the strength of your muscles and bones. Testosterone has an important role in your sex life too. It affects your sex drive, your orgasms and how aroused you are before and during sex.

Testosterone and the menopause

As you get older the amount of testosterone your body makes starts to go down. When you go through the menopause, either naturally or because you have had your ovaries removed, the amount of testosterone in your body drops by about half.

For some women, the reduced amount of testosterone can cause upsetting symptoms, such as not feeling like having sex, not getting aroused during sex and problems having an orgasm. These symptoms usually mean that having sex becomes less pleasurable.

You may have other symptoms too, including

  • tiredness
  • low mood and depression 
  • headaches
  • acne
  • an increase in hair growing on your face
  • hair loss on your head

Transgender men and people who identify as non-binary can also get the symptoms of the menopause. If you identify as non-binary or are a trans man and you’re interested in testosterone and the menopause, you should get specialist advice.

If you’re going through the menopause and any of these symptoms are affecting your day-to-day life, speak to your doctor.

Use of testosterone for the menopause

Around four in every 10 women has sexual symptoms during and after the menopause, including a low sex drive. This can cause a lot of distress and have a big impact on how you feel about your life.

Hormone replacement therapy (HRT) can help to ease many of the symptoms of the menopause, including sexual symptoms. Your doctor may prescribe this first to see if it helps. If HRT doesn’t work for you, your doctor may suggest trying testosterone in addition to HRT. Although it doesn’t work for everyone, around six out of 10 women with severe sexual symptoms find that testosterone helps.

In the UK, testosterone is licensed to treat conditions in men, but it isn’t licensed to treat menopause symptoms in women. That means it’s called an ‘off-label’ medicine for menopause. Some medicines can be, and are, prescribed to be used ‘off-label’ in a different way from the way they are licensed to be given. If you want to use testosterone, you usually need see a specialist to have it prescribed.

Who shouldn’t take testosterone for menopause?

There are some women who should not take testosterone. If you have had hormone sensitive breast cancer or if you have active liver disease, you shouldn’t take it.

Making a decision

As with all medicines, there are benefits and risks to taking testosterone for menopause symptoms. There is only a little research that looks at the long-term effects of taking testosterone for the menopause. Researchers want to do more studies on the impact it may have on bones and muscles, or on mental health and mood.

Some testosterone medicines available for women to take have been made for and tested on men. Many women have taken testosterone for the menopause and found it works for them, but if you’re worried about this, speak to your doctor.

Always talk to your doctor before deciding whether to take a medicine or not.

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How testosterone for the menopause works

Hormone treatments for the menopause, such as HRT and testosterone, replace hormone levels that have fallen in your body. Testosterone is usually given as a transdermal medicine, which means it’s absorbed through your skin.

Types of testosterone for the menopause

There are a few different types of testosterone that you may be prescribed in the UK:

  • A cream or gel to rub onto your skin (Testogel, Tostran or Androfeme).
  • An implant which is put in just under your skin.

Androfeme and testosterone implants aren’t available through the NHS, but you may be offered them if you see a doctor privately.

Taking testosterone for the menopause

If you’re using a cream or gel, rub a small amount onto clean and dry skin every day or every other day. Choose a non-hairy area such as your abdomen (tummy), the top part of your thigh or a buttock. Change the place each time you put it on.

Let your skin dry before you cover it with clothes. Don’t shower or bath for two or three hours after you’ve put the cream or gel on. Wash your hands as soon as you’ve put the testosterone on your skin and be careful not to let anyone else touch it.

You may be given a tube or sachet which has more than one dose in it. You will need to divide this up into the amount you need to take each time. The usual dose is 5mg a day or 10mg every other day, but your doctor will tell you how much you need to take and when. If you’re not sure how much you need to put on, always check.

Testosterone doesn’t usually work straightaway. It can take up to 12 weeks for your symptoms to improve. So, your doctor will probably suggest you try testosterone for three to six months to see if it works for you.

Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.

Taking other medicines

Testosterone for menopause is often taken in addition to HRT. Your doctor may also suggest you take other medicines. If you have changes in your vagina and vulva after the menopause, such as vaginal dryness and discomfort during sex, your doctor may also recommend using vaginal oestrogen. This comes as a cream, tablet or ring which you put into your vagina. You can also use over-the-counter lubricants and creams when you’re having sex. These can help to make sex more comfortable.

Side-effects of testosterone

Side-effects are the unwanted effects of taking a medicine. If you have side-effects, it’s important to talk to the doctor who prescribed your medicine before you stop taking it.

If you’re taking the right amount of testosterone in the right way, the likelihood of getting side-effects is low. Some women do get mild side-effects, but these are not usually severe enough for them to stop taking the testosterone.

The potential side-effects of testosterone are:

  • unwanted hair growth
  • acne
  • hair loss on the front area of your head
  • a deeper voice
  • the area of skin where you put the testosterone gel or cream on can become hairier – you can prevent this by using a different area of skin every day
  • your clitoris becoming larger

There is a chance that testosterone may not work for you. Feeling less like having sex or less aroused can also be a symptom of other things as well as low testosterone levels. Changes in your relationship, other health problems and depression can all affect how you feel about sex. Your doctor should talk to you about this before prescribing testosterone and it’s important to say if there may be other things affecting your sex life.

If testosterone helps to ease your symptoms and you carry on taking it, your doctor will monitor you. You will be asked to have a blood test before you start testosterone. This will be repeated three months after you start taking it, then three months after, and then at least once a year. This can help your doctor see whether you’re getting the right amount of testosterone. After that you’ll be asked to have a blood test every year.

You and your doctor should talk at least once a year about how you’re getting on using the testosterone and the benefits and risks of continuing to take it.

This section does not include every possible side-effect of testosterone. Please read the patient information leaflet that comes with your medicine and speak to your doctor, pharmacist or healthcare professional for more information.

Frequently asked questions

  • Testosterone is usually thought of as a hormone that men produce. So, it would be natural to think that if you’re a woman, and you started having more testosterone, you might become more masculine.

    A recent piece of research looked at lots of different research studies where women took testosterone, to see whether there were side-effects, and if so what these were. Researchers did find that some women developed unwanted hair growth. But there was no evidence of other symptoms of becoming more masculine, such as a deeper voice, losing hair or the clitoris getting bigger.

    Other research studies have shown that some women have these side-effects, but they’re uncommon and not usually severe enough for women to stop taking the testosterone. If you’re worried about side-effects, or you think you may have them, talk to your doctor.

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  • Written by Sarah Smith, Freelancer Health Editor, with Graham Pembrey, Bupa Head of Health Content, December 2020
    Expert reviewer, Dr Samantha Wild, Bupa Clinics GP
    Next review due December 2023