Beyond the Hot Flashes: Exploring Testosterone Therapy for Women

Testosterone has long been viewed as the “male hormone,” but it plays a significant role in women’s health, too. As women age, especially during perimenopause and post-menopause, testosterone levels drop, often leading to symptoms like hot flashes, low libido, fatigue, mood swings, and muscle weakness.

While estrogen and progesterone dominate menopause conversations, testosterone therapy is now gaining scientific traction for its potential to improve quality of life in midlife women.

🔬 Why Does Testosterone Decline in Women?

Women produce testosterone in the ovaries and adrenal glands, but levels begin to fall in their 30s and drop significantly during and after menopause.

🧬 Factors that contribute to declining levels:

• Natural ovarian aging

• Surgical menopause (ovary removal)

• Adrenal dysfunction or chronic stress

• Certain medications, like corticosteroids or chemotherapy

This decline can result in:

• Hypoactive Sexual Desire Disorder (HSDD)

• Low mood and cognitive fog

• Muscle wasting and reduced bone strength

🧪 What Are the Benefits of Testosterone Therapy?

Scientific studies support testosterone’s role in multiple systems in a woman’s body.

1️⃣ Improved Sexual Desire & Satisfaction

Women with HSDD often report enhanced libido and arousal after low-dose testosterone therapy. A recent meta-analysis showed that, compared with placebo, testosterone significantly increased sexual function (arousal, orgasm, pleasure, desire, and responsiveness), self-image, and reduced sexual concerns and distress in postmenopausal women. However, this study also reported that the women had increased weight and a greater likelihood of reporting acne and hair growth, but no serious adverse events.

2️⃣ Better Mood & Cognitive Function

Low testosterone has been linked to mood instability, fatigue, and poor concentration. Testosterone therapy has shown promising results showing improvement in mood and memory. In a pilot study involving more than 500 peri- and post menopausal women, cognitive and mood symptoms significantly improved, with 47% of women reporting an improvement in mood, and 39% reporting an improvement in cognition.

3️⃣ Muscle and Bone Health

Testosterone plays a role in maintaining lean muscle mass and bone density, helping reduce frailty and osteoporosis risk.

💉 How Is Testosterone Administered to Women?

Unlike men, women require very small doses, often 1/10th of the male dose. Common delivery methods include:

• Transdermal creams or gels

• Patches (not available in all countries)

• Pellet implants (subcutaneous, long-lasting)

• Oral capsules (less preferred due to liver metabolism)

🔍 Monitoring is essential: Blood levels must be checked regularly to avoid side effects or overdosing.

✅ Who Is a Candidate for Testosterone Therapy?

Women who may benefit include those who:

• Have gone through early or surgical menopause

• Are experiencing Hypoactive Sexual Desire Disorder

• Feel persistently fatigued or cognitively dull despite normal estrogen levels

• Are medically cleared of other causes of their symptoms

⚠️ Not suitable for women with:

• Breast or uterine cancer history

• Uncontrolled cardiovascular disease

• Severe acne or androgenic symptoms

🧘‍♀️ Ayurvedic Perspective on Testosterone Imbalance

In Ayurveda, low “Ojas” (vitality) and Vata-Pitta imbalance can contribute to hormonal depletion. While testosterone itself isn’t mentioned, symptoms such as low libido, fatigue, and dryness are addressed via:

🌿 Ayurvedic approaches:

• Ashwagandha – Adaptogen to boost energy and hormones

• Shatavari – Supports female reproductive strength

• Warm ghee, milk, and nourishing rasayanas

• Abhyanga (oil massage) to balance vata and enhance circulation

🧠 Ayurveda focuses on restoring balance, not replacing hormones, making it complementary to biomedical therapy.

❓ FAQs About Testosterone Therapy for Women

Q: Is testosterone therapy FDA-approved for women?
A: No, but it is used off-label with support from global societies like ISSWSH (International Society for the Study of Women’s Sexual Health).

Q: How long before I notice results?
A: Many women report improvement in libido and energy within 4–6 weeks. The full effect may take 3 months.

Q: Will I grow facial hair or get acne?
A: If properly dosed and monitored, side effects are minimal. However, misuse or excess dosing can cause masculinizing effects.

Q: Can I take testosterone without estrogen?
A: Yes, but women who also have estrogen deficiency often benefit from combined therapy under medical supervision.

📝 Conclusion: Is Testosterone Therapy Right for You?

While testosterone therapy is not a magic bullet, it offers a science-backed option for specific issues that estrogen therapy alone may not address, particularly low libido, energy loss, and sexual satisfaction.

💬 Final takeaway:
Always seek personalized medical advice, review risks and benefits, and consider integrating lifestyle, nutritional, and Ayurvedic supports for comprehensive hormonal health.

📚 References:

1. Davis SR et al. “Global Consensus Position Statement on Use of Testosterone Therapy for Women.” Lancet Diabetes Endocrinol. 2019.
   🔗 https://pubmed.ncbi.nlm.nih.gov/31353194

2. Glaser RL et al. “Cognition and Mood Improvement with Testosterone Therapy.” Menopause. 2024.
   🔗 https://pubmed.ncbi.nlm.nih.gov/39283522

3. Labrie F. “Androgens in Women: The Role of DHEA and Testosterone.” Endocr Rev. 2015.
   🔗 https://pubmed.ncbi.nlm.nih.gov/26358173

4. Wierman ME et al. “Testosterone Therapy in Women: Clinical Practice Guideline.” JCEM. 2014.
   🔗 https://pubmed.ncbi.nlm.nih.gov/24302779

Akanksha Sharma

Dr. Akanksha Sharma, Head Writer and creator of AtoZ of Pregnancy, is dedicated to empowering women, parents, and families through 360-degree knowledge. She and her team provide evidence-based advice to guide families through pregnancy, parenting and beyond.