Testosterone for Women in Perimenopause and Menopause: Benefits, Risks, and Treatment Options

Many women think of testosterone as a "male hormone," but the truth is that testosterone is an important hormone for women too. Women naturally produce testosterone in their ovaries and adrenal glands, and it plays a key role in several aspects of health.

As women get older and enter perimenopause and menopause, testosterone levels decline along with estrogen and progesterone. For some women, this drop can contribute to symptoms that affect quality of life.

Understanding what testosterone does, when treatment might be helpful, and what the evidence actually says can help women make informed decisions about their hormone health.

What Does Testosterone Do in Women?

Although women produce much lower levels of testosterone than men, it still has important physiological effects.

• Sexual desire and arousal
• Muscle mass and strength
• Bone health
• Cognitive function

Because testosterone influences multiple systems in the body, declining levels can affect women in different ways.

Symptoms of Low Testosterone in Women

Some women notice few changes when testosterone levels decline. Others experience symptoms that can significantly affect daily life.

Possible symptoms include:

• Low libido
• Reduced sexual satisfaction
• Brain fog or difficulty concentrating
• Decreased muscle mass
• Lower exercise tolerance

These symptoms can overlap with other hormone changes in perimenopause, which is one reason a thoughtful clinical evaluation is important.

Testosterone and Sexual Health

The strongest scientific evidence for testosterone therapy in women relates to low sexual desire after menopause.

The International Society for the Study of Women's Sexual Health and other expert groups note that testosterone therapy can improve hypoactive sexual desire disorder (HSDD) in postmenopausal women when used appropriately.

In clinical studies, women receiving testosterone therapy often report:

• Increased sexual desire
• Improved arousal
• More satisfying sexual experiences

It's important to recognize that sexual health is multifactorial. Hormones, relationship dynamics, stress, sleep, and physical health all play a role.

Is Testosterone Therapy Safe for Women?

When prescribed appropriately and monitored carefully, testosterone therapy can be safe for some women.

Most professional guidelines recommend:

• Using physiologic doses designed for women
• Avoiding supraphysiologic levels
• Monitoring symptoms and hormone levels over time

Potential side effects may include:

• Acne
• Mild hair growth
• Voice changes (rare at appropriate doses)
• Changes in cholesterol levels

These effects are dose dependent, which is why careful dosing and follow-up are essential.

How Is Testosterone Prescribed for Women?

In the United States, there is currently no testosterone product specifically approved for women, so therapy is typically prescribed in one of two ways:

1. Compounded topical creams or gels
2. Adjusted doses of testosterone gel formulated for men

Transdermal formulations that go on the skin are recommended, and the goal is to deliver very small doses that mimic natural female levels.

Treatment plans should always be individualized based on symptoms, health history, and patient preferences.

Should Every Woman Take Testosterone?

Testosterone therapy is not appropriate or necessary for everyone.

Many women feel well with optimized estrogen and progesterone alone.

Testosterone may be considered when women have persistent low libido, reduced sexual satisfaction, or symptoms that have not improved with other treatments.

A careful evaluation helps determine whether testosterone therapy is likely to be beneficial.

A Personalized Approach to Hormone Health

Hormone therapy is never one-size-fits-all. Every woman's experience with perimenopause and menopause is different.

The goal of treatment is not to normalize lab numbers—it's to improve quality of life, reduce symptoms, and support long-term health.

For some women, testosterone may be one part of a thoughtful, individualized hormone therapy plan.

Take the Next Step

If you're experiencing symptoms such as low libido or sexual dysfunction during perimenopause or menopause, it may be helpful to explore your hormone health with a knowledgeable clinician.

Awaken Women's Health offers personalized care to help women understand their symptoms and explore treatment options that align with their goals.

We offer hormone therapy in-person and by telehealth in Gig Harbor, WA. Schedule a consultation today to learn more about your options.