Testosterone
Testosterone is an androgen hormone that plays an important role in women’s health. It is produced primarily by the ovaries and adrenal glands and contributes to sexual desire, muscle and bone health, energy, and overall wellbeing.
Unlike estrogen and progesterone, which change considerably during the menopause transition, testosterone generally declines more gradually with age. As estrogen levels fall during perimenopause and menopause, however, the changing balance between these hormones may make some androgen-related effects more noticeable.
Testosterone is particularly important to sexual function, including desire and arousal, but hormone levels are only one of many factors that can influence sexual wellbeing during menopause.
How Testosterone Levels Change Through Life
Reproductive Years
Reproductive Years
Reproductive Years
Testosterone rises during puberty, reaches its highest levels in early adulthood, and gradually declines with age.
Common Features
- Produced by the ovaries and adrenal glands
- Supports sexual desire and function
- Contributes to muscle and bone health
- Gradually declines during adulthood
Perimenopause
Reproductive Years
Reproductive Years
Testosterone generally continues its gradual age-related decline while estrogen and progesterone fluctuate more dramatically.
Common Features
- Testosterone decline is generally gradual
- Estrogen and progesterone change more dramatically
- Relative androgen effects may become more noticeable
- Sexual desire and energy may change for many reasons
Menopause
Reproductive Years
Postmenopause
Testosterone does not suddenly fall at natural menopause, although ovarian hormone production continues to change.
Common Features
- Levels are lower than in early adulthood
- Ovarian androgen production continues
- Adrenal glands remain another source of androgens
- Hormonal balance continues to shift
Postmenopause
Reproductive Years
Postmenopause
Testosterone remains present at lower levels, with androgens continuing to come from ovarian and adrenal sources and peripheral conversion.
Common Features
- Testosterone remains present after menopause
- Levels generally remain lower than in younger adulthood
- Sexual function is influenced by hormonal and nonhormonal factors
- Surgical removal of both ovaries can cause a more abrupt decline
Why Testosterone Matters
- Supports sexual desire and arousal
- Contributes to muscle mass and strength
- Plays a role in bone health
- May influence mood and wellbeing
- Works alongside other hormones throughout life
When Testosterone Levels or Androgen Effects Change
Lower testosterone may be associated with:
- Reduced sexual desire
- Changes in sexual arousal
- Reduced sense of wellbeing in some women
Higher androgen activity may contribute to:
- Acne or oily skin
- Increased facial or body hair
- Scalp hair thinning
These symptoms can have many causes and cannot be attributed to testosterone levels alone. A healthcare provider can help determine whether hormonal or other factors may be involved.
Testosterone and Menopause
Unlike estrogen and progesterone, testosterone does not suddenly decline at menopause. Levels generally decrease gradually with age. However, as estrogen and progesterone change during the menopause transition, the balance between these hormones also shifts.
Sexual Health
Testosterone plays a role in sexual desire and arousal. Some women notice changes in libido during and after menopause, but testosterone is only one part of sexual wellbeing. Estrogen changes, vaginal dryness or discomfort, medications, sleep, stress, relationships, and overall health can also affect sexual desire and satisfaction.
Skin & Hair
Changes in the balance between estrogen and androgens may make androgen-related effects more noticeable. Some women experience increased facial hair, acne or oilier skin, or thinning hair on the scalp.
Muscle & Bone Health
Testosterone contributes to the maintenance of muscle and bone throughout life. However, changes in muscle mass, strength, and bone density during and after menopause are influenced by many factors, including estrogen decline, aging, physical activity, nutrition, and overall health.
Surgical Menopause
Removal of both ovaries can cause a more abrupt reduction in ovarian testosterone as well as estrogen. This hormonal change may be more noticeable than the gradual changes that occur with natural menopause.
Changes in libido, energy, mood, or physical wellbeing are not necessarily caused by low testosterone. If symptoms are persistent or concerning, a healthcare provider can help evaluate hormonal and nonhormonal factors that may be contributing.
Testosterone Therapy for Women
Testosterone therapy may be considered for some postmenopausal women diagnosed with hypoactive sexual desire disorder (HSDD) after other potential causes of low sexual desire have been evaluated.
HSDD involves persistent or recurrent low sexual desire that causes personal distress and cannot be better explained by another medical condition, medication, relationship factor, or other cause.
Testosterone therapy is not currently recommended as a general treatment for fatigue, cognitive changes, mood symptoms, muscle loss, or overall wellbeing during menopause.
Important Considerations
- No testosterone product is currently FDA-approved specifically for women in the United States. Treatment may therefore involve carefully prescribed off-label therapy.
- Doses used for women are much lower than those used for men and should aim to keep testosterone within the normal physiologic range for premenopausal women.
- Blood testing may be used before and during treatment to help avoid excessive testosterone exposure; testosterone levels alone should not be used to diagnose HSDD.
- Monitoring is important. Excess testosterone may cause acne, increased facial or body hair, scalp hair thinning, or voice changes.
- Treatment should be reassessed if meaningful improvement does not occur after an appropriate trial.
Treatment & Support Options
Medical
When testosterone therapy is appropriate for HSDD, transdermal testosterone is generally preferred because dosing can be adjusted and monitored more readily. In the United States, treatment for women is currently prescribed off-label because there is no FDA-approved testosterone formulation specifically for women.
Healthy Lifestyle
- Eat a balanced diet rich in protein, calcium, vitamin D, fruits, and vegetables.
- Participate in regular weight-bearing and strength-training exercise.
- Prioritize good sleep and stress management.
- Avoid smoking and limit alcohol.
- Maintain a healthy weight.
Final Thoughts
Testosterone remains an important part of women’s health throughout life. Although levels generally decline gradually with age, changes in the balance between testosterone, estrogen, and other hormones may influence sexual health and wellbeing. Understanding these changes can help you recognize symptoms and have more informed conversations with your healthcare provider.
Key Takeaways
✓ Testosterone is an important hormone in women, contributing to sexual function, muscle and bone health, and overall wellbeing.
✓ Levels generally decline gradually with age rather than dropping suddenly at natural menopause.
✓ Hormone levels alone do not explain symptoms such as low desire, fatigue, or mood changes.
✓ Testosterone therapy has its clearest evidence for HSDD in appropriately evaluated postmenopausal women.
✓ Treatment requires individualized dosing and monitoring, particularly because no testosterone product is currently FDA-approved specifically for women in the U.S.
Understanding testosterone can help make sense of changes in sexual health and wellbeing.
Want a More Comprehensive Guide?
Looking for a complete guide to every stage of menopause? Explore Menopause Spotlight: Your Essential Guide to Perimenopause, Menopause, and Beyond.
Available in paperback, hardcover and eBook.
Medical Disclaimer
The information on this page is provided for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Testosterone levels, menopause symptoms, and treatment decisions vary from person to person. Always consult your healthcare provider before starting, stopping, or changing hormone therapy, supplements, medications, or other treatments.
If you experience severe or rapidly worsening symptoms or any medical emergency, seek immediate medical attention.