Testosterone Therapy for Women

“The current controversy surrounding
testosterone treatment is causing confusion
amongst women and healthcare professionals alike”.1

Umbrella

What may the Testosterone Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Androgen
  • Male Androgen Hormone
  • Male Hormone
  • Male Sex Hormone
  • Testosterone
  • Testosterone Therapy/Treatment

Testosterone

What is testosterone?

DotS the definition of testosterone may vary. The Australian Menopause Society’s (AMS) definition is:

“Testosterone is the male sex hormone found in smaller amounts in women. In women, increased levels of testosterone can lead to acne and hirsutism. Low levels of testosterone in women may contribute to loss of libido”.2

Female Hormone

Is testosterone a female hormone?

On page one in Testosterone Replacement In Menopause: Is Testosterone A Female Hormone? the British Menopause Society (BMS) elaborate on:

“Yes – premenopausal women produce both testosterone and estrogen physiologically. Androgens, including testosterone, are essential for development and maintenance of female sexual anatomy and physiology, and modulation of sexual behaviour”.3

Libido

What is libido?

DotS the definition of libido may vary. In What Can Affect Your sex Life? Sexual Desire (Libido) the (Australian) Jean Hailes for Women’s Health (JH) definition is:

“Sexual desire or sex drive is your level of interest in sexual activity. It’s normal for your sexual desire to go up and down at different times and for different reasons”.4

Testosterone Therapy

Is testosterone therapy recommended for low libido?

In Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy the JH elaborate on:

Testosterone Therapy for Women“The area of wellbeing and libido is very complex, and research tells us these are likely to be influenced by psychological factors more than testosterone. But testosterone therapy may be a suitable treatment for postmenopausal women who feel distressed by their loss of sexual desire. This condition is known as hypoactive sexual desire disorder (HSDD)”.5

HSDD

In women, what is Hypoactive Sexual Desire Disorder (HSDD)?

DotS the definition of HSDD may vary. In What Is Hypoactive Sexual Desire Disorder (HSDD) In Women? What Causes It? the International Society for Sexual Medicine’s definition is:

“Hypoactive sexual desire disorder (HSDD) is a troublesome condition in which women lose interest in sex. The Society for Women’s Health Research estimates that one in ten women have HSDD, making it one of the most common female sexual health complaints”.6

Postmenopause + HSDD

For postmenopausal women experiencing HSDD, may testosterone therapy be a suitable treatment?

On page one in Testosterone and the Menopause: Testosterone Replacement In Women, published July 2022, the European Menopause and Andropause Society note:

“HSDD after the menopause is the only evidence-based indication for testosterone in women”.7

In Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy the JH note:

Testosterone Therapy for Women“Testosterone therapy is only recommended for women diagnosed with HSDD. There is no evidence to support using testosterone in premenopausal women for low libido or any other condition such as low mood or depression”.8

On page one in Testosterone for Women: Why Use Testosterone? the British Women’s Health Concern elaborate on:

“The current recommended reason is for persistent low sex drive (Hypoactive sexual desire disorder, HSDD) in women after all other possible factors, including taking adequate estrogen, have been addressed. Even with this indication, it does not help everyone”.9

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – MHT Formulations and Options: Testosterone published online 01 December 2023, the authors explain:

“Testosterone is not a standard component of MHT. The only evidence-based indication for testosterone therapy is for the treatment of postmenopausal women who experience loss of sexual desire that causes them to experience concern/distress. When prescribed for this indication, treatment should be transdermal and ideally with a preparation formulated for women. Alternatively, a modified dose of a regulatory-approved male testosterone therapy could be used. With both options, women should be monitored for evidence of clinical or biochemical androgen excess. Compounded testosterone formulations are not recommended due to lack of evidence of safety or efficacy. Detailed guidance regarding testosterone use in women can be found in the Global Consensus Position Statement for Testosterone use in Women”.10

Australia, 19 June 2023

Presently, is Australia the only country in the world with an approved testosterone formulation specifically for women?

In Advancing Menopause Care In Australia: Barriers and Opportunities: The Role of Testosterone, published online 19 June 2023, the authors elaborate on:

“Presently, Australia is the only country in the world with an approved testosterone formulation specifically for women. Its prescribing indication is in line with the evidence of efficacy of transdermal testosterone for the treatment of post‐menopausal women with low sexual desire associated with personal distress (hypoactive sexual desire disorder). Important caveats on the evidence are that…”.11

BMS Statement on Testosterone, 02 March 2023

What does the BMS Statement on Testosterone, 02 March 2023, elaborate on for the treatment of low libido?

The BMS Statement on Testosterone elaborates on:

“The current controversy surrounding testosterone treatment is causing confusion amongst women and healthcare professionals alike. British Menopause Society guidance follows NICE NG23 which recommends that testosterone is used for low libido after other options have been exhausted.

Levels of testosterone in women decline between the ages of 20 and 40. By menopause the levels have plateaued out and are stable. Testosterone is produced by the adrenal glands and the ovaries in peri and post-menopausal women. Testosterone is not the third component of HRT and promoting misinformation is creating unrealistic expectations for women, some of whom have challenging social circumstances. Managing women with hypoactive sexual desire disorder, necessitates a biopsychosocial approach. It is important to consider contributory factors which include vulvovaginal atrophy and relationship issues”.12

Low Mood and Depression

Is there a role for testosterone therapy for low mood or depression?

As noted above in Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy the JH explain:

“Testosterone therapy is only recommended for women diagnosed with HSDD. There is no evidence to support using testosterone in premenopausal women for low libido or any other condition such as low mood or depression”.13

On page four in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

“There is lack of evidence to support testosterone supplementation for the purpose of prevention or improving cognitive function, musculoskeletal health, improving bone density or fracture prevention. Testosterone supplementations should therefore not be offered for these indications”.14

In Advancing Menopause Care In Australia: Barriers and Opportunities: The Role of Testosterone, published online 19 June 2023, the authors explain:

“Despite public opinion being expressed to the contrary, evidence from randomised, placebo‐controlled trials that testosterone will improve mood, wellbeing, musculoskeletal health or cognitive function remains lacking. Internationally, there is agreement that testosterone should not be prescribed for any symptoms, including low mood or depressive symptoms, or any condition other than hypoactive sexual desire disorder in post‐menopausal women without new evidence”.15

05 July 2024

So, does testosterone improve fatigue, wellbeing or cognition?

In Prescribing of Testosterone for Middle-Aged Women ‘Out of Control’, published 05 July 2024, includes:

“Newson said: “Testosterone has a significant influence on brain processing and function so clinicians should stop thinking about it purely as a hormone to improve libido.”

Prof Susan Davis, head of the Monash University Women’s Health Research Programme in Melbourne Australia, and a past president of the Australasian Menopause Society and the International Menopause Society, disputes this suggestion.

She said: “The data clearly supports a trial of therapy in postmenopausal women with low sexual function that bothers them. But we have looked at the evidence inside and out, reviewed all the published literature, and published all of our own data. The evidence that testosterone will improve fatigue, wellbeing, cognition, or anything else you want to list, is just not there”.16

Health Care Provider

What if I am considering testosterone therapy?

If you are considering testosterone therapy, it may be in your best interest to choose to talk to your health care provider about this.

In Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy – How Is Testosterone Used? the JH note:

“If testosterone therapy is going to improve your libido, you will start to notice this after about four weeks. If there is no improvement after six months, you should stop testosterone treatment”.17

Health Topics A-Z

Where may I find Health Topics A-Z related to Testosterone?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Testosterone?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. Advancing Menopause Care In Australia: Barriers and Opportunities – The Role of Testosterone Treatment
  2. Association Between Testosterone and Cognitive Performance In Postmenopausal Women: A Systematic Review of Observational Studies
  3. BMS Comment on Channel 4 Programme: Davina McCall: Sex, Myths and the Menopause
  4. BMS Statement on Testosterone [02 March 2024]
  5. BMS Statement on Testosterone [26 July 2024]
  6. BMS TV: Testosterone Explained
  7. Can You Have Systemic Testosterone on Its Own Without Oestrogen Therapy?
  8. Causes of Low Libido In Postmenopausal Women [Video]
  9. Deciding About Hormone Therapy Use
  10. Don’t Believe the Hype. Menopausal Women Don’t All Need To Check – or Increase – Their Testosterone Levels
  11. Dr Louise Newson Talks Testosterone
  12. Dr Louise Newson: The Truth About the Menopause & HRT
  13. Effects of Testosterone Therapy for Women: A Systematic Review and Meta-Analysis Protocol
  14. Find A Menopause Practitioner [United States and Other]
  15. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  16. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  17. How To Get Female Testosterone Therapy In Menopause [17 June 2024]
  18. I Forgot To Ask the Doctor – E9: The Menopause: Can Every Woman That Wants It Have HRT?
  19. International Society for Sexual Medicine: Sexual Health Topics
  20. International Society for the Study of Women’s Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder In Women
  21. International Society for the Study of Women’s Sexual Health: Find A Provider
  22. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  23. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing, Intimacy and Menopause [+ Video: Menopause Is the End of Your Sex Life] [Other Languages and Formats]
  24. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  25. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Supporting Someone Through the Menopause [+ Video: Men Don’t Need To Know About Menopause] [Other Languages and Formats]
  26. Let’s Talk About Perimenopause
  27. Libido and Testosterone Therapy – Podcast
  28. Looking After Yourself: Managing Low Libido – Testosterone Therapy
  29. Low Sex Drive In Women
  30. Low Sex Drive In Women: Diagnosis & Treatment
  31. Low Testosterone Levels In Women Associated With Double the Risk of Cardiac Events
  32. Managing Your Symptoms
  33. Menopause
  34. Menopause
  35. Menopause
  36. Menopause Management Options
  37. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Testosterone Therapy for Women
  38. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Testosterone
  39. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  40. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  41. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  42. Menopause Relief In the Spotlight Thanks To Monash University-Led Studies [Australia]
  43. Menopause Ruining Your Sex Life?
  44. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  45. Menopause Treatments: What Works, What Doesn’t
  46. Menopause What Are the Symptoms?
  47. Menopause and Sexuality
  48. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  49. NIHR Testosterone Trial [National Institute of Health Research, United Kingdom]
  50. National Center for Complementary and Integrative Health: Herbs At A Glance
  51. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  52. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  53. Navigating Menopause Together: How Partners Can Help
  54. No Evidence Testosterone Helps Treat Pre-Menopausal Symptoms, An Expert Says#LetsDiscuss Libido and Desire
  55. Patty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  56. Perimenopause
  57. Postmenopause
  58. Prescribing Testosterone and DHEA: The Role of Androgens In Women
  59. Prescribing of Testosterone for Middle-Aged Women ‘Out of Control’
  60. Safety and Efficacy of Testosterone for Women: A Systematic Review and Meta-Analysis of Randomised Controlled Trial Data
  61. Sex and Menopause: Treatment for Symptoms
  62. Sex and Sexual Health
  63. Sexual Difficulties In the Menopause: Hormones and Sexual Function – Testosterone
  64. Sexual Health: In-Depth – Testosterone Therapy – Potential Benefits and Risks As You Age
  65. Supporting A Loved One Through Menopause
  66. Symptoms of Low Testosterone In Women (and Reasons Why It Might Be Low)
  67. Testosterone | Dr Louise Newson [Video]
  68. Testosterone May Significantly Improve Sexual Function and Sexual Wellbeing In Postmenopausal Women
  69. Testosterone Replacement In Menopause
  70. Testosterone Therapy In Females Is Not Associated With Increased Cardiovascular or Breast Cancer Risk: A Claims Database Analysis
  71. Testosterone Therapy In Women: A Clinical Challenge
  72. Testosterone Therapy In Women: Does It Boost Sex Drive?
  73. Testosterone Therapy for Hypoactive Sexual Desire Disorder (HSDD)
  74. Testosterone Use for Hypoactive Sexual Desire Disorder In Postmenopausal Women
  75. Testosterone and the Menopause
  76. Testosterone for Menopause: Why Women Face Difficulties Accessing Treatment
  77. Testosterone for Women
  78. The 2023 Practitioner’s Toolkit for Managing Menopause
  79. The Association Between Testosterone and Depression In Postmenopausal Women: A Systematic Review of Observational Studies
  80. The Clinical Management of Testosterone Replacement Therapy In Postmenopausal Women With Hypoactive Sexual Desire Disorder: A Review
  81. The Truth About Menopause Supplements | Dr Sarah Berry
  82. Therapy for the Effects of Menopause
  83. Tips To Help Manage Menopause Symptoms
  84. Using Natural Therapies In the Menopause Transition – Webinar
  85. Vaginal Dryness
  86. Vaginal Dryness After Menopause: How To Treat It?
  87. Vaginal Dryness: What To Do About It
  88. Video Series-2022: Discussing Sexual Health Concerns With Your Health Care Professional
  89. Video Series-2023: NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  90. Video Series-2024: Preparing for Your Menopause Healthcare Visit
  91. Videos and Podcasts: Videos – Interviews: Is Testosterone the Answer To Low Libido? [2021]
  92. Webinars: Previous – Lessons From the Global Consensus on Testosterone for Women
  93. Webinars: Previous – Testosterone and Women
  94. What Can Affect Your Sex Life?
  95. What Everyone Should Know About Menopause Symptoms
  96. What Is Hypoactive Sexual Desire Disorder (HSDD) In Women? What Causes It?
  97. What Side Effects May Occur When Women Take Testosterone?
  98. What’s New – The Use of Testosterone In Women [Video] [March 2021]
  99. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit
  100. World Menopause Day 2019: Global Consensus Position Statement on the Use of Testosterone Therapy for Women: A White Paper [Multiply Languages]
  101. World Menopause Day 2019World Menopause Day 2019: Patient Information Leaflet: Testosterone for Women At Midlife [Multiply Languages]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. BMS Statement on Testosterone. 02 March 2023. British Menopause Society https://thebms.org.uk/2023/03/bms-statement-on-testosterone/ Accessed: 12 July 2024
  2. Glossary of Terms: Testosterone. Content Updated: February 2022. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/381-glossary-of-terms Accessed: 12 July 2024
  3. Testosterone Replacement In Menopause: 2. What Is Its Role In Women? Publication Date: December 2022:1. British Menopause Society https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/ Accessed: 12 July 2024
  4. What Can Affect Your Sex Life? Sexual Desire (Libido). Last Updated: 03 June 2024 | Last Reviewed: 12 December 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/sex-sexual-health/what-can-affect-your-sex-life#sexual-desire-libido Accessed: 12 July 2024
  5. Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy. Last Updated: 19 January 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/looking-after-yourself#sex-and-relationships Accessed: 12 July 2024
  6. What Is Hypoactive Sexual Desire Disorder (HSDD) In Women? What Causes It? International Society for Sexual Medicine https://www.issm.info/sexual-health-qa/what-is-hypoactive-sexual-desire-disorder-hsdd-in-women-what-causes-it? Accessed: 12 July 2024
  7. Testosterone and the Menopause: Testosterone Replacement In Women. 2022:1. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/07/Testosterone-and-the-menopause.pdf Accessed: 12 July 2024
  8. Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy. Last Updated: 19 January 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/looking-after-yourself#sex-and-relationships Accessed: 12 July 2024
  9. Testosterone for Women: Why Use Testosterone? Publication Date: February 2022:1. British Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/testosterone-for-women/ Accessed: 12 July 2024
  10. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Definitions. Published Online: 01 December 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 12 July 2024
  11. Davis S. R., and Magraith, K. Advancing Menopause Care In Australia: Barriers and Opportunities: The Role of Testosterone. Published Online: 19 June 2023. https://www.mja.com.au/journal/2023/218/11/advancing-menopause-care-australia-barriers-and-opportunities Accessed: 12 July 2024
  12. BMS Statement on Testosterone. 02 March 2023. British Menopause Society https://thebms.org.uk/2023/03/bms-statement-on-testosterone/ Accessed: 12 July 2024
  13. Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy. Last Updated: 19 January 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/looking-after-yourself#sex-and-relationships Accessed: 12 July 2024
  14. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 12 July 2024
  15. Davis S. R., and Magraith, K. Advancing Menopause Care In Australia: Barriers and Opportunities: The Role of Testosterone. Published Online: 19 June 2023. https://www.mja.com.au/journal/2023/218/11/advancing-menopause-care-australia-barriers-and-opportunities Accessed: 12 July 2024
  16. Geddes, L. Prescribing of Testosterone for Middle-Aged Women ‘Out of Control. 05 July 2024. href=”https://www.theguardian.com/society/article/2024/jul/05/prescribing-of-testosterone-for-middle-aged-women-out-of-control Accessed: 12 July 2024
  17. Looking After Yourself: Sex and Relationships – Managing Low Libido: Testosterone Therapy – How Is Testosterone Used? Last Updated: 19 January 2024 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/looking-after-yourself#sex-and-relationships Accessed: 12 July 2024
Topic Last Updated: 27 July 2024 – Topic Last Reviewed: 12 July 2024

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