Testosterone is often called "the male hormone," but women produce it too — and it declines with age.

Natural decline: Testosterone levels in women peak in their 20s and decline by about 50% by age 50. Oophorectomy (surgical removal of ovaries) causes an immediate 50% drop.

What the evidence says:

  • Davis et al. (Lancet, 2025) — a comprehensive review confirmed that testosterone therapy improves sexual desire, arousal, and satisfaction in postmenopausal women with HSDD (Hypoactive Sexual Desire Disorder)
  • Evidence for energy and mood benefits is less robust but suggestive
  • Bone density benefits are promising but require more research

Caveats:

  • Testosterone is NOT FDA-approved for women in the US. It is prescribed off-label
  • Doses are 1/10 of male doses — typically 1-2 mg/day transdermally
  • Monitoring is essential — serum levels should be kept within the physiological female range
  • Side effects are rare at correct doses: acne, hair growth, voice changes are signs of excess

The Menopause Society recommends considering testosterone therapy for postmenopausal women with low sexual desire that affects quality of life, after ruling out other causes.