Started hormone therapy but still don’t feel like yourself? Maybe estrogen, part of your bioidentical hormone replacement therapy plan, calmed your hot flashes, but you’re still tired, foggy, and your sex drive has gone into hiding.
It could be that you’re missing another key hormone: testosterone. Yup, testosterone. It’s not just for men.
A recent study has highlighted some of the benefits of testosterone for women. When 279 women already on estrogen added testosterone to their routine, they reported improvements in 15 of 24 menopause symptoms within about three months, including more energy, better focus, and a stronger sex drive.
Here’s what the research found, what it can’t tell us yet, and how to know if testosterone is worth asking your provider about.
What the New Study Found
Researchers looked at the records of 279 women who had been on transdermal estrogen for at least three months. Their average age was 56. After adding transdermal testosterone, the women filled out symptom questionnaires again about three months later, so the results could be compared.
Where Women Felt a Difference
15 of 24 symptoms improved significantly. Here’s where women felt the biggest difference:
| Symptom group | What women reported |
|---|---|
| Energy | Less fatigue and better sleep |
| Muscle and joint | Fewer aches, less pain and muscle tension |
| Mood | Less anxiety, irritability, and low mood, plus more interest in things they enjoy |
| Focus and memory | Easier concentration and less forgetfulness |
| Vaginal and urinary health | Less vaginal dryness (59% improvement), a stronger sex drive (54.8%), and fewer bladder issues |
| Hot flashes and night sweats | Fewer hot flashes (54.9% improvement) and night sweats |
What Didn’t Change
Testosterone didn’t move the needle on everything. Two groups of symptoms showed no meaningful change:
- Nerve-related symptoms: pins and needles, numbness, headaches, and ringing in the ears
- Heart and breathing symptoms: a racing or pounding heartbeat, shortness of breath, and dizziness
That’s useful to know, too. If these symptoms are part of your picture, they may have a different root cause worth exploring with your provider. No single hormone is a cure-all, and this study helps show where testosterone may fit and where it may not.
How Much Should We Read Into These Results?
These findings are encouraging, but they’re an early chapter, not the final word. The researchers looked back at the records of women who had already added testosterone, rather than running a new trial, and there was no comparison group of women who didn’t take it. That makes it hard to know how much of the improvement came from testosterone itself. Women were also followed for only about three months, rated their own symptoms, and in some cases had their estrogen doses adjusted around the same time. None of that cancels the results, but it does mean larger, longer studies are needed to confirm them.
What the Strongest Evidence Supports Today
Large reviews of randomized trials, the gold standard in research, show the clearest benefit for low sexual desire that causes distress in postmenopausal women. That’s why major medical groups currently recommend testosterone for that use. Evidence for mood, muscle, and memory is still limited, with some promising smaller trials and larger studies underway.
Put simply: the research is moving in a hopeful direction, and this new study gives scientists good reason to keep digging.
What Does Testosterone Do for Women?
Women need testosterone too. Your body makes it in your ovaries and adrenal glands, just in smaller amounts than men’s bodies do. It plays a key role in sexual desire and libido and also helps maintain bone density, muscle mass, energy, and mood. In bone, much of its work happens after the body converts it into estrogen, which helps slow bone loss.
Testosterone levels peak in your 20s and decline slowly from there. Unlike estrogen, testosterone doesn’t drop off a cliff at menopause. That gradual decline is one reason its effects can be easy to miss.
If you’re in this stage of life, you might be scratching your head wondering where your drive went. Falling testosterone may be part of the reason. Many women explore testosterone therapy for low libido to help reignite the flame, and as the new study suggests, a little extra testosterone may ease other menopause symptoms too. Scientists are still learning how much lower testosterone contributes to symptoms like fatigue or low mood, which is why research like this matters.
Signs and Symptoms of Low Testosterone in Women
Signs of low testosterone in women include:
- Lowered sex drive
- Lack of energy
- Mood changes
- Brain fog
- Loss of muscle mass and strength
- Insomnia
- Irregular menstrual cycles (if you’re still having periods)
Notice anything? Many of these overlap with low estrogen, thyroid issues, and other common menopause symptoms. There’s also no official cutoff for “low” testosterone in women, which is why lab results and your personal health history work best together.
A quick note on testing: at the FDA’s recent workshop on testosterone in menopausal women, experts recommended checking both free and total testosterone, at least to start. If you’re getting your hormones tested, ask which ones are included.
A Forum Health provider can help you see where your testosterone and other hormone levels stand, so together you can build a BHRT plan that’s unique to you.
Is Testosterone FDA-Approved for Women?
In the US, no testosterone product is FDA-approved for women, not even for low libido. Major medical groups do recommend testosterone for low sexual desire that causes distress, so providers prescribe it off-label, usually at a fraction of the dose used for men.
But this space is making moves. In September 2026, the FDA held its first public workshop in about two decades on testosterone for women in menopause. Experts discussed the research, the patient experience, and the questions still open, especially around heart health, breast cancer risk, and long-term safety. The FDA also signaled that it’s ready to work with drug makers on testosterone products designed for women.
The workshop follows the FDA’s 2025 decision to remove long-standing black box warnings from menopause hormone therapy.
Approval is likely still a few years away, but the message was clear: women’s symptoms deserve better options. As the FDA put it in its closing remarks, “Menopause is inevitable, but women should not have to suffer.”
Want your voice in the conversation? The FDA is accepting public comments on testosterone use in menopausal women through October 19, 2026. Share your experience here.
Side Effects and Safety
When testosterone is prescribed at a dose that keeps your levels in the normal female range, studies haven’t linked it to serious side effects. The most common ones are mild, like acne or unwanted hair growth. Your provider will walk you through other, less common effects and how careful dosing helps avoid them.
Researchers are also still studying the long-term effects on heart health and breast cancer risk, and testosterone generally isn’t recommended for women with heart disease, liver disease, or hormone-sensitive cancers.
That’s why it matters to work with a provider who tracks your labs and symptoms over time and adjusts your dose to fit you and your body.
Could Testosterone Be Part of Your Plan?
Maybe you’re perimenopausal or menopausal and dealing with frustrating symptoms like perimenopause fatigue, menopause brain fog, or joint pain. Already on HRT but have a feeling testosterone might be lacking? Or maybe you’re dealing with low desire and want to understand what’s behind it. The best way forward is to schedule time with a Forum Health provider.
At Forum, we start with listening and getting to know you and your symptoms. Then, we run advanced testing to help build a tailor-made BHRT plan, complete with coaching, monitoring, and re-testing.
Frequently Asked Questions
Do women have testosterone?
Yes. Women make testosterone in the ovaries and adrenal glands, just in smaller amounts than men. Levels peak in your 20s and then decline gradually over the years.
What are the benefits of a female taking testosterone?
The strongest evidence supports testosterone for low sexual desire that causes distress after menopause, which is why many providers consider it part of hormone replacement for low libido. Newer research suggests it may also help with energy, mood, focus, hot flashes, and vaginal dryness, especially for women already on estrogen therapy. Larger studies are underway to confirm these benefits.
Can you take testosterone with estrogen?
Yes. In fact, many providers add testosterone after estrogen therapy is in place, when symptoms like low libido or fatigue still linger. The women in the new study had all been on estrogen for at least three months before starting testosterone.
How long does testosterone take to work for women
It varies, but many women notice changes within a few months. In the new study, improvements showed up at about three months.
Is testosterone FDA-approved for women?
Not yet. No testosterone product is FDA-approved for women in the US, so providers prescribe it off-label at much lower doses than those used for men. The FDA held a public workshop on the topic in September 2026, which may open the door to approved options in the future.
What are the side effects of a female taking testosterone?
When dosed to keep levels in the normal female range, side effects tend to be mild. The most common are acne and unwanted hair growth. Regular lab checks help your provider keep your dose right where it should be.
Sources:
- Elliott B, Klock SM, Hesse J. FDA workshop signals potential approval pathway for testosterone therapy in menopausal women. Holland & Knight. Published September 21, 2026. Accessed October 13, 2026. https://www.hklaw.com/en/insights/publications/2026/09/fda-workshop-signals-potential-approval-pathway-testosterone-therapy
- Fitch J. FDA holding public meeting on testosterone use in menopausal women. Contemporary OB/GYN. Published September 17, 2026. Accessed October 13, 2026. https://www.contemporaryobgyn.net/view/fda-holding-public-meeting-on-testosterone-use-in-menopausal-women
- Hernandez BS, Boyne AM, Fleming B, et al. Improvement in multiple organ systems following testosterone replacement therapy in women previously on standard hormone replacement therapy. J Sex Med. 2026;23(9):qdag116. https://doi.org/10.1093/jsxmed/qdag116
- Should women get treatment for low testosterone? Cleveland Clinic Health Essentials. Published September 22, 2025. Accessed October 13, 2026. https://health.clevelandclinic.org/testosterone-in-women
- Tyagi V, Scordo M, Yoon RS, Liporace FA, Greene LW. Revisiting the role of testosterone: are we missing something? Rev Urol. 2017;19(1). https://pmc.ncbi.nlm.nih.gov/articles/PMC5434832/
