More doctors are writing their menopausal patients prescriptions for testosterone therapy. A 2026 study conducted in the U.S. recorded over 90,000 off-label prescriptions for testosterone to women in 2025, mainly among women ages 45 to 64 and those with diagnoses of menopause. This marked a 58.7% increase from 2024.
So, does scientific evidence support the use of testosterone to alleviate menopause symptoms? Or is it too soon to say?
While testosterone treatment for menopause has gained popularity, there's limited evidence to back up its use, experts say. (Image credit: Bloomberg via Getty Images)There's a common misconception that females experience "androgen deficiency" — a marked decline in testosterone and related hormones — leading up to menopause, said Susan Davis, a professor of endocrinology and the head of the Women's Health Research Program at Monash University in Australia. This is not the case.
Placebo-controlled trials have not been able to show that testosterone treatment helps to alleviate brain fog or improve well-being, mood, bone density or muscle function in menopausal patients, said Davis, who has conducted a number of these trials herself.
On Sept. 17, the FDA held a public workshop to evaluate the evidence for testosterone therapy for menopause, concluding that more evidence is needed to fully assess the use of the hormone as a menopause treatment.
Testosterone for low sex drive?
A review of 36 randomized trials involving 8,480 participants found that testosterone treatment delivered with skin patches was associated with 0.85 additional satisfying sexual events per month in postmenopausal women, compared to a placebo. This observed effect is not huge, Dr. Nanette Santoro, a professor of obstetrics and gynecology at the University of Colorado School of Medicine, told Live Science in an email.
Susan Davis, head of the Women's Health Research Program at Monash University
Notably, testosterone is not FDA approved as a treatment for HSDD in menopause yet. A drug called flibanserin, which affects serotonin in the brain, is approved to treat HSDD for pre- and postmenopausal women under age 65.
Davis said that in her patient groups, it's common for about 1 in 3 trial participants to report an improvement of their symptoms even though they are taking a placebo. Other trials have reported similar findings in their placebo groups, with about 30% to 40% experiencing some improvement in sexual desire and satisfaction, for example.
One study trying to address this gap is the U.K. National Institute for Health and Care Research's ESTEEM trial. This large-scale, gold-standard trial aims to recruit hundreds of menopausal women and test whether using testosterone cream can reliably improve their quality of life. The cream will deliver testosterone through the skin and be applied to the lower abdomen and thighs. (Doctors often advise women to apply the creams in this way because those body parts are easy to hide if the treatment causes localized hair growth that the patients would prefer to conceal.)
In the meantime, though, there isn't strong evidence that testosterone directly improves symptoms of menopause beyond HSDD. "Of all the studies done to date, if there was a screaming benefit, you think you would have seen it," Davis said.
Females' testosterone levels generally decline throughout adulthood, with a slight increase after age 60. However, there isn't a sharp dip in testosterone around the time of menopause. (Image credit: KATERYNA KON/SCIENCE PHOTO LIBRARY via Getty Images)Could taking testosterone for menopause be harmful?
In other countries, such as the U.S., doctors are left trying to adapt medication dosed for males for their female patients, which can lead to a wide variation in dosing. And the effects of these different dosing regimens are poorly understood for female patients. "It is not necessarily unsafe to use male preparations for women, it's just that much, much less must be used," Santoro said.
Additionally, the potential impacts of extra testosterone on cardiovascular health and breast cancer risk are poorly understood, Santoro noted. At lower doses, testosterone can cause mild acne, oily skin, and some increase in facial and body hair growth in postmenopausal women, trials have found; if these symptoms remain mild, they are generally considered acceptable.
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"Women are being prescribed some very big doses in North America, and no one studied the safety of these," Santoro said.
When it comes to hyped therapies like testosterone, she said, "just be cautious about people who tell you they've got the answer that no one else has got."
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