Testosterone for menopause: The treatment is rising in popularity, but does it work?

Testosterone-based therapies for menopause have gained popularity among doctors, but the scientific evidence supporting their effectiveness remains limited, according to recent reports. Though often referred to as a "male" hormone, females naturally produce testosterone, albeit at lower levels than in males. However, testosterone levels in women tend to drop gradually from age 20 to 60, with a slight increase after age 60.

Menopause, which typically occurs around age 51 to 52, does not coincide with a significant drop in testosterone levels. Instead, it's the fluctuations in estrogen and progesterone during perimenopause and their subsequent decline that cause the characteristic symptoms of menopause.

A 2026 U.S. study reported over 90,000 off-label prescriptions for testosterone therapy in women, mainly between ages 45 to 64 and those diagnosed with menopause. This marked a 58.7% increase from 2024. However, the FDA has not yet approved testosterone as a treatment for menopause, perimenopause, or postmenopause. While testosterone is not FDA-approved for HSDD in menopause, a U.K. trial, ESTEEM, is underway to assess the potential benefits of testosterone cream in improving menopausal symptoms.

The trial, expected to conclude by 2028, will track participant symptoms related to menopause, including sleep quality, memory performance, anxiousness, migraines, body mass, and overall well-being. Despite the growing interest in testosterone therapy, experts warn that more robust evidence is needed to fully assess its efficacy in treating menopausal symptoms.