Testosterone and Women: The Hormone We Need to Talk About
Although it is often thought of as a male hormone, testosterone is produced naturally in women by the ovaries and the adrenal glands, in much smaller amounts than in men.
It contributes to libido and sexual function, energy and motivation, mood and wellbeing, concentration and mental clarity and muscle strength. It works alongside oestrogen and progesterone as part of one finely balanced system, which is why looking at testosterone in isolation rarely tells the whole story.
How Levels Change Over Time
Testosterone declines gradually from your late twenties, and then drops more significantly around the menopause. This is a normal part of ageing.
For some women the change is barely noticeable. For others, particularly those who experience surgical menopause or who are more sensitive to hormonal shifts, the impact can be significant, especially on libido and energy levels.
Symptoms of Low Testosterone
The symptoms of low testosterone overlap with those of the perimenopause and menopause, which is part of why they are so often missed. They can include persistent low libido, reduced energy, low mood, loss of muscle strength, and brain fog or difficulty concentrating.
These symptoms have many possible causes, and low testosterone is only one of them. That is exactly why proper assessment matters far more than self-diagnosis from a checklist online.
Libido Is About More Than Hormones
When testosterone is being considered for low libido, it is important to look at the whole picture, because desire is influenced by far more than one hormone. Medications, relationship difficulties, stress and wider lifestyle factors can all affect libido, as can vaginal dryness or soreness that makes sex uncomfortable.
It is also worth understanding the difference between libido and arousal. Libido is your desire or interest in sex, whereas arousal is the body's physical response. The two are related but not the same, and a drop in one is not always explained by the other. A good assessment takes the time to tease these apart, rather than reaching for testosterone as an automatic answer.
When Testosterone Therapy Might Help
The most evidence-based reason for testosterone therapy in women is persistent low sexual desire, medically known as Hypoactive Sexual Desire Disorder, once other contributing factors have been addressed.
Where testosterone is prescribed for libido, it is important that any vaginal dryness or soreness is treated too, often with topical vaginal oestrogen, so that sex is not uncomfortable. Addressing this alongside testosterone gives a far better chance of a meaningful improvement.
Beyond libido, many women report additional benefits such as improved energy, mood and mental clarity. The research around these wider benefits is still developing, but in clinical practice many women describe regaining their spark and feeling more like themselves again. At The Women's Hormone Clinic, testosterone therapy is one of our specialisms, and our approach is grounded in guidance from organisations like the British Menopause Society.
Why It Can Be Hard to Access on the NHS
Accessing testosterone through the NHS can be challenging. Many GPs are unfamiliar with prescribing it for women, and because it is prescribed off-licence for female patients, some clinicians prefer not to take it on.
This is one of the reasons so many women turn to specialist clinics. What matters is that treatment is properly assessed, prescribed at an appropriate dose and carefully monitored, rather than sourced from unregulated products online.
How Treatment Works in Practice
Dosing is carefully calculated to keep levels within the normal female physiological range, which is where testosterone is both safe and effective. It can take three to six months to feel the full effects, so a little patience is needed as your body adjusts.
Side effects are rare when levels are kept within the female physiological range, which is exactly why monitoring matters. Where they do occur, they can include acne, oily skin and facial hair growth. Treatment is always monitored with regular blood tests and reviews so that levels stay where they should be and any side effects are picked up early.
The Social Media Caution
Testosterone has become a wellness buzzword, with women increasingly told online that they should demand it for energy, weight loss or anti-ageing. This is where care is needed.
Testosterone is not a quick fix, and it is not right for everyone. Prescribing it when it is not indicated can cause side effects, and unregulated products carry real risks. As with everything in women's health, the answer is individualised assessment, not a one-size-fits-all trend.
The Bottom Line
Testosterone is a genuinely important hormone for women, and low levels can affect quality of life in ways that are easy to dismiss. At the same time, it is not a miracle cure and it is not for everyone.
If low libido, low energy or brain fog are affecting your quality of life, testosterone could be one piece of your hormonal health picture. The most useful step is a proper assessment with a clinician who can look at everything together and help you make an informed decision.
