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While testosterone is often labeled a ‘male hormone,’ it plays an essential role in women’s health too — especially when it comes to sexual desire during menopause. Learn how balancing hormones can help restore energy, confidence, and intimacy.
Medically Reviewed by: Dr. Suzanne Wolf
Menopause marks a major shift in a woman's hormonal landscape, and for many, sexual health is one of the domains that feels the impact. While much attention has been given to estrogen and progesterone, testosterone — typically thought of as a "male hormone" — plays a meaningful role in women too.
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Dr. Suzanne Wolf, Connected Health's family medicine and women's health physician, shares insight on the evolving topic:
"Testosterone isn't just for men. Testosterone is well studied in women, most notably in relationships to its contribution to sexual function. Testosterone receptors are found throughout the body in men and women. There is data showing benefits for bone health, muscle mass, cognitive function, and even cardiovascular physiology."
Testosterone receptors exist throughout the female body, meaning the hormone can act on many organ symptoms. In women, testosterone contributes to:
During menopause, estrogen levels drop substantially, and while testosterone also declines, the relative loss of androgenic support may contribute to symptoms such as low libido and fatigue.
Thus, in menopausal women, ensuring a balanced hormonal environment, including adequate estrogen and approporate levels of testosterone can support sexual and overall health.. Dr. Wolf reminds us, "there is balance as too much testosterone has been associated with an increased cardiovascular risk. Having adequate estradiol (estrogen) levels is also very important when adding testosterone therapy in women."
One of the clearest areas of evidence for testosterone in women is its role in enhancing sexual desire — particularly in women experiencing low libido (also called hypoactive sexual desire disorder, HSDD) after menopause. Key points:
So for a woman who is post-menopausal, has persistent low sexual desire that causes distress, and has had other contributing issues evaluated and treated, testosterone may be a valuable therapeutic option. However, it’s not a blanket fix for everyone, and expectations must be realistic.
If testosterone is being considered as part of a midlife sexual health plan, several practical aspects are key:
Ensure estrogen is adequate: Because estrogen supports vaginal and pelvic tissue health, blood flow, mood and sexual arousal, having sufficient estradiol (or being on appropriate hormone replacement) often enhances outcomes when testosterone is added.
Formulation & route: Transdermal creams or gels are the commonly used forms in women (applied to thighs, calves, upper arms) because they allow careful dose adjustment and avoid large systemic peaks. Dr. Wolf explains that careful dosing is important and typically about one-tenth the dose used in men.
Monitoring: Before starting therapy, baseline labs are helpful. After therapy begins, monitoring ensures testosterone remains within physiologic female range and checks for signs of androgen excess (acne, unwanted hair growth, deepening voice) and cardiovascular/liver/lipid effects. Many clinicians recommend follow-up labs ~4–6 weeks after start, then every 6-12 months.
Side effects / risks: When used at female-physiologic doses, side effects are uncommon but may include mild acne, increased body/facial hair growth, scalp hair thinning, rarely voice deepening or clitoral enlargement (more likely with excessive doses). Some conditions may preclude use (e.g., current hormone-sensitive cancer, uncontrolled heart disease, liver disease) and any therapy should be overseen by clinicians familiar with midlife women’s health.
Lifestyle & holistic care: Even with testosterone therapy, foundational elements such as good sleep, exercise (especially strength training and pelvic floor), nutrition, stress management, vaginal care (lubricants, atrophy treatment), relationship/communication support remain vital. Hormone therapy isn’t a substitute for these.
Testosterone plays a meaningful, yet often under-recognized, role in women’s health, particularly during the transition through menopause when hormones shift dramatically. For women experiencing persistent, distressing low sexual desire after menopause (and after other causes have been addressed), low-dose testosterone therapy (typically transdermal) can be an evidence-supported option.
While the benefits are most consistent in improving libido and sexual satisfaction, other potential effects on mood, cognition, and energy remain under active study. As always, safety and monitoring matter: maintaining testosterone within the physiologic female range, following up regularly, and balancing estrogen levels are essential to ensure safe and effective care.
At Connected Health, we believe women deserve to be heard, understood, and supported with evidence-based options. Under the guidance of Dr. Wolf, our women’s health physician, we offer comprehensive hormonal health programs — including specialized blood panels and personalized care packages designed to uncover the root causes of midlife symptoms.
As Dr. Wolf reminds us:
“Too often, women’s concerns during perimenopause and menopause are minimized or dismissed. We’re here to listen, identify what’s really going on, and help you feel like yourself again.”
Our goal is to empower women with knowledge and access to the kind of care that honors both the science and the individuality of each patient. If you’re navigating menopause and noticing changes in libido, mood, or energy, you’re not “just getting older” — your hormones tell a story worth listening to. And we’re here to help you make sense of it.
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