Testosterone and Menopause - Beginners Guide - Stella
8 mins

Guide to testosterone for menopause

byDr. Lucy Wilkinson

There has recently been a lot of buzz around testosterone for women going through menopause. But how does it help? Can it really increase your sex drive? And is it available on the NHS for menopause? We answer your questions.

What is testosterone?

Testosterone is a hormone involved in many different processes. Although it’s often thought of as a male hormone, women also produce it. 

Testosterone has a number of important functions, including effects on behaviour, mood and sex drive.

Testosterone levels fall with age. While this isn’t thought to be directly related to menopause, there is a decrease in the amount of testosterone produced by your ovaries at this time.

How does testosterone help with menopause?

Testosterone is currently prescribed to help with low libido, your sex drive, during menopause. This is also known as hypoactive sexual desire disorder (HSDD). Testosterone is usually given alongside oestrogen, as this helps it work best.

There is not yet any evidence to show that testosterone helps with mood, energy levels, brain fog or aches and pains. Research is ongoing about testosterone and menopause.

Conventional HRT, oestrogen with or without progesterone, has been proven to help with menopause symptoms including hot flushes, night sweats and mood swings, along with low libido.

Start your free online menopause assessment to see if HRT is right for you

Does testosterone increase your sex drive?

Testosterone has a number of beneficial effects if you have low libido, including increasing your sex drive.

A 2017 review found that women with low libido who took testosterone had:

  • Greater satisfaction with sex
  • More sex
  • More orgasms
  • Higher sex drive

On the other hand, the research also found that those who took testosterone were more likely to experience a few potentially annoying side effects, such as acne and excess hair growth.

When should you ask your doctor about testosterone?

It’s reasonable to ask your doctor about testosterone if you’re struggling with low libido or problems with sex, and if initial approaches have not helped. 

NICE guidance currently recommends a trial of conventional HRT – oestrogen, along with progesterone for anyone with a uterus – before adding in testosterone for at least three months.

Testosterone can be prescribed by a doctor with special interest or expertise in menopause. This will generally only happen after a full assessment including a discussion about relationship issues, mental health and sexual health. Many different things can contribute to low libido, so it’s important to ensure you are being treated for the right thing.

Just like regular HRT, testosterone is not suitable for everyone. Your doctor will be able to advise on the best options for you.

Do you need to take testosterone if you have low levels?

Testosterone blood tests may be requested for a number of reasons. It’s common for your doctor to check your testosterone level before starting treatment so that they can monitor your progress. Once on treatment, you will need regular tests to ensure that your testosterone level is within the normal range.

Having a low testosterone level doesn’t necessarily mean that you need to start testosterone or increase your dose. Many women have low testosterone levels, but are not troubled by any relevant symptoms. This is thought to happen because the amount of testosterone in the blood stream does not accurately reflect the way testosterone might be working in other parts of the body.

If you aren’t sure about how to interpret your testosterone blood test result, speak to your doctor. 

How do you take testosterone for menopause?

Testosterone is taken as a gel or cream which is applied to your skin, absorbed into the bloodstream and distributed throughout your body.

Common brands include:

  • Testim
  • Tostran
  • Testogel
  • Androfeme

When prescribed for menopause symptoms, testosterone is off-label. This means that the medication is being used in a way which is not included on the medication’s licence. This is relatively common practice in medicine, as doctors often recommend using medications in slightly different ways to those officially listed by the manufacturer.

This means that the person prescribing the medication needs to have sufficient experience to safely prescribe off-label. In the case of testosterone, this often means seeing a menopause specialist or doctor with special interest in menopause.

Is testosterone available on the NHS for menopause?

Some types of testosterone are available on the NHS. The most commonly used are Tostran, Testim and Testogel. Both of these are actually designed to be used by men with low testosterone, so your doctor will prescribe a lower dose than that listed in the patient information leaflet. 

Androfeme 1% testosterone cream is not available on the NHS but is recommended by some doctors. Androfeme is interesting in that it is licensed for use in women, although has so far only been approved by Australian authorities. It needs to be specially imported and prescribed privately. 

Is testosterone for menopause available via Stella?

Yes. If you are interested in getting testosterone through Stella, email hello@onstella.com for more details.

Can I take testosterone with other types of HRT?

You can take testosterone alongside other forms of HRT. It’s important to note that oral HRT, tablets, can affect the way testosterone works. For this reason, your doctor might recommend switching to transdermal HRT, taken as patches, gels or sprays. The additional benefit of transdermal HRT is that it is generally lower-risk than oral HRT.

Learn more with our guide to different types of HRT for menopause.

What are the side effects of taking testosterone for women?

If you’re taking testosterone for menopause, side effects are generally uncommon and your doctor will monitor your testosterone levels by doing regular blood tests. When they do occur, side effects can include:

  • Excess hair growth
  • Acne
  • Weight gain

These usually improve once you stop taking testosterone.

Rare side effects include:

  • Thinning hair
  • Deepening voice
  • Enlargement of the clitoris

We still do not have much definite data on the risks of long-term testosterone use and research is ongoing. But recent studies looking at risks over five years of use seem to be reassuring.

Final word

Testosterone can be a useful addition to your HRT treatment plan if you are struggling with low libido or other issues in your sex life, but so far it hasn’t been proven to help with other symptoms of menopause.

We offer testosterone as part of our clinical services. Email hello@onstella.com if you want to find out more.

Read more about menopause on our blog or in our symptoms library.

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