Should Women Take Testosterone?

Women should take testosterone only for distressing low libido after menopause, the one use backed by trials. US prescriptions rose 146% since 2023.

Most women should not take testosterone, but it is an evidence-based option for one group: postmenopausal women with low sexual desire that causes distress, known as hypoactive sexual desire disorder (HSDD). For fatigue, mood, brain fog, or muscle strength, the evidence is still too limited to recommend testosterone for women.

This article draws on the 2019 Global Consensus Position Statement in the Journal of Clinical Endocrinology and Metabolism, a 2019 meta-analysis of 36 trials in The Lancet Diabetes and Endocrinology, a 2025 review in Climacteric, and NICE menopause guidance updated in April 2026, current as of September 2026.

Why Are More Women Taking Testosterone in 2026?

Testosterone prescriptions for women rose 146% between January 2023 and July 2026, according to an analysis reported by Healthline. Telehealth menopause clinics and social media have driven interest, yet no testosterone product is approved by the US Food and Drug Administration (FDA) specifically for women, which creates dosing and pharmacy access problems.

On September 17, 2026, the FDA called for more data on testosterone therapy for women and encouraged manufacturers to run studies that could support female-specific products. Until then, women are usually prescribed a dose-adjusted male product or a compounded preparation. Testosterone for women is therefore a real treatment with a narrow evidence base, not a general wellness supplement.

What Does Testosterone Do in the Female Body?

Testosterone is a normal female hormone made by the ovaries and adrenal glands, and it influences libido, muscle, bone, and energy. A 2025 review in Climacteric states that testosterone "is unquestionably a normal female hormone that exerts important physiological effects in multiple tissues".

Levels fall with age rather than suddenly at menopause. A 2005 study of 595 women in the Journal of Clinical Endocrinology and Metabolism found testosterone declined steeply with age, most in the earlier decades, with no independent effect of natural menopause. Within each cycle, testosterone rises slightly around ovulation alongside oestrogen (estrogen), as mapped in the guide to the four cycle phases and the article on how libido changes through the cycle.

Solu is a women's wellness app that maps cycle-phase-aware guidance across movement, nutrition, sleep, and energy, built for women tracking hormonal, cycle, and premenstrual symptoms. It keeps libido, energy, and mood ratings across many cycles, so a woman can tell a dip that returns every month from a steady decline lasting half a year.

What Can Testosterone Actually Treat in Women?

Testosterone is proven to treat only low sexual desire with distress in postmenopausal women. The 2019 Lancet Diabetes and Endocrinology meta-analysis pooled 36 randomised trials with 8,480 participants and found testosterone improved desire, arousal, orgasm, and pleasure, and reduced sexual distress, in postmenopausal women.

The evidence for each commonly claimed benefit, built from the sources in this article, breaks down as follows:

Low sexual desire after menopause (HSDD): strong, backed by 36 trials and the 2019 consensus statement.
Muscle, bone, and body composition: limited, with no effects found in the 2019 meta-analysis.
Memory and cognition: limited, with no effects found, though few women contributed data.
Energy, mood, and wellbeing: uncertain, according to the 2025 Climacteric review.
Premenopausal women: insufficient data for any recommendation, per the consensus statement.

Taken together, the trials support testosterone as a targeted sexual-health treatment after menopause, not as an energy or anti-ageing therapy. NICE similarly advises considering testosterone for menopausal low sexual desire only if HRT alone is not effective.

Is Testosterone Safe for Women, and What Are the Side Effects?

Testosterone is generally safe for women in the short term at doses matched to a younger woman's natural levels, and the main side effects are mild acne and extra body or facial hair. The 2019 consensus statement found these doses were not linked to hair loss, clitoral enlargement, or voice change.

Route matters. Oral testosterone raised LDL cholesterol in the 2019 meta-analysis, while patches and creams did not, so non-oral forms are preferred. Weight also rose slightly on average, and no serious adverse events were recorded. The meta-analysis authors say long-term safety still needs investigation, so testosterone sits alongside the wider hormone decision covered in the guide to whether HRT is safe.

Could Low Libido or Low Energy Have Another Cause?

Yes, symptoms blamed on low testosterone in women often have other causes, including low oestrogen, thyroid disease, iron deficiency, poor sleep, relationship strain, depression, and chronic stress. The consensus statement requires a formal biopsychosocial assessment, a review of physical, psychological, and relationship factors, before HSDD is diagnosed.

Three years after her last period, a 54-year-old whose hot flushes have settled on HRT, but whose interest in sex has not returned and who finds that distressing, is the profile the 2019 consensus had in mind. A 38-year-old with heavy periods and exhaustion more likely needs an iron check first, as explained in the guide to which vitamins women should take daily. Stress effects are covered in the article on how stress affects the menstrual cycle, and falling oestrogen in the guide to the signs of low oestrogen.

Can Lifestyle Changes Support Healthy Testosterone Levels?

No lifestyle change raises testosterone to treatment levels, but strength training, enough sleep, adequate protein and total calories, and stress management support the muscle, bone, and energy that testosterone is often sought for.

Resistance training is a well-studied option for muscle and bone after 40, with wider benefits explained in the guide to strength training and heart health. Solu times strength sessions to cycle phase, suggesting heavier lifts when energy tends to peak in the follicular phase and more recovery in the days before a period.

When Should a Woman See a Doctor About Testosterone?

A woman should see a doctor if low sexual desire has lasted for months and causes distress, especially after menopause or when HRT has not helped. Anyone starting testosterone needs a baseline blood level, a repeat test 3 to 6 weeks later, and checks every 6 months, according to the 2019 consensus statement.

The same statement advises stopping treatment if there is no benefit by 6 months. New acne, extra facial hair, scalp hair thinning, or a deepening voice are signs of excess and warrant a prompt review. As of 2026, testosterone used without a prescription, or at doses meant for men, is the most likely to push levels above the female range.

Key Takeaways

The only evidence-based use of testosterone for women is postmenopausal low sexual desire with distress, known as HSDD.
A 2019 meta-analysis of 36 trials and 8,480 participants found sexual function benefits but none for muscle, bone, or cognition.
US testosterone prescriptions for women rose 146% from January 2023 to July 2026, yet no FDA-approved female product exists.
Treatment should be checked with blood tests at 3 to 6 weeks and every 6 months, and stopped if no benefit by 6 months.