Testosterone and Your Menopause Sex Drive

Whether you’re approaching menopause or right in the thick of it, you’ve probably felt a shift in your sex drive. For most women, aging and menopause lead to a decrease in libido due to the dramatic changes in hormone levels and other shifting elements of life and relationships.

While libido is complex and influenced by a wide range of factors, testosterone therapy is one potential option to combat it.

What is Testosterone Therapy?

Most people know that estrogen declines significantly during menopause. Testosterone also plays a vital role in the female body, including your libido, but is less frequently a topic of conversation.

Testosterone declines gradually with age, so the levels in your body around age 50 are about half of what they were in your early 20s. If you’ve had your ovaries removed (oophorectomy), testosterone drops more abruptly.

Testosterone therapy aims to replenish the low levels of this hormone to alleviate certain menopause symptoms, such as your waning sex drive. It’s commonly used for postmenopausal women who are on estrogen therapy but haven’t seen any improvement in their libido. Testosterone therapy can be administered through gels, patches, pills, or creams.

The Pros of Testosterone Therapy

You’ll be glad to know that there is evidence suggesting that testosterone specifically can help improve your libido.

A 2019 review of available research found that testosterone therapy is effective for postmenopausal women who are bothered by low sexual desire. Application of testosterone through the skin (versus oral medication) is preferred to minimize side effects. The data also suggest that testosterone therapy can be effective in improving libido with or without estrogen therapy at the same time.

More research is needed to further study the potential long term health effects on individuals and groups with health risks.

The Cons of Testosterone Therapy

There is no FDA-approved form of testosterone therapy specifically for women around menopause, which means that any testosterone preparations that you use are considered off-label.

Additionally, data is limited on the effectiveness of testosterone therapy for women. While some research shows this hormone can be effective for certain groups of women, there’s not enough research to back recommending its use for everyone. This means that testosterone therapy is still relatively uncommon, and is not a guarantee of success for improving libido.

You may not be a good candidate if you have a history of conditions like cancer, cardiovascular disease, or liver disease as research has not been done in populations with these concerns.

Testosterone therapy may also cause unwanted side effects such as lower HDL (“good”) cholesterol, hair growth, and acne. Research is mixed, however, and much of it has been done on men.

Seek Guidance from Your Healthcare Clinician

If you’re experiencing a waning sex drive during menopause and unsure about what to do, it’s always a good idea to speak to your healthcare clinician about your options. They can discuss available therapies and make personalized recommendations for you, which may or may not include testosterone therapy.

Keep in mind that various factors can contribute to sexual issues that some of you may experience. While trying testosterone therapy may be a solution, you may also need to work on other aspects, such as emotional intimacy, stress, and mood concerns.