Can women take testosterone?
Yes, if menopause has dulled your sex drive, it upsets you and HRT hasn’t helped. That’s the one use with good proof. And the obvious blood test can’t tell you whether you need it.
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Can women take testosterone?
Yes, for one main reason. NICE says to consider it for low sexual desire linked to menopause if HRT alone is not effective.
The NHS says it’s usually only recommended if you’re past menopause, have problems with low sex drive and HRT alone has not helped.
It’s not a man’s hormone. The British Menopause Society (BMS), which guides UK menopause doctors, says women make both testosterone and oestrogen before menopause. Levels fall at menopause, more gradually than oestrogen.
The usual route to testosterone
- 1
Other causes checked
Relationship, stress, low mood and medicines such as antidepressants.
- 2
HRT first
Oestrogen, plus a second hormone (progestogen) if you still have your womb.
- 3
A trial of testosterone
A gel or cream at a low, female dose.
- 4
Review by 6 months
It may take 3 to 6 months to judge. No benefit by 6 months means stop.
Sources: NICE NG23; NHS; BMS; Global consensus 2019
Vaginal dryness making sex sore? The BMS says to treat that too, for example with vaginal oestrogen.
On HRT and your sex drive is still low? Speak to a GP about whether testosterone could help.
What does testosterone do for women?
It can lift sex drive. A 2019 review of 36 trials and 8,480 women found it improved sexual function in women past menopause with low desire that upset them.
An international expert panel put the gain at an average of one more satisfying sexual event a month than a dummy treatment. Desire, arousal and pleasure rose, and distress fell.
| What women hope for | What trials found |
|---|---|
| Sex drive and pleasure | Better, in women past menopause with low desire that upsets them. |
| Energy | No benefit shown. |
| Low mood | No effect shown. |
| General wellbeing | No effect shown. |
| Bones | No effect on bone density at 12 months. |
| Muscle and strength | No clear effect at female doses. |
| Memory and thinking | Not enough evidence. |
Sources: Global consensus 2019; BMS; Islam 2019, Lancet Diabetes Endocrinol
The NHS says research on other menopause symptoms is going on, but more evidence is needed.
If tiredness is your main problem, ask your GP about that on its own. See low testosterone in women for the other causes.
Do I need a testosterone blood test first?
That obvious blood test is your testosterone level, and it can’t decide this. The expert panel found no level that tells women with low desire apart from women without it.
The BMS adds that many women with low levels don’t have upsetting low libido. So a low result alone isn’t a reason to treat.
You still have one. It’s checked before you start, to make sure your level isn’t already high.
Think of the test as a speed check. It keeps you under the female limit, and staying under it keeps side effects uncommon, the BMS says.
When testosterone is checked
- 1
Before you start
Total testosterone, as your starting point.
- 2
Soon after
Ideally 3 to 6 weeks in. Many NHS clinics check at 2 to 3 months.
- 3
Every 6 to 12 months
To keep it inside the lab’s range for women.
Sources: BMS; Global consensus 2019
Total testosterone is the line that counts. The BMS prefers it to the other testosterone lines you may see on a results sheet. One is free testosterone (the part not carried by a protein in the blood).
For the numbers, see testosterone levels in women by age.
What is the best testosterone for women?
A gel or cream on the skin, at a female dose. In trials, tablets raised LDL, a bad cholesterol, but skin products didn’t.
| Type | Where it stands |
|---|---|
| Men’s gel at a small dose | Used in the UK, at typically about a tenth of a man’s dose. |
| 1% cream made for women | Licensed in the UK. The BMS hoped it would be available in 2026. |
| Tablets | Not recommended. They can upset cholesterol. |
| Pellets (implants under the skin) and injections | Not recommended. They can push levels too high. |
| Compounded bioidentical creams | Not recommended by regulators or menopause experts. |
Sources: BMS; Global consensus 2019
Most use is still off-label. That means a doctor prescribes a licensed medicine for a use it isn’t licensed for. The BMS says your GP may be able to prescribe it, sometimes with a specialist.
How to use testosterone gel or cream
- Rub it into clean, dry skin on your lower tummy or upper thighs.
- Let it dry before you get dressed, then cover it with clothing.
- Wash your hands straight after.
- Keep partners and children off the skin until it’s dry.
- Don’t wash that area for 2 to 3 hours.
- Change the spot often, so hair doesn’t grow there.
Why so careful? The NHS says the gel can cause side effects in others who touch it regularly.
What are the side effects of testosterone for women?
The NHS lists acne, unwanted hair growth and weight gain, but says these are not common. The BMS says they usually go away when the dose is lowered or stopped.
Hair loss, a deeper voice and a larger clitoris are rare at female doses.
Long-term safety is less clear. Safety data at female doses don’t go beyond 24 months. The BMS calls short-term heart and breast data reassuring, but wants more.
The BMS says to avoid it or take care if you:
- are pregnant or breastfeeding
- have active liver disease
- have had breast cancer that grows with hormones
- compete in sport
- already have a high or high-normal testosterone level
Still having periods? There’s very little data on testosterone before menopause. If you still have periods and low sex drive, ask your GP about the other causes first.
If your level is high instead, see high testosterone in women.
When to speak to a GP
Low sex drive has many causes, and the NHS says treating the cause should help. Book an appointment if:
- You’re worried about your low sex drive.
- You think a medicine or hormonal contraception is affecting your sex drive.
- Your sex drive hasn’t returned to normal after pregnancy.
- You’re on HRT, your sex drive is still low and you think testosterone might help.
- You’re on testosterone and get acne or extra hair. The BMS says these usually ease when the dose is lowered.
Antidepressants and blood pressure medicines can lower sex drive. Never stop or change a prescribed medicine without your prescriber.
See also blood tests for low libido and blood tests on HRT.