Testosterone and Your Menopause Sex Drive


Whether you’re approaching menopause, or you’re right in the thick of it, you’re probably aware that some pretty significant things change for many women during this season of life - including your sex drive. For most women, libido naturally decreases during menopause as a result of the dramatic change in hormone levels. Fortunately, as we’ve talked about before, there are several things you can do to try and combat this issue, one of which is testosterone replacement therapy.

What is Testosterone Therapy?

One of the main hormones that decline significantly during menopause is testosterone. Testosterone therapy is designed to replenish low levels of this hormone in hopes of alleviating certain menopause symptoms, such as waning sex drive. It’s often used in postmenopausal women who are on estrogen therapy but not seeing any improvement in their libido. Testosterone therapy can be given in the form of gels, patches, pills, or creams.  

Pros of Testosterone Therapy

There is some evidence that testosterone specifically can help improve a woman’s libido. A 2008 study in the New England Journal of Medicine evaluated 814 women over 52 weeks who reported low sexual desire. They were assigned to either receive a patch of 150 or 300 μg testosterone per day or to a placebo group. The group who received 300 μg reported a notable improvement in libido, whereas the placebo and 150 μg group reported no improvement.

A recent review and analysis of randomized controlled trial data found that testosterone therapy is effective for postmenopausal women with low sexual desire causing distress, with administration via non-oral routes (e.g., transdermal application) preferred. More research is required to further study the effects on individual wellbeing and musculoskeletal and brain health.

Cons of Testosterone Therapy

There is no FDA approved form of testosterone therapy for women, which means that any testosterone preparations used are considered off-label.

Additionally, data on the effectiveness of this therapy for women is limited. There is some research that shows this hormone can be effective for certain groups of women, but there’s not enough research to back recommending its use for everyone. There’s an increased risk if you have a history of conditions like cancer, cardiovascular disease, or liver disease, as studies in these populations haven’t really been done. Thus, this is overall not a common treatment, and there’s no guarantee that it will work.

Testosterone therapy may also come with some unwanted side effects for certain women, like lower HDL “good” cholesterol, hair growth, and acne, though the research is mixed and much of it has been done on men.

There are a wide variety of factors that can contribute to sexual issues women experience. While the solution may include trying testosterone therapy, you may need to work on other things like emotional intimacy and stress and mood concerns as well. If you’re experiencing a waning sex drive during menopause and aren’t sure what you can do about it, it’s always a good idea to speak to your doctor about options. S/he will be able to discuss therapies available and their recommendations for you, which may or may not include testosterone therapy.

For more information on the changes that occur during menopause, hormones, and your libido, join the conversation over at Lisa Health!

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