Treatment and Medication

Testosterone therapy for women

Women make testosterone too, and some are offered it in menopause for low sexual desire. What it is, who the guidelines say it is for, and what to ask your doctor.

Contents
  1. The words and the guidance
  2. What it is
  3. Why it happens
  4. What the guidelines say about treatment
  5. When to see a doctor
  6. Questions to ask your doctor
  7. Faith and family
  8. Track it
  9. Common questions
  10. Related topics
  11. Sources

Wanting intimacy less than you used to, and not knowing why, is lonely. It can feel like something you are doing wrong. For some women it is part of the menopause, and testosterone is one of the treatments a doctor may talk about.

The words and the guidance

English
Testosterone therapy
Also searched as
testosterone for women, testosterone gel
Urdu
ٹیسٹوسٹیرون کا علاج
Roman Urdu
testosterone ka ilaaj
  • NICE NG23 says: "Consider testosterone supplementation for people with low sexual desire associated with menopause if HRT alone is not effective." (recommendation 1.5.25)
  • The Pakistan Menopause Society's 2026 recommendations say to start conventional HRT first and make sure a woman has enough estrogen, especially in the vagina, before considering testosterone for persistent low desire (section 5.9).
  • The British Menopause Society says testosterone should only be considered once other causes of low desire, such as relationship difficulties, psychological factors or medicines like antidepressants, have been looked at.
  • Women's Health Concern, the patient arm of the BMS, says there is not yet enough evidence to recommend testosterone for low energy, low mood, fatigue or brain fog.

What it is

Testosterone is usually thought of as a man's hormone, but women make it too. Women's Health Concern describes it as one of the sex hormones women produce alongside estrogen and progesterone. Levels fall gradually with age, and the factsheet says women who have had their ovaries removed, or who have premature ovarian insufficiency, may notice the change more.

Testosterone therapy for women means adding a small amount back, usually as a gel rubbed into the skin. Women's Health Concern says many women notice nothing as their levels fall, while others are more sensitive to the change.

Why it happens

The causes of low desire at this age are rarely just one thing. Women's Health Concern says they are complex and rarely due simply to a low testosterone level. Tiredness, night sweats that wreck your sleep, pain during sex from dryness, a strained marriage, a medicine you take: any of these can be part of it.

That is why the guidelines ask doctors to look at the whole picture before reaching for a hormone.

What the guidelines say about treatment

All three guidelines put HRT first.

NICE NG23 says to "Consider testosterone supplementation for people with low sexual desire associated with menopause if HRT alone is not effective." (1.5.25) When that was written in November 2015, NICE noted, this was an off-label use of testosterone.

The Pakistan Menopause Society's recommendations go into the order of things. Start conventional HRT, make sure a woman has enough estrogen, especially in the vagina, and only then consider testosterone for persistent low desire (5.9). The BMS gives vaginal estrogen as one way to make sure of that vaginal side.

The British Menopause Society adds two more steps. Testosterone should only be considered after other causes have been looked at, including relationship and psychological factors and medicines such as SSRIs and SNRIs, which can lower desire themselves. And low desire remains the main reason to prescribe it: trials so far have not shown a benefit for thinking, mood, energy or muscles and bones.

On side effects, the BMS says they are uncommon when levels stay within the normal female range. The most common are excess hair growth, acne and weight gain, usually reversible when the dose is lowered or treatment stops. The BMS adds that more long-term data on heart and breast outcomes are needed, though short-term data are reassuring. Women's Health Concern says a trial of a few months is usually recommended, and that if there is no benefit by then it is recommended to stop.

The NHS website says testosterone is not currently licensed in the UK to treat menopause symptoms, but a specialist doctor may prescribe it, usually after the menopause, for low sex drive, when HRT alone has not helped.

Available in Pakistan?

Yes. The Pakistan Menopause Society's 2026 list of menopause hormone products available in Pakistan (Table 10) includes a testosterone gel, used on the skin.

When to see a doctor

If low desire is causing you distress, it is worth raising, even if it feels impossible to say. The Pakistan Menopause Society's recommendations note that many Pakistani women may not mention sexual symptoms unless asked respectfully and in private (section 2.2).

If you are already using testosterone and notice new facial hair, acne, or changes in your voice, tell the doctor who prescribed it.

Questions to ask your doctor

  1. Could anything else be behind my low desire, such as a medicine I take, pain during sex or tiredness?
  2. Is my HRT doing enough, including for vaginal dryness, before we think about testosterone?
  3. Would you check my testosterone level first, and how would we keep an eye on it?
  4. How long would we try it for, and how would we decide whether it is working?
  5. What side effects should I watch for?

Faith and family

Intimacy inside marriage is something many women were raised never to discuss, least of all with a doctor. So the symptom stays private, and the strain stays private too. Raising it is not shameful. It is a health question like any other, and asking whether a female doctor is available may make it easier to say.

Track it

  • Roshara's symptom score rates 27 symptoms in a few minutes, with no account. The total is something to take to your appointment. Take the symptom score
  • Where am I? names the stage you might be in. Six questions. Take Where am I?
  • Log it day by day in the tracker, with what came just before. It needs a free account. Open the tracker

Common questions

Isn't testosterone a male hormone?
Women make it too. Women's Health Concern describes it as one of the sex hormones women produce, along with estrogen and progesterone, and says levels fall gradually with age. (Source: Women's Health Concern, Testosterone for women (reviewed February 2026))
Will testosterone help my energy and brain fog?
The evidence does not show that yet. The British Menopause Society says trials so far have not shown a benefit for thinking, mood, energy or muscles and bones, and that low desire remains the main reason to prescribe it. (Source: British Menopause Society, Tool for Clinicians: Testosterone replacement in menopause (reviewed May 2026))
Can a blood test tell me whether I need testosterone?
No. Women's Health Concern says blood tests cannot diagnose whether you need it, but are used as a safety check before and during treatment so levels do not go too high. (Source: Women's Health Concern, Testosterone for women (reviewed February 2026))
Is testosterone licensed for women?
The NHS website says testosterone is not currently licensed in the UK to treat menopause symptoms, though a specialist doctor may prescribe it. Licensing differs from country to country, so ask your doctor what applies where you live. (Source: NHS website, Types of hormone replacement therapy (HRT) (reviewed 9 March 2023))
What if there is no testosterone made for women where I live?
The European Menopause and Andropause Society (EMAS) says that where no approved product for women is available, prescribing one made for men, off-label, is reasonable as long as blood levels stay within the normal female range. It does not recommend compounded 'bioidentical' testosterone, citing a lack of evidence on how well it works and how safe it is, unless nothing licensed is available. (Source: European Menopause and Andropause Society, Menopause Essentials 2026: Testosterone (July 2026))

Related topics

Sources

  1. NICE NG23, Menopause: identification and management (last updated 15 April 2026)Section: 1.5.25, Altered sexual function · Opened 1 October 2026© NICE 2026 Menopause: identification and management. Available from www.nice.org.uk/guidance/ng23 All rights reserved. Subject to Notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
  2. British Menopause Society, Tool for Clinicians: Testosterone replacement in menopause (reviewed May 2026)Section: Who should be offered testosterone?; wider benefits; side effects and risks; how long · Opened 1 October 2026
  3. Women's Health Concern, Testosterone for women (reviewed February 2026)Section: Whole factsheet · Opened 1 October 2026
  4. NHS website, Types of hormone replacement therapy (HRT) (reviewed 9 March 2023)Section: Testosterone · Opened 1 October 2026
  5. Pakistan Menopause Society, Good Clinical Practice Recommendations for Menopause Care in Pakistan (JSOGP 16(2), 28 April 2026)Section: 2.2; 5.9; Table 10 · Opened 1 October 2026
  6. European Menopause and Andropause Society, Menopause Essentials 2026: Testosterone (July 2026)Section: Testosterone preparations · Opened 15 October 2026