Women Are Taking Testosterone. What Does It Actually Do?

Testosterone is having a menopause moment.

You may have seen testosterone offered as a pellet or cream for energy, muscle, brain fog, or sex drive. Sometimes the explanation is one low blood-test result. But can one number really explain why you no longer feel like yourself?

The hormone is real. So are some of its benefits. But the evidence is much narrower than the marketing.

A 2026 study in JACC: Advances looked at a large network of U.S. health records. Testosterone prescribing for women more than doubled between 2016 and 2025, especially among White women in midlife. More prescriptions do not tell us whether the treatment helped or was safe.

In August 2026, the FDA announced a September 17 public workshop on testosterone use in menopausal women. Its purpose is to examine evidence and unanswered questions, including long-term heart and breast safety. A workshop is not a new treatment approval.

What has testosterone actually been shown to help?

The strongest evidence is for women past menopause who have an ongoing loss of sexual desire that bothers them. Before considering treatment, a clinician should look for other reasons for that change. The medical name is hypoactive sexual desire disorder, or HSDD.

For these women, carefully dosed testosterone can improve desire and sexual satisfaction and reduce the distress caused by low desire. Across the research, women had about one more satisfying sexual experience a month, on average, than women taking a placebo, a treatment without testosterone. Some women benefit more, some less, and some do not benefit.

International guidance identifies HSDD after menopause as the use supported by the strongest evidence. Guidance from sexual-health specialists also discusses treatment for some women nearing menopause. There is much less evidence for that group.

That evidence should not be stretched into a claim that testosterone treats every midlife symptom.

A low blood result is not a diagnosis.

Women make testosterone, too. Levels change across life. But there is no single blood-test cutoff that separates women with HSDD from women without it.

Start with what has changed and whether it bothers you. Pain with sex, poor sleep, depression, anxiety, medicines, illness, menopause symptoms, and what is happening in your relationship can all matter. Low desire that does not bother you is not automatically a disorder.

A testosterone blood test can show your starting level and help your clinician check it during treatment. It cannot, by itself, explain low desire or why you do not feel like yourself.

What about energy, brain fog, mood, or muscle?

Research has not shown that testosterone is a reliable treatment for tiredness, brain fog, depression, muscle gain, weight loss, or longer life in women. Studies have not consistently shown that it improves overall well-being or depressed mood. There is not enough evidence that it improves thinking or prevents problems with memory and thinking as women age.

At doses meant to keep testosterone within the usual female range, studies have not shown a clear improvement in muscle strength, the amount of muscle, or bone density after menopause. Testosterone plays a role in muscle. That does not prove taking more will make you stronger.

If strength is your goal, exercises that work your muscles against weight or resistance have much stronger evidence behind them. If exhaustion or brain fog is the problem, that symptom deserves attention without assuming testosterone is the answer.

An individual woman may report feeling better on treatment. Her experience matters. It does not tell us which benefits other women can expect.

How it is given matters.

For HSDD, guidance generally favors testosterone absorbed through the skin. You may hear this called transdermal treatment. The dose and blood checks aim to keep your level within the usual range for women before menopause.

Testosterone taken by mouth can worsen cholesterol levels, so international guidance advises against it. Pellets and injections can produce levels above the usual female range. Sexual-health guidance advises against these forms and compounded products because doses can be harder to control or there is not enough evidence about their use.

Compounded products are medicines specially prepared by a pharmacy. They are not FDA-approved. The FDA does not check their safety, effectiveness, and quality before they are sold in the way it does for approved medicines. Calling a cream natural or personalized does not tell you whether it is safe.

Acne and extra facial or body hair can occur. Levels that are too high can also cause voice changes or hair loss. You need follow-up and a plan for what to do if treatment causes side effects or does not help.

What do we know about heart and breast safety?

Short studies using doses that kept testosterone within the usual female range did not show a clear increase in serious health problems. They cannot tell us whether treatment is safe for every woman or for years of use.

Women at higher risk of heart and blood-vessel disease were often left out of these trials, and many participants were also taking estrogen. We cannot assume the findings apply to every woman. There is not enough evidence to know how testosterone affects the chance of a heart attack or death, or to establish its breast safety over many years.

The international review noted that safety results from trials did not go beyond two years. The FDA’s 2026 workshop materials still list long-term heart and breast safety as unanswered questions.

Testosterone is not an established treatment for preventing heart disease. Your blood pressure, cholesterol, pregnancy history, other medicines, and breast history still belong in the conversation.

Is testosterone approved for women in the United States?

As of September 2026, there is no FDA-approved testosterone treatment specifically for menopausal women. A clinician may prescribe a testosterone medicine approved for another use. This is called off-label prescribing.

Off-label prescribing can be appropriate when evidence supports it. Your clinician should explain the possible benefits and risks, the dose, and how treatment will be checked. A compounded product is different: the medicine itself is not FDA-approved.

The explanation should be more specific than “your hormone level is low.”

The HEART RESERVE takeaway

For some women, testosterone can help with low sexual desire that is causing distress. A clinician needs to assess what is behind that change before recommending it. The evidence does not make testosterone the missing answer to every midlife symptom.

A useful hormone deserves better than hype. And women deserve better than being told one laboratory number explains an entire stage of life.

One question to bring into care: “What specific problem are we treating with testosterone, and what evidence shows it helps that problem in women like me?”

Your Heart Story can help you gather the rest of your history before deciding what belongs in your treatment plan.