What you probably already know: Big debates are happening around testosterone in menopausal women. Testosterone is produced by ovaries, adrenal glands and the brain. It falls and rises during different life stages and studies show that low testosterone could be associated with brain fog, lack of energy and low libido. A recent report found that the rate of prescriptions went up nearly 60% from 2024 to 2025, even though the U.S. Food and Drug Administration has yet to approve a testosterone product for women. Women ages 45-65 accounted for more than 60% of all prescriptions handed out to women last year.
What are the concerns? Some research links testosterone therapy with a higher risk of heart attack or stroke in women. According to the Centers for Disease Control, more than 60 million of women in the U.S. are living with some form of heart disease. Meanwhile others studies show a that testosterone can reduce the symptoms of menopausal. A study by the Newson Research shows women who took transdermal testosterone reported an improvement in hot flashes, dizziness and libido.
Why? According to physician and urologist Dr. Kelly Casperson, a proponent of the use of testosterone by women, emerging evidence suggests that testosterone use in women could lead to improved cognitive function, reduced antidepressant dependence and lower risk factors for neurodegenerative disease. Larger clinical trials are still needed to confirm these results.
Testosterone levels are shown to gradually decline once a woman enters her 30s and only a small number of women have begun taking the hormone, in part because it is difficult to come by. Without FDA approval, medications cannot be covered by insurance, making them less accessible. “The FDA is asking for more safety data, even though the men’s version of testosterone therapy doesn’t require the same level of safety data,” Dr. Casperson wrote.
What it means: Testosterone therapy comes in four forms: gel, injection, pellets implanted under the skin, and cream, which is applied externally. The typical dose prescribed to men measures up to about 50 milligrams a day in gel form, while women’s recommended levels are about five milligrams. “While testosterone deficiency in men is widely recognized, with over a dozen FDA-approved treatment formulations available approved based on 6 months of safety data,” Dr. Casperson says, “women experiencing similar physiological decline are left without a regulated option.”
What happens now? More research needs to be done to evaluate the true implication of testosterone in menopausal women and long-term safety data needs to be identified, especially regarding breast cancer and cardiovascular risks. “All bodies make testosterone, but as long as it is inappropriately labeled as a ‘male hormone,’ it becomes erased from being relevant to all bodies,” Dr. Casperson said. In order to provide equal access to the treatment, more research on the benefits of testosterone need to be funded and completed, along with better access for the health of women.
