Most people think of testosterone as “the defining male hormone”, said biochemist Daniel Kelly on The Conversation. But women also produce it and levels decline with age.
Women have long used testosterone therapy to improve libido and energy. Now, many are turning to it to manage other menopause-related symptoms, such as brain fog and mood swings.
But concerns are growing that the hormone treatment’s surge in popularity on social media is fuelling demand that vastly outstrips evidence for its long-term safety and efficacy.
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How widespread is this new use?
Only four countries – Australia, South Africa, New Zealand and the UK – have authorised a testosterone cream for women, but mostly only to treat low libido. The UK approved the female-formulated testosterone cream AndroFeme in 2025, but the National Institute for Health and Care Excellence (NICE) still needs to appraise it for cost effectiveness; it isn’t yet available on the NHS.
Still, there has been a “very sharp increase” in testosterone referrals to the NHS in Wales for post-menopausal women, a consultant told the BBC. Women there are “posing as men” to buy products from online pharmacies because of difficulties getting NHS prescriptions, she said. In England, NHS prescriptions for testosterone gel to women rose roughly tenfold between 2015 and 2022, said The Pharmaceutical Journal.
The issue is “receiving attention from regulators”, said Kelly on The Conversation. In September, the US Food and Drug Administration held a landmark public workshop on testosterone therapy, “examining evidence gaps and the need for future drug development”.
Does it work?
Most studies have focused on testosterone’s effect on low libido. But preliminary evidence indicates it could help with “a wide range of menopause symptoms, from mood changes to muscle loss”, said New Scientist.
A study published last year involving 510 women at a specialist menopause clinic in the UK found that, after four months on testosterone gel, there were improvements in mood, cognitive symptoms and libido. These findings “do not prove that the testosterone treatment caused these changes”, said Kelly. Testosterone is usually prescribed alongside oestrogen and sometimes progesterone in standard hormone replacement therapy. A study in Wales is currently trying to discover if “anecdotal reports of improved cognition and energy could be scientifically backed”, said the BBC.
More than 30 trials studying testosterone use for various health conditions in women are under way or planned in the US, said Reuters. “We do not have any evidence in women that it will improve muscle mass or bone density or mood or well-being or really any other metric,” said Stephanie Faubion, director of Mayo Clinic’s Center for Women’s Health and medical director of The Menopause Society. “What testosterone is being touted for in the lay public and on social media is not really what we have data for.”
Placebo-controlled trials have also not conclusively proven that testosterone alleviates brain fog, mood, bone density or fatigue, endocrinology professor Susan Davis told LiveScience.
What are the concerns?
Most testosterone treatments are not formulated and dosed for female patients. So in the UK, a “workaround” has been to measure out a tenth of a sachet of men’s testosterone gel by eye, said Kelly. That’s “a less precise way to deliver a hormone for which the therapeutic dose is so small”. Too much testosterone can increase the likelihood of unwanted side effects, such as voice deepening or rapid growth of facial and body hair.
“When you persistently have very high testosterone levels, you can get undesirable permanent side effects,” menopause specialist Michelle Olver told the BBC. “Nobody wants to have baldness, deepening of the voice or enlargement of the clitoris.”
The potential impacts of extra testosterone on cardiovascular health and breast cancer risk are “poorly understood”, said LiveScience. There is little evidence or data on the long-term safety for women. Yet online, they are “being bombarded with a tsunami of information providing them with the most sky-high expectations imaginable”, said gynaecology professor Nanette Santoro.
