Menopause is a natural phase of a woman’s life, marking the end of reproductive capability. During this transition, women experience a significant decline in hormone levels, particularly oestrogen. However, testosterone, often associated with masculinity, also plays a crucial role in women’s overall health and wellbeing. In this blog post, I explore the importance of testosterone, its changes during menopause, and whether menopausal women should consider testosterone supplementation.

Understanding testosterone

Testosterone is primarily known as the male sex hormone, but it is present in both men and women, although in different quantities. In women, testosterone is produced by the ovaries and adrenal glands. It contributes to various bodily functions, including maintaining bone density, muscle mass, libido, mood regulation, cognitive function, and overall energy levels. It plays a vital role in helping us look and feel our best.

What happens to our testosterone in menopause?

During menopause, a woman’s hormone levels undergo significant fluctuations. Oestrogen levels decline steeply, leading to the well-known symptoms like hot flashes, vaginal dryness, and mood swings. However, testosterone levels also decline but at a slower rate. Research suggests that testosterone levels in women decrease by approximately 50% from premenopausal to postmenopausal stages.

The decline in testosterone levels during menopause can lead to several undesirable symptoms and health issues. Some common effects of low testosterone in menopausal women include decreased libido, reduced energy levels, muscle weakness, decreased bone density, increased body fat, cognitive difficulties, and mood disturbances like depression and irritability.

Why use testosterone replacement therapy? 

One of the leading causes of concern for women during menopause is vaginal dryness, loss of sex drive and, in general, feeling less feminine. Supplementing testosterone can help women combat those issues and live happier, more fulfilled lives.

Many women find that taking testosterone as part of their HRT provides further improvements than taking oestrogen alone. Benefits you might experience include improved energy and stamina, improved sleep, improved muscle mass and strength, improved concentration and memory and increased libido and sexual arousal levels.

It can take up to a few months for improvements to take effect, so you may be advised to take if for 3-6 months in the first instance before reviewing your symptoms with your doctor.

Can I get it on the NHS?

Current UK NHS guidelines only recommend testosterone if you have severely reduced libido or ‘Hypoactive Sexual Desire Disorder’, but there is good evidence to show that the benefits of testosterone could help many more women in their perimenopause and menopause for the reasons listed above.

I think the current availability of testosterone for women is an equality issue, and it’s something that I am campaigning to change. The reason is, if a man visits his GP with a complaint of a low libido or an inability to obtain or maintain an erection, he will be prescribed testosterone (after various medical checks). But if a woman does the same, testosterone is, in most cases, not discussed at all. This is something that needs to change.

Testosterone should be considered for every woman after the onset of peri/menopausal symptoms, when they seek help for their symptoms.

If you’re concerned about your levels, visit your doctor (and you will need to do this privately) and request that they be checked. It is possible to measure your available testosterone levels in your blood by having your ‘total testosterone’ and SHBG levels checked, and your ‘Free Androgen Index’ (FAI) calculated.

But having a low testosterone level doesn’t necessarily mean that you need to start testosterone or increase your dose. Many women have low testosterone levels but are not troubled by any relevant symptoms. This is thought to happen because the amount of testosterone in the blood stream does not accurately reflect the way testosterone might be working in other parts of the body.

 Should I be supplementing testosterone? 

Each woman’s experience with menopause is unique, and the decision regarding testosterone supplementation should be made on an individual basis. Your healthcare provider should conduct thorough assessments, evaluate symptoms, and measure hormone levels to determine if testosterone supplementation is appropriate and safe for you.

If you’d like to understand more about this, click here to enquire or to book a consultation.