Dr Lindsey Thomas on menopause and testosterone

With the spotlight on menopause in the media, it means that we are starting to (hopefully!) become more aware of the wide-ranging symptoms and the impact they can have on women’s lives. This is opening up much-needed conversations around how women can feel their best and live healthily going forward.

Not everyone will need or want Hormone Replacement Therapy (HRT), and there are women for who this won’t be an ideal option. But it is important that HRT it is forming a part of the ongoing discussion.

When we think about female hormones we normally think about oestrogen and progesterone, and when we talk about HRT (as it is known in the UK ) we are talking about topping up or replacing these hormones.

Oestrogen is the hormone needed to help with most symptoms and a progesterone is added to protect the lining of the womb; which is why if you have had a hysterectomy you won’t usually need this.

But what about testosterone?

Although testosterone is often thought of as a male hormone it is an important hormone for women too; men just produce more of it. In women testosterone is produced in the ovaries, adrenal glands and other tissues in the body.

Testosterone levels naturally start to reduce both with age and with the menopause, but how this affects women will be like every aspect of the menopause; individual – with some women not noticing any symptoms, even with very low levels. This drop is more abrupt in women who have their ovaries removed or take medications, which affect hormone production. As the body doesn’t have the same time to get used to the lower levels, symptoms can be more severe.

Lower testosterone levels can, in some women, mean they have less of a desire to have sex and feel less aroused. And for some women using testosterone can play a part in improving this. A low sex drive is common during the menopause and can be very distressing in terms of wellbeing and relationships.

Low hormone levels play an important part, but as sexual desire is complex it’s important to look at the whole picture, from how you feel emotionally to how things are in your relationship and even the impact of some medications. Vaginal and vulval changes in the menopause can also make sex uncomfortable or even painful, as well as less pleasurable. However, the good news is this discomfort is often treatable.

Testosterone for some women may be a really important part of their HRT, but when should you take it, and do you need think about it? The British Menopause Society recognises that at the moment the research that has been done, shows that adding in testosterone for some women can help to improve desire and arousal. But unfortunately at the moment there are no high quality studies that show it helps with other symptoms.

There are women however, who feel that they have noticed improvements in symptoms that standard HRT hasn’t helped with, such as mood, cognitive function and muscular and joint pain. It is important that we listen to women and learn more about the potential benefits of testosterone, with a need for well-designed studies to shed more light on this.

If you feel that testosterone may help you, or want to discuss whether you think this might be suitable for you, then a good starting point would be to make an appointment with your GP or practice nurse. Unlike HRT, testosterone products are off-license for women, so not every medical professional will feel confident with prescribing (although with guidance this is changing), and you may need to be referred to see a menopause specialist.

For more stories, advice and interviews, head to the Menopause Your Way Stories hub. To browse and shop a curated edit of menopause products, visit the Menopause Your Way page on QVC.

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We understand there’s a lot of information out there on the menopause. You can read through the NICE guidance on menopause management, as well as the NHS overview on the menopause.