Testosterone in Women: The role in Menopause

Menopause is a natural biological transition that marks the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. 

While much attention is given to the decline of estrogen and progesterone during menopause, testosterone in women also plays a crucial role in this stage of life. 

Often considered a "male hormone," testosterone is, in fact, essential for women's health, influencing energy levels, mood, libido, and overall well-being.

Testosterone is an androgen hormone produced in the ovaries, adrenal glands, and peripheral tissues. Although women produce significantly less testosterone than men, it still contributes to key physiological functions, including muscle strength, bone density, cognitive function, and sexual health.

During menopause, testosterone levels may decline gradually, leading to various symptoms that affect a woman’s quality of life. Unlike estrogen and progesterone, which can drop dramatically during menopause, testosterone production decreases more steadily with age. However, some women may experience more pronounced declines, exacerbating menopausal symptoms.

A reduction in the levels of testosterone in women during menopause can contribute to several physical and psychological symptoms, including:

• Reduced libido and sexual dysfunction: Testosterone in women plays a significant role in sexual desire and arousal. Low levels can lead to decreased libido, vaginal dryness, and difficulty achieving orgasm.

• Fatigue and reduced energy levels: Many women report increased feelings of tiredness and a lack of motivation. This may be as a result of sleep disturbances associated with the menopause, however low testosterone levels may also contribute.

• Loss of muscle mass and strength: Testosterone helps maintain muscle tissue, and a decline can contribute to reduced muscle strength and overall body composition changes.

• Cognitive changes and mood swings: Some women experience mood disturbances, irritability, anxiety, or difficulty concentrating during the menopause. There are many reasons why this might occur, one of which may be associated with testosterone decline.

Given the impact of low testosterone, some menopausal women consider testosterone replacement therapy (TRT) as part of their hormone therapy regimen. While TRT is more commonly prescribed for men, research suggests that low-dose testosterone therapy may offer benefits for postmenopausal women in relation to low libido. Testosterone treatment is not recommended as treatment for low mood, reduced energy levels and fatigue, or loss of muscle mass.

However, testosterone therapy is not without risks. Side effects can include:

• Acne
• Excessive hair growth
• Voice deepening
• Potential cardiovascular risks. 

Therefore, it is crucial for women considering TRT to consult their healthcare provider to weigh the potential benefits and risks.

For women who prefer to manage their symptoms without hormone therapy, several lifestyle changes can help support your hormonal health:

• Exercise regularly: Strength training and high-intensity interval training (HIIT) can help stimulate testosterone production.

• Maintain a balanced diet: Consuming healthy fats, protein, and micronutrients such as zinc and vitamin D supports hormone production.

• Manage stress: Chronic stress can elevate cortisol levels, which may suppress testosterone.

• Get quality sleep: Sleep is essential for hormone regulation, including testosterone balance.

Testosterone in women - While estrogen and progesterone often take centre stage in discussions about menopause, testosterone is an equally important hormone for women's health. Understanding the role of testosterone can help menopausal women make informed decisions about managing symptoms and maintaining their well-being. Whether through lifestyle adjustments or medical interventions, addressing testosterone decline can contribute to a healthier and more fulfilling life during and after menopause.

You may like to check your testosterone levels. If you are already taking HRT and would like to explore whether testosterone treatment could be an option for you, book in with one of our GP’s or Women’s Health Specialist Nurses to discuss further.