In a historic move, the FDA conducted its inaugural public workshop on the use of testosterone in menopausal women in September 2026. This significant event aimed to address critical questions about the role of testosterone in women’s health, its safe use, and the development of standardized treatments specifically designed for women.
As of now, testosterone is not FDA-approved for female patients, even though the off-label prescription of testosterone for women has surged, with reports indicating a nearly threefold increase in prescriptions from 2016 to 2025.
Experts at the FDA workshop acknowledged that the strongest evidence supporting testosterone therapy in women pertains to the treatment of hypoactive sexual desire disorder (HSDD), characterized by diminished sexual desire. However, they also recognized that further research is necessary to explore the potential benefits of testosterone on mood, energy, memory, and muscle mass.
In a recent analysis involving over 1,220 women in perimenopause or menopause conducted by Hone Health, participants reported substantial improvements across 18 menopause-related symptoms when treated with testosterone. The most noteworthy enhancements were observed in areas such as sexual desire, energy levels, strength, and overall stamina.
Reported Improvements from Testosterone Therapy
In the aforementioned analysis conducted by Hone Health in September 2026, the improvement of menopause symptoms was systematically evaluated in a cohort of 1,220 women who received testosterone treatment without concurrent estrogen or progesterone hormone therapy. Using a standardized questionnaire designed for healthcare providers, the following categories displayed the most significant advancements:
- Sexual Health: Enhanced sexual desire was among the most reported improvements.
- Energy and Stamina: Increased energy levels and improved stamina were widely noted.
- Physical Strength: Participants experienced noticeable gains in muscle mass and overall strength.
These findings imply that testosterone may play a vital role in enhancing energy, desire, and vitality in menopausal women.
Dr. Natalie Kunsman, MD, a family physician specializing in hormone health and regenerative medicine, emphasized the broader implications of testosterone’s role in the female body. “Tracking specific symptoms is like looking through a keyhole when we know testosterone is working the whole room,” she stated.
Potential Benefits of Testosterone Beyond Sexual Health
According to physicians affiliated with Hone Health, the advantages of testosterone for women extend well beyond just sexual health. Testosterone receptors are found in various systems within the female body, including the brain, muscles, bones, and cardiovascular system. Although women experience a gradual decline in testosterone levels with age, this decrease does not occur as dramatically during menopause as the declines seen in estrogen and progesterone.
Kunsman delineates several potential benefits of testosterone as follows:
- Preservation of Lean Muscle Mass: Testosterone plays a crucial role in maintaining lean mass, particularly as women age and become more susceptible to conditions like sarcopenia.
- Metabolic Health: Optimizing testosterone levels may aid in regulating weight and blood sugar levels. A deficit in testosterone is linked to an increase in body fat post-menopause.
- Bone Density: Testosterone contributes to bone formation and helps reduce the risk of osteoporosis, particularly important during menopause.
- Cognitive Function: The hormone may influence neuroplasticity and mental acuity, with studies indicating improvements in mood and cognitive functionalities following testosterone treatment.
- Cardiovascular Health: Testosterone has the potential to enhance blood vessel function and lower blood pressure for women.
- Inflammation Management: It may help manage low-grade chronic inflammation, partially by reducing body fat that can exacerbate inflammatory responses.
According to Kunsman, testosterone should be a key component of discussions regarding hormone replacement therapy (HRT), alongside estrogen and progesterone. She asserts, “Just because we don’t have testicles doesn’t mean we don’t need testosterone,” advocating for physiological doses tailored for women’s specific health needs at different life stages.
Consultation Guidelines for Considering Testosterone Therapy
For women experiencing symptoms such as reduced sexual desire, fatigue, diminished strength, or unexplained weight gain during perimenopause or postmenopause, it is crucial to consult a healthcare provider. Here are some guiding questions for the discussion:
- Am I a suitable candidate for low-dose testosterone therapy?
- Will you recommend a blood test to verify low testosterone levels?
- Are you open to prescribing low-dose testosterone, regardless of blood test results?
- What testosterone formulation do you recommend, and why (cream, patch, injection, etc.)?
- What is considered an optimal testosterone level for a woman of my age and circumstance?
- How will we monitor my hormone levels and adjust the dosage if necessary?
- What risks associated with this therapy should I be aware of, given my health background?
Should your healthcare professional be reticent about prescribing testosterone within standard female ranges, telehealth services may provide access to guided testosterone therapy, which usually includes comprehensive hormonal assessments, lab work, and ongoing consultations.
Research Methodology
The findings and statistics presented originate from patient data collated by Hone Health within the Women’s Optimization category as of September 2026. Symptom improvements were gauged using the Menopause Quality of Life Questionnaire (MENQOL), a validated instrument that assigns scores ranging from 0 to 6, where lower numbers indicate fewer or less bothersome symptoms. Unlike men, for whom there’s a standardized questionnaire for assessing testosterone deficiency, no equivalent exists for evaluating women.
The results were derived by comparing initial and most recent MENQOL assessments. Exclusions were made for patients with fewer than two assessments. The analyzed group consisted of 1,220 women who had been prescribed testosterone without any recorded prescriptions of estradiol, estrogen, or progesterone from Hone.
It is important to note that these findings are observational and do not imply causation. The prescription data reflect the history only within Hone Health, and some patients may have received hormonal treatments from other providers not accounted for in this data analysis.
This information was produced by Hone Health and reviewed for dissemination by Stacker.
