Testosterone has seen a surge in demand in recent years. The hormone can boost sex drive in menopause, so it is not surprising people want to try it! But this treatment isn’t right for everyone. To find out if it could help you, your first port of call is to speak to your healthcare provider. They can refer you for a blood test. Find out what they are testing for and what your results mean.
Find what you need quickly
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What is testosterone?
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Why is testosterone important in menopause?
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Who can get prescribed testosterone for menopause?
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Is there a test for testosterone?
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When should you get a testosterone test?
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Testing during testosterone treatment
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What is a normal testosterone level?
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What happens if your testosterone level is too low?
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What happens if your testosterone level is too high?
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Final word
What is testosterone?
Testosterone is an important hormone for both sexes. It helps build muscle and maintain healthy bone density and desire for sex. Men have higher levels of testosterone than women, but you may be surprised to learn that premenopausal women produce three times more testosterone than estrogen, which is the main female sex hormone.
Why is testosterone important in menopause?
Testosterone levels start to decline gradually once you hit 30, but the effect becomes more obvious during menopause because your body also stops producing as much estrogen.
Some people are more sensitive to this change than others and it can cause low sex drive – also known as low libido. When a lack of sexual desire disrupts your life for a long period of time and leaves you distressed, you meet the criteria for hypoactive sexual desire disorder (HSDD).
Those who go through medically induced or surgical menopause experience a more dramatic fall in testosterone and may struggle with more severe symptoms as a result.
Things like stress, relationships, mental health, and some medication also affect your sex drive. Your healthcare provider will consider the whole picture before deciding if testosterone is the best choice for you.
Find out more about menopause and anxiety.
Who can get prescribed testosterone for menopause?
Testosterone is usually only recommended if you are already taking estrogen and/or progesterone HT. It is also only currently recommended for people with HSDD.
Some people say it also helps with mood, brain fog, energy, and aches and pains, but there is not enough scientific evidence to back this up at the moment.
Is there a test for testosterone?
Yes, your testosterone levels can be checked with a blood test. Blood is either taken from a vein or by a finger prick.
There are a few different ways to measure testosterone levels in the blood. During testosterone treatment for menopause the ‘total testosterone level’ is used most frequently.
When should you get a testosterone test?
A testosterone test can help:
- To find out your baseline before starting testosterone treatment
- To check that your testosterone treatment is not resulting in testosterone levels that are higher than normal for a person born female
- To check if you have a medical condition linked to high testosterone, such as polycystic ovary syndrome (PCOS)
A testosterone test won’t tell you:
- If you are in menopause or not
- Why you are tired, weak, or gaining weight
- If your estrogen and progesterone HT is working
Testing during testosterone treatment
Your testosterone levels will usually be checked about 6-12 weeks after you start testosterone. Your testosterone dose may be changed as a result and you will have another blood test three months later.
You will still need to have your levels checked every 6-12 months even if you notice an increase in your sex drive and your testosterone levels are in the recommended range.
Testosterone levels don’t indicate if the treatment is working. Results are used to manage your dose so your blood levels do not become too high.
What is a normal testosterone level?
Normal values change throughout your life and depend on your biological sex. There are also several different types of testosterone tests and each laboratory has slightly different ‘normal’ ranges.
As a guide, a normal testosterone level may be between:
- 0.29 – 1.67 nmol/L – if you are under 50
- 0.1 – 1.42 nmol/L – if you are over 50
If you are taking testosterone as part of your HT, your healthcare provider will aim to keep your levels within the normal range for under 50s. This is to minimize the risk of side effects.
What happens if your testosterone level is too low?
Some assume that a testosterone level below the ‘normal’ range for women your age would mean that you should take testosterone, but this is not the case. Many women who don’t suffer from a low libido have lower levels. Many women with troubling low libido have normal levels.
A low result does not affect your healthcare provider’s decisions about testosterone. It is your symptoms, if you have any, that matter.
What happens if your testosterone level is too high?
Higher than normal levels of testosterone can increase your risk of side effects. Common side effects can include:
- Extra hair growth on your face or body
- Oily skin or acne
- Weight gain
Rare side effects include hair loss, voice deepening, and clitoral enlargement.
Researchers have noted an association between breast and endometrial cancers and females with higher blood levels of testosterone in several studies. However, this does not prove that women who are taking testosterone, but not given enough to push their levels above the normal range, have an increased risk of cancer.
If you are taking testosterone as part of your HT and your level becomes too high your dose will likely be decreased. You should have a repeat blood test three months later to make sure your treatment remains safe.
If your testosterone levels are very high and you are experiencing significant side effects, for example if your voice has deepened, you will likely be advised to stop testosterone therapy altogether.
Read more about possible risks and side effects in our guide to testosterone for menopause.
Final word
Testosterone treatment alongside standard HT can help those struggling with low sex drive. If you and your healthcare provider decide that testosterone may be helpful for you, you will have blood tests every few months to keep your levels within a safe range.
Find out more about menopause on our blog or in our symptoms library.
- Parish SJ, Kling JM, 2023, ‘Testosterone use for hypoactive sexual desire disorder in postmenopausal women’, Menopause, vol. 30. no. 7, pp. 781-783
- Sharon J. Parish, MD, NCMP1; Juliana M. Kling, MD, MPH, FACOG, NCMP. Testosterone Use for Hypoactive Sexual Desire Disorder in Postmenopausal Women. The Menopause Society, Released March 9, 2023
- Dunsmoor-Su R, Fuller A, Voedisch A 2021, ‘Testosterone Therapy in Women: A Clinical Challenge’, Obstetrics & Gynecology, vol. 138, no.5, pp. 809-812
- Parish SJ, James, A, Simon, S.R, Davis, AG, Goldstein, I, Goldstein, SW, Kim, NN, Kingsberg, SA, Morgentaler, A, Nappi, R.E, Park, K, Stuenkel, C.A, Traish, AM, Vignozzi, L 2021, ‘International Society for the Study of Women’s Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women’, The Journal of Sexual Medicine, vol. 18, no. 5, pp. 849–867
- Stella, Testosterone and menopause – beginner’s guide
- Watts EL, Perez‐Cornago A, Knuppel A, Tsilidis KK, Key TJ, Travis RC, 2021, ‘Prospective analyses of testosterone and sex hormone‐binding globulin with the risk of 19 types of cancer in men and postmenopausal women in UK Biobank’, International Journal of Cancer, vol. 149, pp. 573–584
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