Testosterone can be an important part of hormone therapy (HT) for some people, providing relief for those experiencing low libido. If you’re already on HT or considering it, you may be wondering if you can use it alongside other hormones. Exactly how does it fit in with the rest of your treatment? Read our expert guide to find out more.
Testosterone and menopause
While often thought of as a ‘male’ hormone, testosterone is also produced in the female body. It has several important functions, such as in mood and sexual function.
Testosterone can be a useful addition to your HT routine. It is not FDA-approved for low libido in women, but some menopause experts support its use for women who are suffering from low libido and already take traditional HT treatment – estrogen with or without progesterone.
Testosterone has been shown to improve:
- Satisfaction with sex
- Number of orgasms
- Sex drive
Sounds promising!
Is testosterone a kind of HT?
Yes, testosterone can be thought of as a kind of HT. Testosterone levels decrease with age and your ovaries begin to produce less of this hormone as you go through menopause. Taking testosterone can increase testosterone levels in the blood and organs.
Testosterone for menopause is most commonly prescribed as a gel. Brand names include Tostran or Testogel. While this is a proven and widely prescribed treatment, testosterone gel is prescribed off-label.
What does off-label mean?
Off-label means that the medication was FDA-approved to treat certain patients or conditions, but a healthcare provider is using them to treat problems that the medication was not approved for by the FDA. This is common practice in medicine – it simply means that your healthcare provider needs sufficient knowledge and training and will ensure you are monitored for safety if necessary.
In this case, testosterone gels were originally studied for use by men with low testosterone levels. Research on their safety and efficacy in women was not conducted as part of the original approval process.
It’s important to follow your healthcare provider’s instructions when something is prescribed off-label as instructions can be very different from what is listed on the product information sheet. For instance, women using testosterone gel will generally need to take a much lower dose than men who have been prescribed the same medication.
Our guide to different types of HT for menopause.
Can you take other kinds of HT with testosterone?
Yes, you can take other types of HT with testosterone. It’s generally best to take testosterone alongside estrogen, which is used in most HT treatments.
Systemic HT
Current guidance is to start testosterone only after a trial of estrogen-containing systemic HT. Systemic HT comes in the form of oral tablets, or transdermal patches, gels, or sprays.
This trial is recommended because estrogen-containing HT may improve your low libido symptoms without needing to add testosterone. Estrogen also has the benefit of working very well to treat many other symptoms of menopause including hot flashes, mood swings, and poor sleep.
Vaginal HT
It’s also important to think about vaginal and genital symptoms of menopause, such as tightness, dryness, itch, burning, and painful sex. These symptoms happen because lowered levels of estrogen affect vaginal tissues.
These changes can also have a huge impact on your sex life and libido. The good news is that they can be treated effectively with either systemic HT or a very low-risk form of HT known as vaginal HT. This comes in the form of estrogen creams, gels, pessaries, and vaginal rings. The estrogen is applied directly to your vagina and other affected areas. Treatment eases and even reverses the changes seen in menopause – vitally important if you’re also struggling with low libido.
Can you take testosterone without any other kind of HT?
You can take testosterone on its own, although this is not generally recommended.
Taking testosterone alongside estrogen has a number of benefits. Here’s what to consider:
- Estrogen treats many different menopause symptoms, all of which can contribute to low libido and sexual difficulties
- Testosterone without estrogen can lead to more side effects, including acne and excess hair
Since estrogen is not suitable for everyone, using testosterone alone could be a reasonable choice in some circumstances. Speak to your healthcare provider to find out what’s right for you.
Will taking testosterone affect your other HT prescriptions?
Your healthcare provider might recommend changes to your other HT medications if you start testosterone, particularly if you take certain HT tablets. HT taken orally can increase the sex hormone binding globulin (SHBG) that can bind to testosterone and prevent it from working. This can make your testosterone gel or cream less effective. Your doctor may recommend switching to transdermal HRT, which doesn’t cause the same problem.
For the same reason, your healthcare provider may suggest switching from oral to transdermal HT – patches, pills, or sprays – before trying testosterone. The theory is that moving away from HT tablets reduces your SHBG and frees up the testosterone already in your system. Some women find that this simple switch is enough to help with their symptoms, avoiding the need for testosterone supplements.
Final word
Testosterone and other forms of HT go hand-in-hand. Your doctor is likely to recommend a combination of both testosterone and estrogen as part of your treatment.
But remember HT is not suitable for everyone. Speak to your healthcare provider for advice on the best options available to you.
Find out more about menopause on our blog or in our symptoms library.
- Achilli C, Pundir J, Ramanathan P, Sabatini L, Hamoda H, Panay N. Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis. Vol. 107, no. 2, pp. 475-482
- Bolour, S., Braunstein, G. 2005, Testosterone therapy in women: a review. Int J Impot Res vol. 17, pp. 399–408
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